健脾益肾补血中药同步放化疗对非小细胞肺癌患者疗效及肿瘤标志物水平的影响

The Efficacy of Concurrent TCM and Chemo-radio Therapy in the Treatment of Patients with Non-small Cell Lung Cancer and Its Influence on Tumor Markers Levels

目的分析健脾益肾补血中药同步放化疗对非小细胞肺癌患者疗效及肿瘤标志物水平的影响。方法选取116例中晚期非小细胞肺癌患者,随机分为观察组和对照组,每组58例,对照组接受同步放化疗,观察组在此基础上加用健脾益肾补血中药汤剂。比较两组患者的临床疗效、血清肿瘤标志物水平、骨髓抑制以及各器官不良反应。结果治疗后,观察组总缓解率高于对照组(73.21%vs.58.62%),但差异无统计学意义(χ~2=2.696,P=0.101);观察组生存率显著高于对照组(91.38%vs.77.59%),差异有统计学意义(χ~2=4.209,P=0.04)。治疗后,两组的血清肿瘤标志物CEA、CA-125、CYFRA21-1、SCCAg水平均较治疗前显著降低(P<0.05),且观察组的降低幅度均大于对照组(P<0.05)。治疗期间,观察组白细胞减少和血小板减少的总发生率低于对照组(P<0.05),而血红蛋白减少总发生率与对照组相比无显著差异(P>0.05)。治疗期间,观察组胃肠道反应、放射性食管炎、放射性肺炎等不良反应的总发生率显著低于对照组(P<0.05),而肝功能损伤发生率与对照组比较无显著差异(P>0.05)。结论健脾益肾补血中药汤剂辅助同步放化疗治疗局部中晚期非小细胞肺癌的远期疗效显著,可有效降低患者的血清肿瘤标志物及不良反应。

Objective To investigate the efficacy of concurrent Traditional Chinese Medical(TCM)and chemo-radio therapy in the treatment of patients with non-small cell lung cancer(NSCLC)and its influence on tumor markers levels.Methods 116 patients with NSCLC were selected and divided randomly into control group and observation group,58 cases in each group.Patients in the control group were treated with concurrent chemo-radio therapy,and patients in the observation group were treated with concurrent chemo-radio therapy and TCM.The changes including clinical efficacy,levels of serum tumor markers,myelosuppression and adverse reactions of various organs were compared between the observation group and control group before and after treatment.Results After treatment,the total response rate of observation group in short-term effects were higher than that of control group(73.21%vs.58.62%),but the differences had no statistical significance(χ2=2.696,P=0.101);While the survival rate of observation group in long-term effects was significantly higher than that of control group(91.38%vs.77.59%,χ2=4.209,P=0.04).The levels of serum tumor markers including CEA,CA-125,CYFRA21-1 and SCCAg in the two groups after treatment were significantly reduced compared with those before treatment(P<0.05),and scales of reduction in observation group were all greater than that in control group(P<0.05).During treatment,total incidence of leucopenia and thrombocytopenia in observation group were lower than that in control group(P<0.05),and total incidence of decreased hemoglobin in observation group had no statistical significance compared with that in control group(P>0.05).During treatment,total incidence of adverse reaction,such as gastrointestinal tract reaction,radioactive esophagitis and radioactive pneumonia in observation group,were dramatically lower than that in control group(P<0.05),and incidence of hepatic injury in observation group had no statistical significance compared with that in control group(P>0.05).Conclusion There is a significant long-term effect on patients with local advanced non-small cell lung cancer when they are treated with TCM combined with concurrent chemo-radio therapy,which can effectively reduce the patient’s serum tumor markers and the adverse reactions.