消积清肺饮联合粒子植入治疗晚期非小细胞肺癌的临床观察

Clinical observation on treating advanced non-small cell lung cancer with Xiaoji Qingfei Yin plus particle implantation

目的:观察中药联合化疗、1-125粒子植入治疗晚期非小细胞肺癌的客观疗效、远期生存时间。方法:选取我院肿瘤科2015年1月-2017年1月晚期非小细胞肺癌(包括Ⅲb、Ⅳ期)患者149例,按随机数字表法分为中药组、联合组、对照组。对照组50例根据不同病理类型给予化疗。中药组49例应用消积清肺饮加减。联合组50例在服用中药、化疗基础上在CT引导下行肺部肿瘤和肿大淋巴结行1-125粒子植入。结果:联合组近期客观缓解率为84.00%,对照组为60.00%,两组差异具有统计学意义(P<0.01),联合组优于对照组。联合组临床症状缓解率为78.00%,对照组为58.00%,两组差异有统计学意义(P<0.05),联合组优于对照组。联合组2年生存率为46.0%,对照组为24.0%,两组差异有统计学意义(P<0.05),联合组优于对照组。中药组临床症状缓解率为59.0%,2年生存率为20.41%,与对照组比较差异无统计学意义。联合组气胸发生率为12.96%,发热发生率为18.52%,与其他两组比较差异有统计学意义,P<0.05。联合组与对照组的肝肾损害及心脏损害、消化道反应、骨髓抑制比较,差异无统计学意义。中药组消化道反应与其他两组比较差异无统计学意义,其他不良反应均显著低于联合组、对照组。结论:中药消积清肺饮能缓解晚期非小细胞肺癌.临床症状,延长生存期,联合化疗、1-125粒子植入能明显提高临床症状缓解率、客观缓解率、远期生存时间。

Objective:To observe objective effects and long-term survival time of TCM medicine with chemotherapy and I-125implantation on advanced non-small cell lung cancer.Methods:149cases(including stageⅢb,Ⅳ)from January2015to January2017were randomly divided into the TCM group,the combined group and the control group.50cases in the control group were given chemotherapy according to different pathological types.49cases in the TCM group took Xiaoji Qingfei Yin.50cases in the combined group were treated with iodine125particles implantation more.Results:The objective response was84.0%in the combined group and60%in the control group;the difference between the groups was statistically significant(P<0.01);and the combined group was superior to the control group.The remission rate was78.00%in the combined group and58.00%in the control group;the difference was statistically significant(P<0.05);and the combined group was superior to the control group.The2-year survival was46.0%in the combined group and24.0%in the control group;the difference was statistically significant(P<0.05);the combined group was superior to the control group.The remission rate of clinical symptoms was59.0%and the2-year survival rate was20.41%,with on significant difference compared with the control group.The incidence of pneumothorax was12.96%in the combined group and18.52%in the fever;there were significant differences among the groups(P<0.05).There was no significant difference between the combined group and the control group in the liver and kidney damage and heart damage,gastrointestinal reaction and myelosuppression.There was no significant difference between the TCM group and the other groups in the digestive tract reaction;and the other adverse reactions were significantly lower than other group.Conclusion:Xiaoji Qinggan Yin can relieve the clinical symptoms,prolong survival,combined chemotherapy and I-125implantation can significantly improve clinical symptom remission rate,objective remission rate and long-term survival time.