中医序贯疗法配合胸腔内化疗治疗晚期非小细胞肺癌合并恶性胸腔积液的临床疗效

Clinical efficacy of sequential therapy of traditional Chinese medicine(TCM) combined with intrathoracic chemotherapy in the treatment of non-small cell lung cancer with malignant pleural effusion

目的观察中医序贯疗法联合胸腔内灌注化疗在晚期非小细胞肺癌合并恶性胸腔积液治疗中的临床疗效。方法应用随机平行对照方法,将86例患者随机分为2组,对照组患者应用胸腔灌注化疗,治疗组在化疗基础上应用中医序贯疗法,比较两组患者的临床疗效及不良反应。结果治疗组的有效率略高于对照组(44.2%vs.32.6%),但差异无统计学意义(P>0.05)。治疗组的胸水总引流量显著多于对照组[(5 308±1 620)m L vs.(4 436±1 310)m L,P<0.01]。经过4个疗程治疗,治疗组生活质量改善率高于对照组(62.8%vs.39.5%,P<0.05),中医症状评分总有效率高于对照组(65.1%vs.41.9%,P<0.05),CD3+、CD4+及CD4+/CD8+值升高,优于对照组(P<0.05);治疗组消化道反应及胸痛发生率低于对照组(P<0.05)。结论中医序贯疗法联合胸腔内灌注化疗临床疗效可靠,可有效改善患者的化疗不良反应,提高免疫功能,改善生活质量。

Objective To observe the effects of sequential therapy of traditional Chinese medicine（TCM）combined with intrathoracic chemotherapy in the treatment of non-small cell lung cancer（NSCLC） with malignant pleural effusion.Methods Totally 86 patients with advanced NSCLC were divided into treatment group and control group.Control group was treated with chest tube drainage chemotherapy;treatment group received sequential therapy of TCM on the basis of the treatment for control group.The recent curative effect,TCM syndrome,Karnofsky score（KPS score）,pleural fluid drainage /distribution of T cell subgroup（CD3^＋,CD4^＋ and CD4^＋ /CD8^＋） and the adverse reactions were observed before and after treatment.Results The clinical efficacy of treatment group was slightly higher than that of control group（44.2%vs.32.6%）,but there was no significant difference（P〉0.05）.The total drainage volume of pleural effusion in treatment group was more than that of control group（P〈0.01）.After 4 courses of treatment,the improvement rate in treatment group was higher than that of control group（62.8%vs.39.5%,P〈0.05）.The total effective rate of TCM symptom scores and the levels of CD3~＋,CD4~＋ and CD4~＋ /CD8~＋ in treatment group were higher than those of control group（P〈0.05）.The incidences of chest pain and gastrointestinal reaction in treatment group were lower than those of control group（P〈0.05）.Conclusion Sequential therapy of TCM combined with intrathoracic chemotherapy has good efficacy in the treatment of NSCLC with malignant pleural effusion,and it can effectively relieve the adverse effects of chemotherapy and improve the immune function and quality of life.