替吉奥胶囊联合六君子汤加减三线治疗老年晚期肺鳞癌的临床研究

Clinical Study of S-1 Capsule Combined with Modified Liujunzi Decoction in the Third-line Treatment of Advanced Lung Squamous Cell Carcinoma in Elderly Patients

目的:探讨替吉奥胶囊联合六君子汤加减三线治疗晚期老年肺脾气虚型肺鳞癌的临床疗效。方法:选取2017年1月至2018年11月中山市中医院肿瘤科收治的晚期老年肺鳞癌患者100例作为研究对象,随机分为观察组和对照组,每组50例。所有患者已经经过一线及二线化学治疗进展,辨证为肺脾气虚型。观察组采用替吉奥胶囊联合六君子汤加减治疗,对照组采用六君子汤加减治疗,比较2组患者治疗效果。结果:观察组体力状况评分总有效率88%,对照组为48%,2组比较差异有统计学意义(P<0.05)。2组治疗前瘤体大小比较,差异无统计学意义(P>0.05);治疗后2、3、6和12个月CT检测结果显示观察组瘤体逐渐变小,12个月后达到(11.89±2.67)cm^2,而对照组瘤体大小变化不大,2组治疗后比较,差异有统计学意义(P<0.05)。2组常见不良反应(骨髓抑制、恶心呕吐、脱发)发生率比较,差异无统计学意义(P>0.05)。结论:替吉奥胶囊联合六君子汤加减较单纯六君子汤加减治疗老年晚期肺鳞癌效果较好,不良反应未见增加,可推广于老年晚期肺脾气虚型肺鳞癌的三线治疗。

Objective: To explore the clinical efficacy of S-1 capsule combined with modified Liujunzi Decoction in the third-line treatment of advanced lung squamous cell carcinoma in elderly patients with lung-spleen qi deficiency syndrome. Methods: A total of 100 elderly patients with advanced lung squamous cell carcinoma admitted to the department of oncology,Zhongshan Hospital of traditional Chinese medicine from January 2017 to November 2018 were randomly divided into an observation group and a control group,with 50 cases in each group.All patients had undergone first-line and second-line chemotherapy progress,and syndrome differentiation was lung-spleen qi deficiency syndrome.The experimental group was treated with S-1 capsule combined with modified Liujunzi decoction,while the control group was treated with modified Liujunzi Decoction.The therapeutic effects of the 2 groups were compared.Result:The total effective rate of physical condition in the observation group was 88%,and the control group was 48%.The difference between the 2 groups was statistically significant ( P <0.05).There was no significant difference in tumor size between the 2 groups before treatment ( P >0.05).The results of CT examination at 2,3,6 and 12 months after treatment showed that the tumor volume in the observation group gradually became smaller,reaching (11.89±2.67) cm^2 after 12 months,while the tumor size in the control group did not change much.The difference between the 2 groups was statistically significant ( P <0.05).There was no significant difference in the incidence of common adverse reactions (myelosuppression,nausea and vomiting,alopecia) between the 2 groups ( P >0.05). Conclusion: Compared with modified Liujunzi Decoction alone,the treatment of S-1 capsule combined with modified Liujunzi Decoction is better in the treating elderly patients with advanced lung squamous cell carcinoma.The adverse reactions are not increased,which can be promoted to the third-line treatment of advanced lung squamous cell carcinoma with lung-spleen qi deficiency syndrome in the elderly.