益气复元汤联合化疗治疗晚期肺鳞癌的临床观察及对血浆Visfatin的影响

Clinical effect of Yiqi Fuyuan decoction combined with chemotherapy in treatment of advanced lung squamous cell carcinoma and its influence on plasma visfatin level

目的:评价益气复元汤联合化疗对晚期肺鳞癌的临床疗效及对血浆Visfatin水平的影响。方法:将60例晚期肺鳞癌患者随机分为治疗组和对照组各30例,对照组接受DP方案化疗:多西他塞75mg/m2,静脉滴注,d1;顺铂25mg/m2,d1-3;21d为1个疗程,至少完成2个疗程。治疗组在此基础上口服益气复元汤治疗。评定2组临床疗效,观察治疗期间的不良反应(胃肠道反应、骨髓抑制、乏力),通过观察2组患者治疗前血浆Visfatin水平与疾病进展时间(PFS)、总生存期(OS)之间的关系,了解其相关性。结果:总有效率治疗组为20.0%,对照组为16.7%,2组差异无统计学意义(P>0.05)。PFS治疗组为(4.9±0.5)个月,对照组为(3.7±0.4)个月;OS治疗组为(9.0±0.9)个月,对照组为(7.5±0.7)个月,差异均无统计学意义(P>0.05),但治疗组PFS、OS有延长趋势。治疗组不良反应(胃肠道反应、骨髓抑制、乏力)发生率均较对照组明显下降(P<0.05)。所有患者治疗前血浆Visfatin水平与PFS存在相关性(P=0.046),与OS之间无相关性(P=0.307)。治疗组治疗后血浆Visfatin水平较治疗前明显下降(P<0.05),对照组治疗前后血浆Visfatin水平差异无统计学意义(P>0.05)。结论:益气复元汤联合化疗可减轻晚期肺鳞癌患者不良反应,使其PFS、OS有延长趋势。晚期肺鳞癌患者血浆Visfatin水平与PFS存在相关性,但与OS无相关性;益气复元汤联合化疗可降低血浆Visfatin水平。

Objective： To investigate the clinical effect of Yiqi Fuyuan decoction combined with chemotherapy in the treatment of advanced lung squamous cell carcinoma and its influence on plasma visfatin level. Methods： A total of 60 patients with advanced lung squamous cell carcinoma were randomly divided into treatment group and control group,with 30 patients in each group. The patients in the control group were given chemotherapy with DP regimen（ intravenous dripping of docetaxel 75 mg/m2 on day 1 and cisplatin 25 mg/m2 on days 1-3 for at least two cycles（ 21 days/cycle）,and those in the treatment group were given oral Yiqi Fuyuan decoction in addition to the treatment in the control group. Clinical outcome was analyzed for both groups,adverse reactions（ gastrointestinal reactions,bone marrow suppression,and weakness） were evaluated during treatment,and the correlation of plasma visfatin level before treatment with progression-free survival（ PFS） and overall survival（ OS） was analyzed. Results： There was no significant difference in overall response rate between the treatment group and the control group（ 20. 0% vs 16. 7%,P 〉0. 05）. There were also no significant differences in PFS and OS between the treatment group and the control group（ PFS： 4. 9 ±0. 5 months vs 3. 7 ± 0. 4 months,P 〉0. 05; OS： 9. 0 ± 0. 9 months vs 7. 5 ± 0. 7 months,P 〉0. 05）,but PFS and OS in the treatment group tended to increase. The treatment group had significantly lower incidence rates of adverse reactions（ gastrointestinal reactions,bone marrow suppression,and weakness） than the control group（ P〈 0. 05）. For all patients,plasma visfatin level before treatment was correlated with PFS（ P = 0. 046）,while it was not correlated with OS（ P = 0. 307）. The treatment group had a significant reduction in plasma visfatin level after treatment（ P〈 0. 05）,while the control group showed no significant change（ P〉 0. 05）. Conclusion： Yiqi Fuyuan decoction combined with chemotherapy can alleviate adverse reactions and prolong PFS and OS in patients with advanced lung squamous cell carcinoma. In such patients,plasma visfatin level was correlated with PFS,but was not correlated with OS; Yiqi Fuyuan decoction combined with chemotherapy can reduce plasma visfatin level.