复方苦参注射液局部治疗晚期肺癌恶性胸腔积液的初步体会

Compound Kushen Injection as a Local Therapy for Patients with Advanced Lung Cancer Associated with Malignant Pleural Effusion

目的:观察复方苦参注射液局部治疗晚期肺癌合并恶性胸腔积液的疗效。方法:44例肺癌并胸腔积液患者随机分为治疗组24例,采用复方苦参注射液+顺铂灌注化疗;对照组20例,采用顺铂灌注化疗。每周1次,灌注3次后评定疗效、不良反应、PS评分和免疫指标变化。结果:治疗组有效率为66.7%,对照组有效率为45.0%,治疗组胸水控制有效率高于对照组(P<0.05);治疗后治疗组评分改善率为75.2%,对照组为50.0%,2组比较,差异有统计学意义(P<0.05);2组不良反应类似,均以Ⅰ～Ⅱ度胃肠道反应和骨髓抑制为主,治疗组不良反应发生率低于对照组,2组差异无统计学意义(P>0.05);治疗组治疗后比较治疗前和对照组治疗后,免疫指标CD3+、CD4+、CD8+各数据增高,CD4+/CD8+比值下降,但差异无显著性(P>0.05)。结论:复方苦参注射液用于胸腔局部治疗时可提高机体免疫功能,减毒增效,改善临床症状,提高生活质量。

OBJECTIVE：To observe the curative effect of compound Kushen injection as a local therapy for patients with advanced lung cancer associated with malignant pleural effusion.METHODS：A total of 44 patients with advanced lung cancer associated with malignant pleural effusion were randomly assigned to receive either compound Kushen infection plus cisplatin perfusion（trial group,n = 24） or cisplatin perfusion alone（control group,n = 20） once a week.After cisplatin perfusion for a total of 3 times,the curative effect,toxic effects,PS scores and immune indicators were evaluated.RESULTS：The effective rate in the treatment group was higher than in the control group（66.7% vs.45.0%,P 〈0.05）.There were significant differences between the two groups in the improvement rate of PS scores（75.2% vs.50.0%,P 〈 0.05）.The toxic reactions in the two groups was similar,with gastrointestinal tract reactions of Ⅰ-Ⅱ degree and bone marrow suppression showing the highest incidences in both groups.There was lower incidence of toxic reactions in the treatment group than in the control group,but the difference was not significant（P 〉0.05）.In the treatment group,the levels of CD3 ＋,CD4 ＋ and CD8 ＋ increased while the ratio of CD4 ＋ /CD8 ＋ decreased after 3-week treatment compared with before treatment or compared with the control group after 3-week treatment,but the differences were not significant（P 〉 0.05）.CONCLUSION：Compound Kushen injection as a local therapy can improve the immunologic function,attenuate toxicity while enhancing curative effect,improving clinical symptoms and improving the quality of life for patients with advanced lung cancer associated with malignant pleural effusion.