清气化痰汤联合化疗对中晚期非小细胞肺癌痰热阻肺证患者CEA、CA125及Cyfra21-1水平的影响

Influence of Qingqihuatan Decoction Combined with Chemotherapy on CEA,CA125 and CYFRA21-1 in Treating Patients with Non-small Cell Lung Cancer at Middle-late Stage of Phlegm Heat Resistance Pulmonary Syndrome

目的:观察清气化痰汤联合化疗对中晚期非小细胞肺癌痰热阻肺证患者血清肿瘤标志物癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角蛋白19片段(CYFRA21-1)的影响。方法:选取2013年1月至2016年12月无锡市中医医院收治的ⅢB、Ⅳ期非小细胞肺癌痰热阻肺证患者40例,随机分为对照组和观察组,每组20例。对照组患者采用化疗,观察组患者在对照组基础上加用清气化痰汤联合治疗。比较2组治疗方案的近期疗效,评价患者的生命质量变化,监测治疗前后血清肿瘤标志物CEA、CA125及Cyfra21-1水平变化,记录不良反应。结果:观察组近期疗效65.0%,高于对照组的30%,差异有统计学意义(P<0.05)。观察组经治疗后与生命质量相关的情感、活动功能、生理、社会FACT-L评分较对照组升高显著,差异有统计学意义(P<0.05)。观察组患者治疗后的肿瘤标志物CEA、CA125、CYFRA21-1水平均显著低于对照组患者,差异有统计学意义(P<0.05)。2组患者均出现恶心呕吐、便秘、血小板降低、白细胞减少等不良反应,观察组发生率均明显降低,与对照组比较差异性显著,差异有统计学意义(P<0.05)。结论:清气化痰汤联合化疗能显著提高中晚期非小细胞肺癌痰热阻肺证患者的生命质量,减毒增效优势突出,其机制与下调CEA、CA125、CYFRA21-1等因子表达而诱导癌细胞凋亡有一定相关性,值得临床推广运用。

Objective： To explore the influence of Qingqihuatan Decoction combined with chemotherapy on CEA,CA125 and CYFRA21-1 in treating patients with non-small cell lung cancer at middle-late stage of phlegm heat resistance pulmonary syndrome.Methods： 40 patients with non-small cell lung cancer at middle-late stage of phlegm heat resistance pulmonary syndrome who were treated in our hospital from January 2013 to December 2016 were randomly divided into a control group of 20 cases and an observation group of 20 cases. The patients in the control group were given pemetrexed and cisplatin for chemotherapy; while the patients in the observation group were given Qingqihuatan Decoction on the basis of control treatment. The paper was aimed at observing the recent curative effect,evaluating the living quality,monitoring the levels of CEA,CA125 and CYFRA21-1,and recording the adverse reactions. Results： The recent efficiency of the patients in observation group was 65. 0%,which was higher than 30% of the control group（ P〈0. 05）; the living quality scores of emotional,activity function,physical and social for the patients in observation group were higher than that of the control group（ P〈0. 05）; the levels of CEA,CA125 and CYFRA21-1 of the patients in observation group was lower than that of the control group（ P〈0. 05）; Two groups of patients had adverse reactions such as nausea,vomiting,constipation,reduced platelet and white blood cells,hair loss,and liver and kidney impairment,the incidence of observation group were significantly lower（ P〈0. 05）. Conclusion： The therapy can improve the patients＇ living quality. It has the advantage of toxicity reducing and efficacy enhancing. The mechanism may be associated with regulating CEA,CA125 and CYFRA21-1 to induce apoptosis of cancer cells,and it is worthy of clinical promotion.