“养肺健脾方”联合常规西药治疗气阴两虚型老年肺癌合并衰弱临床研究

A clinical study on treating senile lung cancer of the Qi and Yin both deficiency type plus frailty with “the Yangfei Jianpi prescription” plus conventional Western medicine

目的:观察自拟养肺健脾方联合常规西药治疗气阴两虚型老年肺癌合并衰弱患者的临床疗效。方法:将64例老年肺癌合并衰弱患者随机分为两组,对照组32例给予营养指导及常规西药治疗,有咳嗽、咳痰者,予以止咳化痰药;有痰中带血者,予以口服止血剂;有疼痛者,按癌痛三阶梯止痛原则进行镇痛治疗;有呼吸困难者,予以吸氧或阿片类药物;有睡眠障碍、抑郁焦虑者,予以镇静、抗抑郁、抗焦虑药物。观察组32例,在对照组基础上加用自拟养肺健脾方中药汤剂,每日1剂。两组均治疗21天。治疗前后,采用衰弱表型量表(Frailty Phenotype,FP)评价患者的衰弱状态;采用日常生活活动能力量表(Activity of Daily Living Scale,ADL)、简明运动测试量表(Short Physical Pefformance Battery,SPPB)评价患者日常生活活动能力;根据中医证候积分变化评估中医证候疗效。结果:治疗后,观察组FP、ADL评分均较治疗前明显降低(P<0.05),SPPB评分较治疗前明显升高(P<0.05)。观察组FP、ADL评分均明显低于对照组(P<0.05),SPPB评分明显高于对照组(P<0.05)。观察组中医证候疗效总改善率明显高于对照组(P<0.05)。结论:在常规西药治疗的基础上加用自拟养肺健脾方治疗气阴两虚型老年肺癌合并衰弱疗效确切,能改善患者的衰弱状态,提高患者的躯体活动能力及日常生活活动能力。

Objective:To observe the clinical efficacy of“the Yangfei Jianpi prescription”(自拟养肺健脾方)plus conventional Western medicine in the treatment of senile lung cancer of the Qi(气)and Yin(阴)both deficiency type plus frailty.Methods:A total of 64 elderly patients were randomly divided into two groups,thirty-two patients in the control group were given nutritional guidance and conventional Western medicine treatment.Patients with cough and expectoration were given antitussive or phlegm-reducing drugs;oral hemostatic agent should be given to patients with blood in sputum.For patients with pain,analgesic treatment should be carried out according to the three-step analgesic principle of cancer pain.Oxygen or opioids should be given to patients with breathing difficulties;Patients with sleep disorders,depression and anxiety should be given sedation,anti-depression and anti-anxiety drugs.On the basis of the treatment in the control group,the observation group(32 cases)was given the Yangfei Jianpi decoction,one dose a day.Both groups were treated for 21 days.Frailty phenotype(FP)was used to evaluate the frailty status before and after treatment.The Activity of daily living(ADL)score and Short-physical performance battery(SPPB)score were used to evaluate the activity of daily life of patients.Change of TCM syndrome score was used to evaluate the curative effect of TCM syndrome.Results:After treatment,FP and ADL scores in the observation group were significantly lower than those before treatment(P<0.05),SPPB score was significantly higher than that before treatment(P<0.05).The FP and ADL scores in the observation group were significantly lower than those in the control group(P<0.05),the SPPB score in the observation group was significantly higher than that in the control group(P<0.05).The total improvement rate of TCM syndromes in the observation group was significantly higher than that in the control group(P<0.05).Conclusion:On the basis of conventional Western medicine treatment,the Yangfei Jianpi prescription plus conventional Western medicine is effective in the treatment of senile lung cancer of the Qi and Yin both deficiency type plus frailty,it can improve the frailty state of patients,and promote their physical activity and activities of daily life.