培土滋阴化痰方联合EGFR-TKI治疗EGFR敏感突变晚期非小细胞肺癌的效果及预后

Effects and prognosis of peitu ziyin huatan recipe combined with EGFR-TKI in the treatment of EGFR-sensitive mutant advanced non-small cell lung cancer

目的:观察培土滋阴化痰方联合表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗表皮生长因子受体(EGFR)敏感突变晚期非小细胞肺癌(NSCLC)的效果及预后。方法:回顾性分析驻马店市中心医院2017年5月至2019年5月采用EGFR-TKI治疗(对照组)及联合培土滋阴化痰方治疗(观察组)各80例EGFR敏感突变NSCLC患者的临床资料。两组均以治疗30 d为一个疗程,比较临床疗效,并记录其治疗前、治疗3个疗程后的免疫功能及血清肿瘤标志物,标志物包括血清癌胚抗原(CEA)、糖蛋白抗原125(CA-125)、人鳞状细胞癌相关抗原(SCCAg)、神经元特异性烯醇化酶(NSE),记录随访过程中的不良反应发生情况及远期疗效如肿瘤无进展生存(PFS)。结果:治疗3个疗程后,观察组总控制率高于对照组(P<0.05);治疗3个疗程后,观察组患者CD3^+、CD4^+及CD4^+/CD8^+水平均较治疗前上升(P均<0.05),且高于同期对照组(P<0.05),而CD8^+水平较治疗前下降(P<0.05),且明显低于同期对照组(P<0.05);对照组CD3^+、CD4^+及CD4^+/CD8^+水平均较治疗前显著下降(P均<0.05),而CD8^+水平较治疗前比较差异未见统计学意义(P>0.05);治疗3个疗程后,两组患者CEA、CA-125、SCCAg、NSE水平较治疗前均显著下降(P均<0.05),且观察组低于对照组(P<0.05);两组患者不良反应发生率及总有效率比较差异未见统计学意义(P>0.05);观察组患者PFS高于对照组(P<0.05)。结论:在EGFR-TKI基础上联合培土滋阴化痰方确可有效改善EGFR敏感突变NSCLC患者临床症状,提高其临床疗效,并有利于免疫功能的提高及血清肿瘤标志物水平的降低,且远期疗效较好。

Objective To observe the effects and prognosis of peitu ziyin huatan recipe combined with epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI)in the treatment of epidermal growth factor receptor(EGFR)-sensitive mutant advanced non-small cell lung cancer(NSCLC).Methods The clinical data of each 80 patients with EGFR-sensitive mutant NSCLC who received EGFR-TKI treatment in Zhumadian Central Hospital from May 2017 to May 2019 were retrospectively analyzed.The two groups took 30 d as a course of treatment.The clinical efficacy was compared,and the immune function,serum tumor markers,such as serum carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA-125),human squamous cell carcinoma associated antigen(SCCAg),neuron-specific enolase(NSE)before treatment and after 3 courses of treatment and occurrence of adverse reactions during follow-upand long-term efficacy such as tumor progression-free survival(PFS)were recorded in the two groups.Results After 3 courses of treatment,the total control rate in observation group was significantly higher than that in control group(P<0.05).After 3 courses of treatment,the levels of CD3+,CD4+and CD4+/CD8+in observation group were significantly higher than those before treatment(P<0.05),and they were significantly higher than those in control group during the same period(P<0.05),and the level of CD8+was significantly lower than that before treatment(P<0.05),and they significantly lower than that in control group during the same period(P<0.05).The levels of CD3+,CD4+and CD4+/CD8+in control group were significantly lower than those before treatment(P<0.05),but there was no statistically significant difference in the CD8+level compared with that before treatment(P>0.05).After 3 courses of treatment,the levels of CEA,CA-125,SCCAg and NSE in the two groups were significantly lower than those before treatment(P<0.05),and the levels in observation group were significantly lower than those in control group(P<0.05).There were no statistically significant differences in the incidence rates of adverse reactions and total effective rate between the two groups(P>0.05).The PFS in observation group was significantly higher than that in control group(P<0.05).Conclusions Combination of peitu ziyin huatan recipe on the basis of EGFR-TKI can effectively improve the clinical symptoms and enhance the clinical efficacy of EGFR-sensitive mutant NSCLC patients,and it is conducive to the improvement of immune function and the reductions of serum tumor markers,and it has good long-term efficacy.