理脾固本汤化裁治疗中晚期非小细胞肺癌EGFR-TKIs靶向治疗后胃肠道不良反应的疗效观察

Therapeutic Effect of Lipi Guben Decoction( 理脾固本汤) on Gastrointestinal Adverse Reactionsafter Targeted Treatment of EGFR - TKIs in Advanced Non - Small Cell Lung Cancer

目的研究理脾固本汤化裁治疗中晚期非小细胞肺癌EGFR-TKIs靶向治疗后胃肠道不良反应的疗效。方法:选取医院2017年1月—2018年12月收治的70例中晚期非小细胞肺癌EGFR-TKIs靶向治疗后出现胃肠道不良反应的患者,随机分为对照组和观察组,各35例。对照组使用西医支持疗法,观察组加用理脾固本汤化裁,治疗2周。比较两组疗效,观察治疗前后中医症状积分变化,检测两组胃肠激素(胃泌素、胃动素、血管活性肠肽),比较胃电图参数(胃窦、胃体)改变情况,记录不良反应,治疗结束后维持3周随访,记录患者胃肠反应复发率。结果观察组总有效率为91.4%(32/35),高于对照组总有效率68.6%(24/35)(P<0.05)。观察组中医症状积分各项评分均较治疗前下降,且优于对照组(P<0.05或P<0.01)。两组患者治疗后胃泌素、胃动素及血管活性肠肽均降低(P<0.05或P<0.01),且观察组下降更多(P<0.05),胃电图示观察组胃窦及胃体部振幅较治疗前升高(P<0.01)。治疗后3周内,观察组胃肠反应复发率为8.6%(3/35),低于对照组复发率28.6%(10/35)(P<0.05)。结论理脾固本汤化裁能有效治疗中晚期非小细胞肺癌EGFR-TKIs靶向治疗后胃肠道不良反应,且复发率低。

Objective To study the therapeutic effect of Lipi Guben Decoction(理脾固本汤)on gastrointestinal adverse reactions after targeted treatment of EGFR-TKIs in advanced non-small cell lung cancer.Methods From January 2017 to December 2018,70 patients with gastrointestinal adverse reactions after EGFR-TKIs targeted treatment of advanced non-small cell lung cancer in our hospital were randomly divided into control group and observation group with 35 cases in each group.The control group was treated with western medicine and the observation group was treated with Lipi Guben Decoction for 2 weeks.The curative effect of the two groups was compared.The changes of TCM symptom integral before and after treatment were observed.The gastrointestinal hormones(gastrin,motilin,vasoactive intestinal peptide)were detected.The changes of electrogastrogram parameters(antrum and body of stomach)were compared.The adverse reactions were recorded.The follow-up maintained for 3 weeks after treatment,and the recurrence rate of gastrointestinal reactions was recorded.Results The total effective rate of the observation group was 91.4%,higher than that of the control group(68.6%)(P<0.05).The scores of TCM symptom scores in the observation group were lower than those before treatment,and better than those in the control group(P<0.05 or P<0.01).After treatment,gastrin,motilin and vasoactive intestinal peptide were decreased in both groups(P<0.05 or P<0.01),and those were decreased more significantly in the observation group(P<0.05).Within 3 weeks after treatment,the recurrence rate of gastrointestinal reaction in the observation group was 8.6%,lower than that in the control group(28.6%)(P<0.05).Conclusion Lipi Guben Decoction can effectively treat gastrointestinal adverse reactions after EGFR-TKIs targeted treatment of advanced non-small cell lung cancer,and the recurrence rate is low.