参芪扶正汤联合GP化疗方案治疗IIIb、Ⅳ期非小细胞肺癌脾虚证临床研究

Clinical Research on the Effects of Shenqi Fuzheng Decoction Combined with GP Chemotherapy on Non-Small Cell Lung Cancer of Spleen Deficiency Syndrome in IIIB and Ⅳ Phases

目的:观察参芪扶正汤联合GP化疗方案治疗IIIB、Ⅳ期非小细胞肺癌脾虚证的临床疗效。方法:将本院收治的IIIB、Ⅳ期非小细胞肺癌脾虚证患者114例随机分为对照组和观察组各57例。对照组采用GP方案干预,观察组联合给予参芪扶正汤内服治疗。比较两组的近期疗效,监测治疗前后机体免疫功能变化,检测肿瘤标志物及外周血因子的水平变化,评价患者的生活质量变化,记录不良反应。结果:观察组的近期疗效为61.4%,明显优于对照组的近期疗效29.8%(P<0.05);其机体免疫功能改善更加明显,T细胞亚群CD3+、CD4+、CD4+/CD8+、NK水平较对照组显著升高,而CD8+水平则较对照组明显降低(P<0.05);治疗后观察组患者的肿瘤标志物CEA、CA125、NSE及外周血因子TGF-β1水平均显著低于对照组(P<0.05);观察组经治疗后的生活质量优于对照组,其FACT-L各功能评分显著高于对照组(P<0.05);观察组的不良反应明显少于对照组(P<0.05)。结论:参芪扶正汤联合GP化疗方案治疗IIIB、Ⅳ期非小细胞肺癌脾虚证疗效肯定,利于提高机体免疫功能,降低血清肿瘤标志物水平,提高生活质量,降低毒副作用。

Objective： To observe the clinical effects of Shenqi Fuzheng Decoction combined with GP chemotherapy on the nonsmall cell lung cancer of spleen deficiency syndrome in IIIB and Ⅳ phases. Methods： Totally 114 cases with non-small cell lung cancer of spleen deficiency syndrome in IIIB and Ⅳ phases were randomly divided into control group and observation group,with57 cases in each group. Control group were conducted GP intervention while observation group were given oral administration of Shenqi Fuzheng Decoction combined with GP chemotherapy. The short-term effects and changes of body immunities before and after the treatment between the two groups were compared. The tumor markers and the change of the levels of peripheral blood cytokines were detected,the change of the life quality of the patients was measured and the adverse reaction was recorded. Results：The short-term effective rate in observation group was 61. 4%,apparently better than that（ 29. 8%） in control group（ P 〈0. 05）. The immunity got obvious improvement and the levels of T cell subset of CD3 ＋,CD4 ＋,CD4 ＋ / CD8 ＋ and NK got greater increased in observation group compared with these in control group while the level of CD8 ＋ got obvious decline compared with that in control group（ P 〈 0. 05）. The levels of tumor markers of CEA,CA125,NSE and TGF-β1 in observation group were greatly lower than these in control group（ P 〈 0. 05）. The living quality of the patients after the treatment in observation group was better than that in control group. The scores of various function of FACT-L were markedly higher than those in control group（ P 〈 0. 05）. The adverse reactions in observation group were apparently less than those in control group（ P 〈 0. 05）. Conclusion： Shenqi Fuzheng Decoction combined with GP chemotherapy has definite therapeutic effects on the non-small cell lung cancer of spleen deficiency syndrome in IIIB and Ⅳ phases,which can improve the body immunity,lower the level of serum tumor markers,enhance the living quality and reduce the toxicity and side effects.