益气化瘀方配合化疗治疗晚期非小细胞肺癌临床研究

Application effect of TP chemotherapy Plus Yiqi Huayu decoction in advanced Non-small cell lung cancer patients

目的:评价益气化瘀方配合TP方案化疗干预在晚期非小细胞肺癌(NSCLC)患者中的应用效果,并探讨机制。方法:将170例NSCLC患者随机分为两组。对照组85例(最终完成76例)予TP方案化疗;治疗组85例(最终完成79例)在对照组治疗基础上予益气化瘀方治疗。两组均21d为1个周期,连续治疗4个周期。比较两组自评-主观全面评定量(PG-SGA)评分、生活质量、细胞免疫功能指标评分及不良反应,并统计疗效。结果:两组治疗后PG-SGA评分均低于本组治疗前(P<0.05),且治疗组低于对照组(P<0.05)。治疗后治疗组在躯体功能、情绪功能、认知功能、社会功能、角色功能方面评分高于对照组(P<0.05)。两组治疗后CD3、CD4均较本组治疗前升高(P<0.05),CD8降低(P>0.05);治疗后治疗组CD3、CD4高于对照组(P<0.05),两组治疗后CD8比较差异无统计学意义(P>0.05)。治疗组不良反应发生率18.99%(15/79),对照组不良反应发生率39.47%(30/76),治疗组不良反应发生率低于对照组(P<0.05)。治疗组总有效率89.9%(71/79),对照组为73.7%(56/76),两组有效率比较差异有统计学意义(P<0.05)。结论:在化疗基础上给予益气化瘀方可减轻老年晚期NSCLC患者的临床症状、改善患者生活质量、降低化疗药物不良反应,同时为临床应用PG-SGA量对肺部肿瘤患者营养评估提供理论依据。

Objective:Evaluate the Yiqi Huayu decoction in advanced Non-small cell lung cancer(NSCLC) patients by patient-generated subjective assessment and explore the mechanism. Methods:Select 170 cases patients that accord with the inclusion criteria then randomly divided into the treatment group ( n =85)and control group ( n =85);there were 15 cases lost in the study,the lost rate was 8.82%,a total of 155 patients were completed,including 79 in the treatment group and 76 in the control group. The control group was given TP(Paclitaxel+cisplatin) chemotherapy;the treatment group was given Yiqi Huayu decoction on the basis of the control group.Both groups were treated with 21 days as a cycle for 4 consecutive cycles. Then scores of PG-SGA scale,quality of life,cell immune function index score,adverse reaction and efficiency of both group cases were observed and compared. Results:After treatment,PG-SGA scores in both groups were lower than before treatment ( P <0.05);and the treatment group was lower than the control group ( P <0.05). After treatment,the score of physical function,emotional function,cognitive function,social function and role functions was higher than that of the control group ( P <0.05).The scores of fatigue,nausea,vomiting,pain,loss of appetite,constipation and economic difficulties were all lower than the control group ( P <0.05);both CD 3 and CD 4 scores were higher than those before treatment ( P <0.05),and the CD 8 score was lower than before treatment ( P >0.05). The treatment group CD 3 score and,the CD 4 score was higher than control group after the treatment ( P <0.05);the incidence of adverse reactions of the treatment group was 18.99%(15/79),the incidence of adverse reactions of the control group was 39.47%(30/76);there were statistically significant differences in the incidence of adverse reactions in the two groups ( P <0.05). The total effective rate of the treatment group was 89.9%(71/79),and the control group was73.7%(56/76).The difference of the two groups was statistically significant ( P <0.05). Conclusions:Give organic combination therapy of traditional Chinese medicine on the basis of chemotherapy can reduce clinical symptoms of the elderly patients with advanced NSCLC,improve quality of life,reduce the drug adverse reaction of chemotherapy,meanwhile,the PG-SGA scale was used to provide theoretical basis for the nutritional assessment of lung cancer patient.