扶正合剂联合化疗治疗中晚期非鳞非小细胞肺癌的临床观察

Clinical observation of Fuzheng mixture combined with chemotherapy in the treatment of advanced non squamous non-small cell lung cancer

目的观察扶正合剂联合化疗治疗中晚期非鳞非小细胞肺癌(NSCLC)的临床疗效和不良反应。方法将80例中晚期非鳞NSCLC患者按照随机数字表法分为2组。对照组40例予培美曲塞二钠联合顺铂治疗;治疗组40例在对照组治疗基础上加服扶正合剂治疗。2组均21 d为1个疗程,2个疗程后统计临床疗效及治疗过程中不良反应情况,并观察2组治疗前后外周血T淋巴细胞亚群(CD3^+、CD3^+/CD4^+、CD3^+/CD8^+)、肿瘤标志物[癌胚抗原(CEA)、细胞角质蛋白片段19(CYFRA21-1)]情况。结果对照组总有效率47.5%,疾病控制率60.0%,治疗组总有效率67.5%,疾病控制率82.5%,治疗组临床疗效优于对照组(P<0.05)。治疗后治疗组CD3^+、CD3^+/CD4^+均升高(P<0.05),CD3^+/CD8^+降低(P<0.05);治疗后对照组CD3^+、CD3^+/CD4^+均降低(P<0.05),CD3^+/CD8^+升高(P<0.05)。治疗后2组CD3^+、CD3^+/CD4^+、CD3^+/CD8^+比较差异均有统计学意义(P<0.05)。治疗后2组CEA、CYFRA21-1均降低(P<0.05),且治疗后治疗组CEA低于对照组(P<0.05);CYFRA21-1组间比较差异无统计学意义(P>0.05)。2组不良反应白细胞计数下降、血红蛋白下降、血小板计数下降、恶心呕吐分级情况组间比较差异有统计学意义(P<0.05),肝、肾功能损害分级情况比较差异无统计学意义(P>0.05)。结论扶正合剂联合化疗治疗中晚期非鳞NSCLC疗效确切,可明显改善患者症状,提高生活质量和免疫功能,减轻化疗毒副作用。

Objective To observe the effect and adverse reaction of Fuzheng mixture combined with chemotherapy in the treatment of advanced non squamous non-small cell lung cancer(NSCLC). Methods 80 cases with advanced non squamous NSCLC were divided into two groups according to random number table method. 40 cases in control group were treated by pemetrexed disodium and cisplatin. 40 cases in treatment group were treated by Fuzheng mixture on the basis of the control group. Both groups were treated for 21 days as a course of treatment. After two courses of treatment, the clinical efficacy and adverse reactions during the treatment were counted, and the peripheral blood T-lymphocyte subsets(CD3^+, CD3^+/CD4^+, CD3^+/CD8^+) and tumor markers [ carcinoembryonic antigen(CEA), cytokeratin fragment 19(CYFRA21-1) ]before and after treatment were observed. Results The total effective rate was 47.5% in control group and 67.5% in treatment group, the disease control rate was 60.0% in control group and 82.5% in treatment group. The clinical curative effect of the treatment group was better than that of the control group(P<0.05). After treatment, CD3^+, CD3^+/CD4^+ in the treatment group were increased(P<0.05),and CD3^+/CD8^+ was decreased(P<0.05). After treatment, CD3^+, CD3^+/CD4^+ in the control group were decreased(P<0.05),and CD3^+/CD8^+ was increased(P<0.05). There were significant differences in CD3^+, CD3^+/CD4^+, CD3^+/CD8^+ between the two groups after treatment(P<0.05). After treatment, CEA and CYFRA21-1 of the two groups were decreased(P<0.05), and CEA of the treatment group was lower than that of the control group(P<0.05). There was no significant difference in CYFRA21-1 between the two groups(P>0.05). There were statistically significant differences in adverse reactions between the two groups such as decreased white blood cell counts, decreased hemoglobin, decreased platelet counts, and nausea and vomiting(P<0.05), and there was no significant difference in liver and kidney function damage(P>0.05). Conclusion Fuzheng mixture combined with chemotherapy is effective in the treatment of advanced non scaly NSCLC. It can obviously improve the symptoms, improve the quality of life and immune function, and reduce the toxic and side effects of chemotherapy.