清肺化痰汤加减对老年晚期非小细胞肺癌(痰热郁肺证)的辅助化疗效果

Adjuvant Chemotherapy Effects of Qingfei Huatan Decoction in Elderly Patients with Advanced Non-small Cell Lung Cancer(Phlegm Heat Obstructing Lung Syndrome)

目的:观察清肺化痰汤加减对老年晚期非小细胞肺癌(NSCLC)(痰热郁肺证)的辅助化疗效果。方法:老年晚期NSCLC患者80例随机分为对照组和观察组各40例。对照组采用多西他赛联合顺铂(DP)方案化疗,观察组在对照组基础上加用清肺化痰汤加减。治疗4个疗程后,比较两组患者治疗前后的中医证候积分、生存质量(FACT-L),以及癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)和细胞角质素片段抗原(CYRAF21-1)等血清肿瘤标记物水平变化;评价临床疗效(总缓解率、临床获益率),统计两组不良反应发生情况。结果:治疗后,两组患者中医症候积分、血清肿瘤标记物水平均较治疗前明显降低,FACT-L评分则较前明显提高(P<0.05);且观察组上述指标均明显优于对照组(P<0.05)。观察组总缓解率和临床获益率均明显高于对照组(P<0.05)。观察组恶心呕吐发生率明显低于对照组(P<0.05),血红蛋白降低、白细胞减少、肝功能损伤发生率两组差异无统计学意义(P>0.05)。结论:清肺化痰汤加减可有助于降低老年晚期NSCLC(痰热郁肺证)临床症状,降低肿瘤标志物水平和药物不良反应发生率,提高生存质量,效果显著。

Objective:To study the adjuvant chemotherapy effects of Qingfei Huatan decoction in elderly patients with advanced non-small cell lung cancer(NSCLC)(phlegm heat stagnant lung syndrome).Methods:A total of 80 elderly patients with advanced NSCLC were randomly divided into control group and observation group with 40 cases in each group.The control group was treated with DP chemotherapy,and the observation group was additionally treated with Qingfei Huatan decoction on the basis of the control group.After 4 courses of treatment,the TCM syndrome scores,functional assessment of cancer therapy-lung(FACT-L),levels of serum tumor markers of carcinoembryonic antigen(CEA),neuron-specific enolase(NSE)and cytokeratin fragment antigen(CYRAF21-1)between the two groups were compared and analyzed before and after treatment.The clinical efficacy after treatment(total remission rate,clinical benefit rate)were compared to evaluate the efficacy,and the occurrence of adverse reactions between the two groups were recorded.Results:After treatment,the TCM symptom scores and serum tumor marker levels of the two groups were all lower than those before treatment,and the FACT-L scores were significantly higher than those before treatment(P<0.05);the above indicators of the observation group were significantly better than those of the control group(P<0.05).After treatment,the total remission rate and clinical benefit rate of the observation group were significantly higher than those of the control group(P<0.05).During the treatment,the incidence of nausea and vomiting of the observation group was significantly lower than that of the control group(P<0.05),there were no significant differences between the two groups in the incidences of hemoglobin reduction,leukopenia and liver function damage(P>0.05).Conclusion:Qingfei Huatan decoction can help reduce the clinical symptoms of elderly patients with advanced NSCLC(phlegm-heat stagnant lung syndrome),reduce the levels of tumor markers and the incidence of adverse reactions of chemotherapy drugs,and improve the quality of life with remarkable curative effect.