抗瘤增效方减轻晚期非小细胞肺癌化疗不良反应的时效研究

Time-effect relationship of Kangliu Zengxiao Decoction in reducing chemotherapyassociated adverse reactions in patients with advanced non-small cell lung cancer

目的观察不同给药时间对抗瘤增效方减轻晚期非小细胞肺癌化疗不良反应的影响。方法选择124例非小细胞肺癌患者,随机分为提前10、5和0 d应用抗瘤增效方+化疗组(A、B、C组)以及单纯化疗组(D组)。比较4组患者的中医症状及证候、生存质量、免疫功能以及骨髓抑制、肝肾功能、消化道等不良反应的差异。结果 A组患者治疗后的中医症状(神疲乏力、腰酸腿软)和证候改善率均明显优于B、C、D组(P<0.05);A组治疗后CD3、CD4百分比和CD4/CD8比值均较B、C、D组明显升高(P<0.05);生存质量改善率也明显优于D组(P<0.01)。不良反应方面,A组的骨髓抑制(白细胞和中性粒细胞降低)、肝脏毒性、恶心呕吐的发生率均明显低于D组(P<0.05),其他不良反应发生率组间比较差异均无统计学意义(P>0.05)。结论抗瘤增效方在化疗前10 d应用对减轻晚期非小细胞肺癌化疗不良反应、提高患者生存质量及免疫功能等方面较化疗前5 d及化疗同时运用具有更好的效果。

Objective To observe the time-effect relationship of Kangliu Zengxiao Decoction in reducing chemotherapy-associated adverse reactions in patients with advanced non-small cell lung cancer.Methods One hundred and twenty-four patients with advanced non-small cell lung cancer were randomly divided into four groups.Patients in group A,group B and group C were treated with Kangliu Zengxiao Decoction 10 d,5 d and 0 d before chemotherapy respectively,and those in group D received chemotherapy only.The main clinical symptoms,quality of life,immune function and adverse reactions of myelosuppression,liver and kidney function,and digestive system were compared among groups.Results The improvement rates of clinical symptoms(fatigue,aching lumbus and limp legs),the percentages of CD3 and CD4,and the ratio of CD4 to CD8 in group A were significantly higher than those in group B,group C and group D(P<0.05),and the improvement rate of quality of life in group A was significantly higher than that in group D(P<0.01).The incidences of myelosuppression(decrease in numbers of white cells and neutrophils),hepatotoxicity,nausea and vomiting in group A were significantly lower than those in group D(P<0.05),while there was no significant difference in the incidences of the other adverse reactions among groups(P>0.05).Conclusion Application of Kangliu Zengxiao Decoction 10 d before chemotherapy may gain better results in reducing adverse reactions of chemotherapy,improving quality of life and immune function than administration 5 d and 0 d before chemotherapy in patients with advanced non-small cell lung cancer.