清肺消积方配合化疗治疗老年晚期非小细胞肺癌临床疗效及对血清肿瘤标志物、炎性因子和免疫功能的影响

Effects of Qingfei Xiaoji Prescription on Elderly Patients with Advanced Non-small Cell Lung Cancer and Its Influence on Serum Tumor Markers, Inflammatory Factors and Immune Function

目的探讨清肺消积方配合化疗治疗老年晚期非小细胞肺癌的临床疗效及对患者血清肿瘤标志物、炎性因子和免疫功能的影响。方法采用随机数字表法将晚期非小细胞肺癌脾虚湿困证患者90例分为对照组和观察组各45例。对照组采用GP方案(顺铂+吉西他滨)化疗,28d为1个周期。观察组在对照组基础上予清肺消积方,每日1剂,每日2次,冲服,14 d为1个疗程。2组均连续治疗3个化疗周期。观察2组治疗前后糖类抗原125(CA125)、癌胚抗原(CEA)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、IgA、IgG水平,监测2组不良反应。结果与本组治疗前比较,2组治疗后IgA、IgG水平明显升高,CA125、CEA、IL-6、TNF-α水平明显降低,差异有统计学意义(P<0.05)。2组治疗后比较,观察组CA125、CEA、IL-6、TNF-α水平低于对照组,IgA、IgG水平高于对照组,差异有统计学意义(P<0.05)。观察组临床获益率为95.56%(43/45),对照组为77.78%(35/45),观察组明显优于对照组(P<0.05)。2组患者Ⅲ～Ⅳ度不良反应率差异无统计学意义(P>0.05),观察组恶心呕吐、白细胞减少、血红蛋白降低等不良反应率明显低于对照组(P<0.05)。结论清肺消积方配合GP化疗方案治疗老年晚期非小细胞肺癌可减轻炎症反应,提高免疫水平,改善预后。

Objective To investigate the clinical efficacy of Qingfei Xiaoji Prescription in the treatment of elderly patients with advanced non-small cell lung cancer and its effect on serum tumor markers, inflammatory factors and immune function. Methods Totally 90 patients with advanced non-small cell lung cancer and syndrome of spleen deficiency and dampness were divided into control group and observation group according to random number table method, with 45 cases in each group. The control group was treated with GP regimen （cisplatin plus gemcitabine）, 28 d as a cycle. The observation group was treated with Qingfei Xiaoji Prescription on the basis of the control group, one dosage per day, twice a day, take after mixing it with water, 14 d as a treatment course. Both groups were treated for three cycles. The levels of carbohydrate antigen 125 （CA125）, carcinoembryonic antigen （CEA）, interleukin-6 （IL-6）, tumor necrosis factor-α （TNF-α）, IgA and IgG were observed before and after treatment. Adverse reactions of both groups were monitored. Results Compared with before treatment, the levels of IgA and IgG significantly increased in both groups, and the levels of CA125, CEA, IL-6 and TNF-α were significantly lower, with statistical significance （P〈0.05）. After treatment, the levels of CA125, CEA, IL-6 and TNF-α in the observation group were lower than those in the control group, and the levels of IgA and IgG were higher than those in the control group, with statistical significance （P〈0.05）. The clinical benefit rate of the observation group was 95.56% （43/45）, and that of the control group was 77.78% （35/45）. The observation group was significantly better than the control group （P〈0.05）. There was no statistical significance in the rate of adverse reactions between the two groups （P〉0.05）. The adverse reaction rates such as nausea and vomiting, leukopenia and hemoglobin decreased in the observation group were significantly lower than those in the control group （P〈0.05）. Conclusion Qingfei Xiaoji Prescription combined with GP chemotherapy regimen can reduce inflammation, boost immunity and improve prognosis for the treatment of elderly patients with advanced non-small cell lung cancer.