化痰排浊解毒法联合胸腔镜根治术治疗早期非小细胞肺癌疗效及对免疫功能、生活质量的影响

Curative Effect of Huatan Paizhuo Jiedu Method Combined with Thoracoscopic Radical Resection for Early-Stage Non-Small Cell Lung Cancer and Its Effect on Immune Function and Quality of Life

目的:观察化痰排浊解毒法联合胸腔镜根治术治疗早期非小细胞肺癌患者的疗效及对免疫功能、生活质量的影响。方法:选取60例Ia~IIa期非小细胞肺癌痰热阻肺证患者,按随机数字表法分为对照组及观察组各30例。对照组采取肺癌胸腔镜根治术后常规治疗,观察组在对照组基础上加用化痰排浊解毒法中药治疗,2组均连续治疗3个月。比较2组临床疗效,比较2组治疗前后中医证候积分、免疫功能指标[调节性T细胞(Treg)、辅助性T细胞17(Th17)]、血清指标[巨噬细胞抑制因子-1(MIC-1)、尿激酶型纤溶酶原激活物(uPA)、基质金属蛋白酶-9(MMP-9)]、生活质量[肺癌患者生存质量测定量表(FACT-L)评分]、观察2组治疗期间不良反应发生情况。结果:观察组疾病控制率(DCR)为96.67%,对照组为76.67%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候积分均较治疗前下降,观察组中医证候积分低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组Treg指标值均较治疗前下降,Th17、Th17/Treg比值均较治疗前上升,差异均有统计学意义(P<0.05);治疗后,观察组Treg指标值低于对照组,Th17、Th17/Treg比值均高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组MIC-1、uPA、MMP-9水平均较治疗前下降(P<0.05),观察组上述3项水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组FACT-L量表中生理状况、情感状况评分均较治疗前下降,功能状况、肺癌相关症状评分均较治疗前上升,差异均有统计学意义(P<0.05),社会/家庭状况与治疗前相比,差异无统计学意义(P>0.05);治疗后,观察组FACT-L量表中生理状况、情感状况评分均低于对照组,功能状况、肺癌相关症状评分均高于对照组,差异均有统计学意义(P<0.05),2组社会/家庭状况评分比较,差异无统计学意义(P>0.05)。2组在治疗过程中,均未发生与药物相关的严重不良反应。结论:化痰排浊解毒法联合胸腔镜根治术治疗早期非小细胞肺癌临床疗效显著,可改善患者临床症状,提高免疫功能,提高生活质量,用药安全性较高。

Objective:To observe the curative effect of Huatan Paizhuo Jiedu method combined with thoracoscopic radical resection for early-stage non-small cell lung cancer and its effect on immune function and quality of life.Methods:A total of 60 cases of patients with non-small cell lung cancer with phlegm-heat obstructing the lung syndrome from stage Ia to stage IIa were selected and divided into the control group and the observation group according to the random number table method,with 30 cases in each group.After thoracoscopic radical resection,the control group was given routine treatment,and the observation group was additionally treated with Chinese medicine of Huatan Paizhuo Jiedu method based on the treatment of the control group.Both groups were treated for three months.The Chinese medicine syndrome scores,the immune function indexes including regulatory T cells(Treg)and T helper 17(Th17)cells,the serum indexes including macrophage inhibitory cytokine-1(MIC-1),urokinase-type plasminogen activator(uPA)and matrix metalloproteinase-9(MMP-9),the quality of life including Functional Assessment of Cancer Therapy-Lung(FACT-L)scores before and after treatment and the clinical effects in the two groups were compared.During treatment,the incidence of adverse reactions in the two groups was observed.Results:The disease control rate(DCR)was 96.67%in the observation group and 76.67%in the control group,the difference being significant(P<0.05).After treatment,Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment,and the Chinese medicine syndrome score in the observation group was lower than that in the control group,differences being significant(P<0.05).After treatment,the Treg values in the two groups were decreased when compared with those before treatment,and the values of Th17 and Th17/Treg ratio were increased,differences being significant(P<0.05).After treatment,the Treg value in the observation group was lower than that in the control group,and the values of Th17 and Th17/Treg ratio were higher than those in the control group,differences being significant(P<0.05).After treatment,the levels of MIC-1,uPA and MMP-9 in the two groups were decreased when compared with those before treatment(P<0.05),and the above three levels in the observation group were lower than those in the control group,differences being significant(P<0.05).After treatment,the scores of physiological states and emotional states in FACT-L in the two groups were decreased when compared with those before treatment,and the scores of function and related symptoms of lung cancer were increased,differences being significant(P<0.05);there was no significant difference being found in the comparison of social/family situation before and after treatment(P>0.05).After treatment,the scores of physiological states and emotional states in FACT-L in the observation group were lower than those in the control group,and the scores of function and related symptoms of lung cancer were higher,differences being significant(P<0.05);there was no significant difference being found in the comparison of social/family situation between the two groups(P>0.05).During treatment,there was no serious adverse reactions related to drugs in the two groups.Conclusion:Huatan Paizhuo Jiedu method combined with thoracoscopic radical resection has a significant clinical effect in treating early-stage non-small cell lung cancer,and can improve clinical symptoms,immune function and quality of life with high medication safety.