自拟益气养阴方辅助放疗治疗晚期非小细胞肺癌33例临床观察

Clinical Observation on Self-Made Supplementing Qi and Nourishing Yin Prescription Combined with Radiotherapy for Treating Advanced Non-Small-Cell Lung Cancer in 33 Cases

目的观察自拟益气养阴方辅助放射治疗(简称放疗)对于晚期非小细胞肺癌(NSCLC)的效果。方法选取河北省邢台市人民医院2013年5月至2015年4月收治的晚期NSCLC患者66例,按随机数字表法分为对照组与研究组,各33例。对照组采取放疗,研究组在对照组治疗基础上加用自拟益气养阴方,持续治疗2个月。治疗结束后,对比两组临床疗效,免疫功能指标(CD3+,CD4+,CD8+,CD4+/CD8+),血清细胞因子[转化生长因子-β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)]水平,以及血清肿瘤标志物[细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)、糖类抗原125(CA125)]水平,并于疗程结束后随访12~24个月,对比两组患者生存情况。结果研究组总有效率为75.76%,显著高于对照组的51.51%(P<0.05);治疗后,研究组患者的CD3+,CD4+,CD4+/CD8+较对照组高,CD8+较对照组低(P<0.05);治疗后,两组患者的血清TGF-β1,TNF-α,IL-1β,IL-6水平均降低,且研究组较对照组低(P<0.05);治疗后,两组患者的血清CYFRA21-1,CEA,CA125水平均降低,且研究组较对照组低(P<0.05);研究组患者中位生存期较对照组长(P<0.05);研究组患者12个月生存率为63.64%,高于对照组的39.39%(P<0.05)。结论自拟益气养阴方辅助放疗治疗晚期NSCLC效果显著,可减少血清细胞因子及肿瘤标志物含量,改善患者机体免疫功能,提高疗效,延长患者生存期。

Objective To investigate the clinical effect of self-made supplementing qi and nourishing yin prescription combined with radiotherapy in the treatment of advanced non-small cell lung cancer(NSCLC).Methods Totally 66 NSCLC patients in Xingtai People's Hospital from May 2013 to April 2015 were randomly divided into the control group and the study group,33 cases in each group.The control group was treated with radiotherapy,on this basis,the study group was treated with self-made supplementing qi and nourishing yin prescription.The treatment lasted for 2 months.After treatment,the clinical efficacy,immune function indexes(CD3+,CD4+,CD8+,CD4+/CD8+),levels of serum cytokines(TGF-β1,TNF-α,IL-1β,IL-6),levels of serum tumor markers(CYFRA21-1,CEA,CA125)were compared between two groups.The patients were followed up for 12-24 months after the treatment,and the survival of the two groups was compared.Results The total effective rate of the study group was 75.76%,which was significantly higher than 51.51%of the control group(P<0.05).After treatment,the levels of CD3+,CD4+,CD4+/CD8+in the study group were higher than those in the control group,but the level of CD8+,in the study group was lower than that in the control group(P<0.05).The levels of serum TGF-β1,TNF-α,IL-1β,IL-6 in the two groups were decreased,and those in the study group were lower than those in the control group(P<0.05).The serum CYFRA21-1,CEA and CA125 levels of the two groups were decreased,and those in the study group were lower than those in the control group(P<0.05).The median survival time of the study group was longer than that of the control group(P<0.05).The survival rate at the 12th month was 63.64%,which was higher than 39.39%of the control group(P<0.05).Conclusion Self-made supplementing qi and nourishing yin prescription combined with radiotherapy in the treatment of advanced NSCLC has significant effect,it can reduce the content of serum cytokines and tumor markers,improve the immune function and the curative effect,and prolong the survival time of the patients.