益肺消积颗粒联合EGFR-TKIs治疗晚期非小细胞肺癌的临床疗效

Clinical efficacy of combined use of YiFeiXiaoJi granules and EGFR-TKIs in treatment of patients with advanced non-small cell lung cancer

目的探讨益肺消积颗粒联合表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKIs)治疗晚期非鳞状非小细胞肺癌(NSCLC)的临床疗效。方法 47例NSCLC患者随机分为益肺消积颗粒+吉非替尼或埃克替尼联合治疗组(A组,24例)和吉非替尼或埃克替尼单药治疗组(B组,23例)。记录两组中医症候和功能状态改善程度、客观反应率、疾病控制率以及生存情况,采用ELISA法检测患者血浆过氧化物酶体增殖物激活受体γ(PPAR-γ)、葡萄糖转运蛋白1和胰岛素样生长因子1水平,并分析外周血循环肿瘤细胞(CTC)的数量变化。结果与B组相比,A组治疗后中医症候改善,美国东部肿瘤协作组评分降低,客观反应率、生存率以及PPAR-γ水平增加(P<0.05或P<0.01)。两组治疗后外周血CTC数量均较治疗前减少(P<0.01或P<0.05),但组间比较差异无统计学意义(P>0.05)。结论益肺消积颗粒能提高晚期NSCLC患者对EGFR-TKIs治疗的敏感性,改善患者的生活质量,并延长生存期。PPAR-γ水平和CTC数量可作为临床判断益肺消积颗粒增敏EGFR-TKIs疗效的参考指标。

Objective To investigate the clinical efficacy of combined use of YiFeiXiaoJi granules and epidermal growth factor receptor-tyrosine kinase inhibitors（EGFR-TKIs）in the treatment of patients with advanced non-squamous non-small cell lung cancer（NSCLC）.Methods Forty-seven patients with NSCLC were randomly divided into two groups of A（treated with YiFeiXiaoJi granules plus gefitinib or icotinib,24cases）and B（treated with gefitinib or icotinib,23cases）.The syndrome of traditional Chinese medicine,performance status,objective response rate,disease control rate and survival rate were recorded.The levels of peroxiisome proliferator-activated receptor-γ（PPAR-γ）,glucose transporter-1 and insulin-like growth factors-1 were detected by ELISA.The number of circulating tumor cells（CTC）in peripheral blood was analyzed.Results Compared with group B,the syndrome of traditional Chinese medicine was improved,Eastern Cooperative Oncology Group score was decreased,while objective response rate,survival rate and level of PPAR-γwere increased after treatment in group A（P〈0.05 or P〈0.01）.The number of CTC after treatment was less than that before treatment in both groups（P〈0.01 or P〈0.05）,which was not significantly different between groups of A and B（P〉0.05）.Conclusion YiFeiXiaoJi granules can increase the sensitivity of advanced NSCLC patients to EGFR-TKIs in the treatment,improve the living quality and prolong the survival time of patients.The level of PPAR-γand number of CTC may serve as the potential indicators for predicting the efficacy of EGFR-TKIs sensitized by YiFeiXiaoJi granules.