健脾化痰方配合化疗治疗晚期非小细胞肺癌20例疗效观察

Treatment of Late Stage of Non-Small Cell Lung Cancer by Jianpi Huatan Fang Associated with Chemotherapy: A Clinical Observation of 20 Cases

目的:观察健脾化痰方配合化疗治疗晚期非小细胞肺癌的临床疗效。方法:将40例晚期(Ⅲb期、Ⅳ期)非小细胞肺癌患者随机分为2组,均使用NP化疗方案。治疗组20例,在化疗基础上加服自拟健脾化痰方(组成:党参、白术、黄芪、茯苓、薏苡仁、砂仁、甘草、法半夏、陈皮);对照组20例,在化疗基础上加服安慰剂(组成:麦芽、谷芽、甘草)。2组均以3周为1疗程,治疗2疗程后评定疗效。观察2组治疗前后生存质量、近期疗效、T淋巴细胞亚群变化及药物不良反应等。结果:治疗组治疗后生存质量总积分及肺癌特异模块、身体状况等方面与治疗前比较,差异均有非常显著性意义(P<0．01)。近期疗效有效率治疗组为35％,对照组为30％,2组比较,差异无显著性意义(P>0．05)。治疗组治疗后CD3+、CD4+上升与治疗前比较,差异均有显著性意义(P<0．05)。治疗组在粒细胞减少、血小板减少、谷草转氨酶升高、谷丙转氨酶升高、BUN升高等不良反应发生程度与对照组比较,差异均有显著性意义(P<0．05)。结论:健脾化痰方配合化疗能够提高晚期非小细胞肺癌患者生存质量,减少或减轻化疗药物引起不良反应的发生。

Objective: To observe the curative effect of Jianpi Huatan Fang (JHF,健脾化痰方) associated with chemotherapy for late stage of non - small cell lung cancer (NSCLC). Methods: 40 cases ofⅢb andⅣstage of NSCLC were allocated to 2 groups randomly with NP chemotherapy programme. The treatment group (20 cases) was based on chemotherapy and added with JHF (composed of Radix Codonopsis, Rhizoma Atractylodis Macrocephalae, Radix Astragali, Poria, Semen Coicis, Fructus Amomi, Radix Glycyrrhizae, Rhizoma Pinelliae Preparata and Pericarpium Citri Reticulatae); the control group (20 cases) was based on chemotherapy and added with placebo (composed of Fructus Hordei Germinatus, Fructus Se-tariae Germinatus and Radix Glycyrrhizae) . Three weeks constituted the course of treatment and 2 courses were given to evaluate the curative effect. The survival quality, short - term curative effect, the changes of T - lymphocyte subset and adverse reaction of medicine were observed before and after treatment. Results: After treatment, the specific module of lung cancer and physical condition compared with before treatment ( P < 0. 01); in control group, the total scoring was decreased after treatment. The effective rate was 35% , 30% in treatment group and control group respectively ( P > 0. 05). In treatment group, the comparison of CD3+ and CD4+before and after treatment showed marked significance ( P < 0. 05), and with counter results in control group. The comparison of reducing of granulocyte and blood platelet, increase of GOT, GPT and BUN of treatment group with control group showed marked significance ( P < 0. 05), but comparison of anemia showed no marked significance (P> 0. 05). Conclusion: JHF can increase survival quality in late stage of NSCLC, decrease the adverse reaction of chemotherapy medicine.