肺癌患者化疗期间中医证型及升血汤干预作用研究

Research on TCM Syndrome of Lung Cancer Patients and the Intervention Effect of Shengxuetang Plays during Chemotherapy

目的观察肺癌患者围化疗期中医证型的变化以及中药升血汤对化疗毒副反应、患者免疫功能的影响。方法Ⅲ、Ⅳ期肺癌患者60例,随机分为治疗组(化疗加升血汤)及对照组(化疗加升白安),观察治疗前后外周血白细胞、血红蛋白、血小板数、T细胞亚群、NK细胞活性及其它化疗毒性反应。结果Ⅲ、Ⅳ期肺癌患者化疗前以气阴两虚及气虚痰湿兼血瘀为主要中医证型,化疗期间的中医证型逐渐向气阴两虚、痰瘀互阻的方向转化;两组姜化疗期间出现骨髓抑制几率相似,但治疗组以Ⅰ度骨髓抑制为主,对照组以Ⅱ度骨髓抑制为主。对照组应用粒细胞集落刺激因子明显高于治疗组(P<0.01),治疗组患者免疫功能较化疗前及对照组明显提高(P<0.05);与对照组比较,治疗组患者肝肾功能损伤例数明显减少。结论中晚期肺癌患者化疗期间以气阴两虚、痰瘀互阻为主要证型,升血汤能减轻化疗所致的骨髓抑制,节省医疗费用,对机体部分免疫功能具有保护和促进作用,保护肝肾功能。

Objective To observe the TCM syndrome changes of lung cancer patients before and after chemotherapy and the effect of Shengxuetang on dealing with side and toxic effects caused by chemotherapy and patient＇s immune function. Method Phase III and IV lung cancer patients were randomly divided into two groups, treatment group and control group. Patients in the treatment group were given the combination of chemotherapy and Shengxuetang, while those in the control group were given the combination of chemotherapy and berbamine. Peripheral WBC count, HGB level, platelet count, T-cell count, and NK cell activity were measured, and other toxic effects were observed before and after chemotherapy. Results Before chemotherapy, there were two syndrome types, one is the deficiency of Qi and Yin, and the other is phlegm-damp due to deficiency of Qi accompanied with blood stasis. During the treatment, these two syndrome gradually transformed to the deficiency of both Qi and Yin and coagulation of phlegm and blood stasis. The chance for patients to develop myelosuppression had no difference between two groups, however, most patients in the treatment group developed grade Ⅰ myelosuppression, while in the control group, most patients developed grade Ⅱ myelosuppression. G-CSF was prescribed more in the control group than in the treatment group （P〈0.01）. Immune function of patients improved better in the treatment group than in the control group （P〈0.05）. Cases with fiver and kidney damage were less in the treatment group than in the control group. Conclusion Most cases of advanced lung cancer patients can be classified as deficiency of both Qi and Yin and coagulation of phlegm and blood stasis according to TCM theory. Shengxuetang is effective in relieving myelosuppression caused by chemotherapy, so that it could help save medical cost. It could also protect and enhance body immune system, and protect fiver and kidney function as well.