益气养阴方联合化疗、甲磺酸奥希替尼片治疗非小细胞肺癌脑转移的临床疗效观察

Clinical observation of Yiqi Yangyin Decoction combined with chemotherapy and oxitinib mesylate tablets in the treatment of brain metastases of non-small cell lung cancer

目的观察益气养阴方联合化疗、甲磺酸奥希替尼片治疗非小细胞肺癌(NSCLC)脑转移的临床疗效。方法将76例NSCLC脑转移患者按照随机数字表法分为2组。对照组38例予常规化疗、甲磺酸奥希替尼片治疗,治疗组38例在对照组治疗基础上予益气养阴方口服。2组疗程均为3个化疗周期。2组治疗前后比较欧洲癌症研究与治疗组织肺癌患者生活质量量表(EORTC QLQ-LC43)评分,血清癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、S100B蛋白水平变化,统计实体瘤疗效,并对患者随访进行远期生存率比较。结果治疗组疾病控制率(DCR)78.95%(30/38),对照组DCR 63.16%(24/38),治疗组疗效优于对照组(P<0.05)。治疗后2组血清CEA、CYFRA21-1、S100B蛋白水平均较本组治疗前降低(P<0.05),且治疗后治疗组均低于对照组(P<0.05)。治疗后2组EORTC QLQ-LC43各项评分均较本组治疗前升高(P<0.05),治疗后治疗组情感功能、认知功能、总健康状况评分高于对照组(P<0.05)。2组不良反应比较差异有统计学意义(P<0.05),治疗组安全性优于对照组。随访27个月,治疗组生存率73.7%(28/38),对照组生存率50.0%(19/38),治疗组生存率高于对照组(P<0.05)。结论益气养阴方联合化疗、甲磺酸奥希替尼片治疗NSCLC脑转移患者疗效显著,能有效降低血清CEA、CYFRA21-1、S100B水平,延长患者生存期,不良反应较少,有着广阔的应用前景。

Objective To observe the clinical effect of Yiqi Yangyin Decoction combined with chemotherapy and oxitinib mesylate tablets in the treatment of brain metastases of non-small cell lung carcinoma(NSCLC).Methods A total of 76 patients with brain metastases from lung cancer were randomly divided into 2 groups by random number table method,the control group(n=38)was treated with pemetrexed combined with carboplatin and oxitinib,and the treatment group(n=38)was additionally treated with Yiqi Yangyin Decotion on the basis of the control group.After 3 chemotherapy cycles,the changes in EORTC QLQ-LC4 score,serum carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1),and S100B protein levels in the two groups were compared between the two groups before and after treatment,the curative effect of solid tumors was counted,and the long-term survival curve was evaluated.Results The disease control rate(DCR)in the treatment group and that in the control group was 78.95%(30/38)vs 63.16%(24/38),respectively,and the curative effect was better in the treatment group than the control group(P<0.05).After treatment,the serum CEA,CYFRA21-1 and S100B protein levels in the two groups were lower than those before treatment(P<0.05),and those were lower in the treatment group than in the control group(P<0.05).The scores of EORTC QLQ-LC43 in the two groups were higher than those before treatment(P<0.05),the scores of emotional function,cognitive function and total health status in the treatment group were higher than those in the control group(P<0.05).The difference in adverse reactions between the two groups was statistically significant(P<0.05),and the safety was better of the treatment group than in the control group.Conclusion It has a significant effect in the treatment of patients with NSCLC brain metastases,that Yiqi Yangyin Decoction combined with chemotherapy and osimertinib mesylate.The mothed can effectively reduce serum S100B,CEA,and CYFRA21-1 levels,and significantly improve the survival of patients with fewer adverse reactions.Broad application prospects.