补肺化瘀汤辅助吉非替尼对晚期非小细胞肺癌患者临床预后及生活质量的影响分析

Effect of Bufei Huayu Decoction Adjuvant Treatment Combined with Gefitinib on Clinical Prognosis and Quality of Life of Patients with Advanced Non-small Cell Lung Cancer

【目的】观察补肺化瘀汤辅助吉非替尼对晚期非小细胞肺癌患者临床预后及生活质量的影响。【方法】将60例晚期非小细胞肺癌患者随机分为观察组和对照组,每组各30例。对照组单纯给予吉非替尼单药化疗,观察组在对照组基础上加服补肺化瘀汤治疗,每个疗程21 d,连续观察2个疗程。观察2组患者治疗前后外周血T淋巴细胞亚群[CD3+、CD4+、CD8+和CD4+/CD8+]和相关临床指标[血管表皮生长因子(VEGF)、基质金属蛋白酶9(MMP-9)]及生活质量卡氏评分(KPS)的变化情况,并对2组患者化疗后的临床疗效及毒副反应进行评定。【结果】(1)经2个疗程治疗后,观察组的疾病控制率为86.7%(26/30),对照组为70.0%(21/30),观察组的疗效明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的CD3+、CD4+、CD4+/CD8+水平均较治疗前有所降低,CD8+水平均较治疗前有所升高(P<0.05);但观察组治疗后的CD3+、CD4+、CD4+/CD8+水平均略高于对照组,而CD8+水平略低于对照组,差异均有统计学意义(P<0.05或P<0.01)。(3)治疗后,2组患者的VEGF、MMP-9水平均较治疗前明显降低,KPS评分均较治疗前明显升高(P<0.05);但观察组患者治疗后VEGF、MMP-9水平明显低于对照组,而KPS评分明显高于对照组,差异均有统计学意义(P<0.01)。(4)治疗过程中,观察组患者的胃肠道反应、转氨酶升高、白细胞减少的发生率均明显低于对照组,差异均有统计学意义(P<0.05或P<0.01)。【结论】补肺化瘀汤辅助吉非替尼治疗晚期非小细胞肺癌,能有效抑制肺癌细胞的增殖,改善患者免疫系统功能,降低不良反应发生率,提高患者生活质量。

Objective To investigate the effect of Bufei Huayu Decoction adjuvant treatment combined with gefitinib on clinical prognosis and quality of life of patients with advanced non-small cell lung cancer.Methods A total of 60 patients with advanced non-small cell lung cancer were randomly divided into observation group and control group,30 cases in each group.The control group was given chemotherapy of gefitinib alone,and the observation group was given Bufei Huayu Decoction adjuvant treatment combined with gefitinib.Twenty-one days constituted a course of treatment,and the treatment for the two groups lasted 2 courses.Before and after treatment,the levels of T lymphocyte subsets CD3+,CD4+,CD8+,and CD4+/CD8+in the peripheral blood,the clinical related parameters of vascular endothelial growth factor(VEGF)and matrix metalloprotease 9(MMP-9),and the Karnofsky performance status(KPS)scores of the quality of life in the two groups were observed.After treatment,the clinical efficacy,and the toxic and side effects of the chemotherapy in the two groups were evaluated.Results(1)After two courses of treatment,the disease control rate of the observation group was 86.7%(26/30),significantly higher than that of the control group(70.0%;21/30),and the clinical efficacy of the observation group was significantly stronger than that of the control group(P<0.05).(2)After treatment,the levels of T lymphocyte subsets CD3+,CD4+,and CD4+/CD8+were decreased and the level of CD8+was increased in the two groups as compared with those before treatment(P<0.05),and the levels of T lymphocyte subsets CD3+,CD4+,and CD4+/CD8+were higher while the level of CD8+was lower in the observation group than those in the control group,the differences being statistically significant(P<0.05 or P<0.01).(3)After treatment,the levels of VEGF and MMP-9 were decreased and Karnofsky Performance Status(KPS)scores of quality of life were increased in the two groups as compared with those before treatment(P<0.05),and the levels of VEGF and MMP-9 were lower and the KPS scores were higher in the observation group than those in the control group,the differences being statistically significant(P<0.01).(4)During the treatment,the incidence of gastrointestinal reactions,transaminase elevation and leukopenia in the observation group was significantly lower than that in the control group(P<0.05 or P<0.01).Conclusion Bufei Huayu Decoction adjuvant treatment combined with gefitinib can effectively inhibit the growth of lung cancer cells,improve the immune system function,reduce the incidence of adverse reactions,and improve the quality of life of patients with advanced non-small cell lung cancer.