扶正抑癌方联合化疗治疗非小细胞肺癌的近期疗效及其对免疫功能的影响

Impact on curative effect and immune function of NSCLC patients treated by combination of traditional Chinese medicine( TCM) with Western medicine

目的：观察扶正抑癌方对非小细胞肺癌（NSCLC）化疗患者的近期疗效及其对免疫功能的影响;对中晚期非小细胞肺癌患者生存质量及机体免疫功能的影响。方法：中药治疗：扶正抑癌方辨证加减内服,每天1剂,30天为1个疗程。化疗：长春瑞滨25mg/m2,第1、8天,顺铂20~30mg/m2,第1~3天,外周静脉滴注,21天为1个疗程。4个疗程后评价疗效。观察近期疗效、临床证候变化、治疗前后免疫功能变化及生活质量变化。结果：治疗后治疗组瘤体稳定率89.28%,显著高于对照组的71.42%（P〈0.05）。治疗组中医证候改善的总有效率（71.42%）与对照组（39.28%）,差异有统计学意义（P〈0.01）。治疗组和对照组卡氏评分总有效率分别为67.85%、42.85%,差异有统计学意义（P〈0.01）。治疗组治疗后免疫指标CD3＋、CD4＋、CD4＋/CD8＋比值、自然杀伤细胞（NK细胞）活性、治疗前后自身对照差异有统计学意义（P〈0.05）。两组治疗后比较NK、CD4＋/CD8＋比值升高差异有统计学意义（P〈0.05）。结论：采用扶正抑癌方联合化疗治疗中晚期非小细胞肺癌,可提高机体免疫功能,提高患者生活质量,延长生存期,是一种疗效肯定、安全性高、并发症少的综合治疗方法。

Objective：To obverse the impact on curative effect and immune function of NSCLC patients treated with Fuzheng Yi＇ai Decoction in the medium or late stage NSCLC patients. Methods：Fuzheng Yi＇ai Decoction were given and modified according to different clinical symptoms, one dose a day for 30 days as one course of treatment. Chemotherapy ： Vinorelbine （ 25 mg/m2 in the 1 st and 8 th day） and Cisplatin （ 20 - 30mg/m2 from the 1 st to 3 th day ） were given intravenously,21 days as one course of treatment. After 4 courses of treatment ,curative effect, clinical syn- drome, and the changes of immune function and quality of life, before and after therapy,were observed. Results： After therapy in the treatment group tumors stable rate was 89.28% obviously higher than that the control group 71.42% （ P 〈 0.05 ）. The total effective rate of syndrome improvement was 71.42% in treatment and 39.28% in control group （ P 〈 0.01 ）. The total effective rate of KPS（Karnofsky performance status） was 67.85 % in treatment group and 42.85 % in control group（ P 〈 0.01 ）. The immune indexes of CD3 ＋ , CD4 ＋, CD4 ＋/CD8 ＋ and NK cells activity, there was a statistical difference （ P 〈 0.05 ） before and after therapy. Conclusion： The medium or late stage NSCLC patients trea- ted by Fuzheng Yi＇ai Decoction with chemotherapy ,which can improve the patents＂ immune function and life quality, and prolong patients＂ survival period.