健脾温肾方联合化疗调节肺癌患者雌二醇水平的临床观察

Regulatory Effect of Jianpi Wenshen Recipe in Combining with Chemotherapy on the Blood Level of Estradiol in Patients with Lung Cancer

目的观察健脾温肾方联合化疗治疗中晚期非小细胞肺癌对雌二醇(E2)水平的调节作用,分析E2变化与瘤体变化的关系。方法51例非小细胞肺癌患者随机分为中药组16例(健脾温肾方)、中药加化疗组18例(健脾温肾方加化疗)和单纯化疗组17例(单纯化疗),治疗2个月。比较治疗前后E2的变化以及瘤体的变化。结果中药组、中药加化疗组未手术者疾病控制率分别为53.85%(7/13)和80.00%(8/10),均高于化疗组(44.44%,4/9),但差异无统计学意义(P>0.05)。治疗后中药组及中药加化疗组E2水平均较治疗前显著降低(均P<0.05);治疗后E2变化与瘤体变化趋势一致的占全部31例患者中的26例,差异有统计学意义(P<0.01)。结论健脾温肾方联合化疗可以稳定瘤体,下调雌激素水平;雌激素的变化与瘤体变化存在相关性;降低雌激素水平是健脾温肾方治疗肺癌的作用机制之一。

Objective To observe the regulatory effect of Jianpi Wenshen Recipe （JPWS）, a Chinese herbal preparation for strengthening Pi and warming Shen, combined with chemotherapy on the level of estradiol （E2） in patients with mid-late non-small cell lung cancer （NSCLC）, and to analyse the relationship between the changes of estradiol and tumor size. Methods Fifty-one NSCLC patients were randomized into three groups： 16 cases in the JPWS group treated with JPWS alone, 18 cases in the test group treated with combined therapy of JPWS plus chemotherapy, and 17 cases in the chemotherapy group treated with chemotherapy alone, all were treated for 2 months. The changes of blood E2 level and tumor size before and after treatment were compared. Results The disease control rate in the JPWS group and combined therapy group was 53.85% （7/13） and 80.00% （8/10）, respectively, both were higher than that in the chemotherapy group （44.40%, 4/9）, but the difference showed statistical insignificance （ P 〉 0.05）. E2 level was significantly lowered after treatment in the former two groups （all P〈0.05）, and the change was in accordance with that of tumor size in 26 out of 31 patients （P〈0.01）. Conclusion JPWS combined with chemotherapy can stabilize the tumor size and down-regu- late E2 level, with the change of E2 correlated with that of tumor size in patients. Hence, decreasing E2 is one of the mechanisms for JPWS in treating lung cancer.