益气养精法结合化疗治疗中晚期老年非小细胞肺癌的临床疗效观察及生存期影响因素分析

Clinical observation and prognostic factors of combined qi-essence-enriching medicine and chemotherapy for middle and advanced non-small cell lung cancer

目的探索精气两亏型中晚期老年非小细胞肺癌(NSCLC)的有效治疗方案及影响生存期的相关因素。方法共纳入99例患者,随机分为治疗组(51例)和对照组(48例),两组化疗均采用NP方案,治疗组在化疗期间服用具有益气养精、健脾和胃功效的抗瘤增效方,化疗结束后长期服用具有益气养精、解毒散结作用的肺岩宁方。随访生存时间以及肿瘤标志物(CEA、CYFRA21-1)、血管内皮生长因子(VEGF)水平变化情况;采用Forward LR(逐步回归法)建立Cox比例风险回归模型,对12项可能影响生存期的因素进行分析。结果治疗组、对照组中位生存期比较,差异无统计学意义(P>0.05)。治疗前后组内比较,治疗组VEGF水平差异有统计学意义(P<0.05),对照组各指标差异均无统计学意义(P>0.05);组间治疗后比较,VEGF水平差异有统计学意义(P<0.05)。Cox比例风险回归模型分析提示,细胞类型、化疗疗程是老年晚期非小细胞肺癌患者生存期的影响因素。结论益气养精法结合化疗能显著降低精气两亏型中晚期老年非小细胞肺癌患者血清VEGF水平,或可在一定程度上延长患者生存期;病理类型和化疗疗程是影响生存期的危险因素。

Objective To explore the effective treatment of the old patients with middle-late advanced non-small cell lung cancer（NSCLC） and analyze its prognostic factors. Methods In this prospective randomized controlled trial, 99 cases of lIIa-stage IV type were involved, 51 cases in the treatment group and 48 cases in the control group. Both groups were given Vinorelbine and cisplalin for 2-4 cycles. Additionally, the treatment group was administered ＂Kangliu Zengxiao Reci- pe＂ during chemnotherapy and ＂Feiyanning Decoction＂ after chemotherapy. The survival time, tumor markers and vascular endothelial growth factor（VEGF） were observed. The Cox Regression Model was set to analyze the twelve prognostic factors by Forward LR. Results After treatment, the median survival time of the both groups had no statistical significance（P 〉0.05） ; the level of VEGF decreased significantly in the treatment group（P 〈0.05 ） and less in the control group （ P 〉 0.05 ） ; but there was a statistical significance between the two groups（ P 〈 0. 05 ）. Pathological type and the courses of chemotherapy were the risk factors related to survival time. Conclusion Qi-yin-enriching therapy helps decrease the level of VEGF and prolong survival time in elderly advanced NSCLC ; pathological type and the courses of chemotherapy are the risk factors related to survival time.