生脉胶囊联合一代EGFR-TKI靶向治疗晚期非小细胞肺癌的疗效分析

Efficacy of Shengmai capsule combined with first-generation EGFR-TKI in targeted treatment of advanced non-small cell lung cancer

目的探讨生脉胶囊联合一代表皮生长因子受体(EGFR)-酪氨酸激酶抑制剂(TKI)靶向治疗晚期非小细胞肺癌(NSCLC)患者的疗效。方法选取2018年1月-2019年9月杭州师范大学附属医院收治的晚期NSCLC患者90例,按照随机表法分为生脉胶囊组、EGFR-TKI组、联合组,每组30例。3组患者采取常规治疗及最佳营养支持治疗。生脉胶囊组口服生脉胶囊;EGFR-TKI组口服一代TKI靶向药物凯美纳;联合组口服EGFR-TKI和生脉胶囊,用法用量同上。3组疗程均为3个月。比较3组疗效、治疗前后卡氏功能状态量表(KPS)评分、免疫功能变化,以及不良反应发生情况。结果联合组客观有效率均高于生脉胶囊组和EGFR-TKI组(P<0.05)。3组疾病控制率比较,差异无统计学意义(P>0.05)。联合组治疗前后KPS评分的差值低于生脉胶囊组和EGFR-TKI组(P<0.05)。联合组治疗前后CD3^+、CD4^+和CD4^+/CD8^+的差值高于生脉胶囊组和EGFR-TKI组(P<0.05)。3组不良反应发生率比较,差异无统计学意义(P>0.05)。结论生脉胶囊联合一代EGFR-TKI靶向药物凯美纳治疗晚期NSCLC疗效较好,可改善患者生存质量,提高免疫功能。

Objective To study the efficacy of Shengmai capsule combined with a representative epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) in the treatment of advanced non-small cell lung cancer (NSCLC).Methods The 90 patients with advanced NSCLC admitted to the Affiliated Hospital of Hangzhou Normal University from January 2018 to September 2019 were randomly divided into the combination group (30 cases),the Shengmai capsule group (30 cases) and the EGFR-TKI group (30 cases).All the patients in the three groups were treated with routine therapy and optimal nutritional support.In the EGFR-TKI group and the Shengmai capsule group,the first-generation EGFR-TKI Kemena or Shengmai capsule was taken orally,respectively.In the combination group,EGFR-TKI and Shengmai capsule were both administrated as above.All the three groups were treated with 3 months.The therapeutic efficacy,KPS score,immune function and adverse reactions of the three groups were compared before and after treatment.Results Objective response rate (ORR) of the combination group was higher than that of Shengmai capsule group and EGFR-TKI group (P<0.05).There was no significant difference in disease control rate (DCR) among the three groups (P>0.05).The differences in KPS scores of the combination group before and after the treatment were smaller than those of Shengmai capsule group and EGFR-TKI group (P<0.05).On the contrary,the differences in CD3^+,CD4^+ and CD4^+/CD8^+ before and after the treatment were greater in the combination group than those in Shengmai capsule group and EGFR-TKI group (P<0.05).There was no significant difference in adverse reactions among the three groups (P>0.05).Conclusions Shengmai capsule combined with the first-generation EGFR-TKI Kemena shows great therapeutic efficacy in advanced NSCLC,which can improve the quality of life and immune function of patients.