绞股蓝抗癌方辨证同步化疗和维持治疗中晚期非小细胞肺癌的临床分析

Clinical Analysis of Jiaogulan Kang'ai Decoction Combined with Dialectical Synchronous Chemoradiotherapy and Maintenance Treatment in Middle and Advanced Stage Non-small-cell Lung Cancer

目的:探讨绞股蓝抗癌方辨证同步化疗和维持治疗中晚期非小细胞肺癌(NSCLC)的近期和远期疗效。方法:将107例中晚期NSCLC患者按住院先后顺序随机分为对照组52例和观察组55例。对照组选择多西他赛注射液加顺铂(TP)方案进行治疗;观察组在对照组治疗的基础上加用绞股蓝抗癌方辨证内服,1剂/d。两组疗程直至出现病情进展后终止观察。于化疗前和化疗结束后1个月采用CT扫描实体瘤大小、进行生活质量Karnofsky评分、主要症状和体征评分、并检测T淋巴细胞亚群,NK细胞水平;记录无进展生存期(PFS)和进行安全性评价。结果:观察组实体瘤疗效总有效率为72.73%,高于对照组的53.85%(P<0.05);观察组PFS为(8.1±1.6)个月,优于对照组的(5.4±1.5)个月(P<0.01);治疗后观察组主要症状、体征均低于对照组,Karnofsky评分高于对照组(P<0.01);观察组生活质量提高+稳定率为87.27%,高于对照组的71.15%(P<0.05);治疗后观察组CD3^+,CD4^+,CD4^+/CD8^+和NK细胞水平均较治疗前上升(P<0.01),并高于治疗后对照组水平(P<0.01);治疗后观察组CD8+水平较治疗前下降(P<0.01),并低于对照组(P<0.05);化疗期间观察组Ⅲ和Ⅳ度不良反应的发生率为21.82%,低于对照组的40.38%(P<0.05)。结论:绞股蓝抗癌方辨证同步化疗和维持治疗中晚期NSCLC化疗患者能缩小瘤体、减轻化疗产生的毒副反应、改善临床症状、提高患者生活质量和免疫功能,并能延长无进展生存期,近期和远期疗效均显著。

Objective： To investigate the short-term and long-term effects of Jiaogulan Kangai decoction combined with dialectical synchronous chemoradiotherapy and maintenance treatment in treating middle and advanced stage non-small-cell lung cancer （NSCLC）. Method： One hundred and seven patients with middle and advanced stage NSCLC were randomly divided into control group （52 cases） and observation group （55 cases） according to their admission sequence. Patients in control group received docetaxel plus cisplatin （TP） method. Based on the treatment of control group, patients in observation group also received dialectical Jiaogulan Kangai decoction, 1 dose/day. The observation was stopped until progressive disease appeared. Before and one month after chemotherapy, size of solid tumor was detected by CT. Karnofsky scores were graded for quality of life, and main signs and symptoms were graded. Levels of T-lymphocyte cell subsets and natural killer （NK） cells were detected. Progression free survival （PFS） was recorded and safety was evaluated. Result： The total effective rate was 72.73 % in observation group, higher than 53.85 % in control group （P 〈 0. 05）. PFS was （8. 1 ± 1.6） months in observation group, superior to （5.4 ± 1.5） months in control group （P 〈0.01 ）. After treatment, the scores of main signs and symptoms in observation group were lower than those in control group, while scores of Karnofsky were higher than those in control group （P 〈 0.01 ）. The improvement of quality of life and index of stability in observation group was 87.27% in observation group, higher than 71.15% in control group （P 〈 0.05）. After treatment, levels of CD3＋, CD4 ＋ , CD4＋/CD8＋ and NK in observation were increased as compared with the levels before treatment （P 〈0.01 ）, and they were higher than those in control group （P 〈0.01 ）. Level of CD8 ＋ in observation group was decreased after treatment （P 〈 0.01 ） and it was lower than that in control group （P 〈 0. 05）. The incidence of Ⅲ and Ⅳ degree adverse effect in chemotherapeutic period was 21.82% in observation group, lower than 40.38% in control group （P 〈 0.05）. Conclusion： Jiaogulan Kangai decoction combined with dialectical synchronous chemoradiotherapy and maintenance treatment can shrink the size of solid tumor, relieve toxic and side effect of chemoradiotherapy, ameliorate clinical symptoms, improve patients＇ quality of life and immunity, and prolong progression free survival in the treatment of non-small-cell lung cancer, with obvious short- term and long-term efficacy.