补肺消萎汤联合放射性粒子植入术对晚期非小细胞肺癌正虚毒结型患者免疫状态及症状负担的影响

Effect of Bufei Xiaowei Decoction Combined with Radioactive Particle Implantation on Immune Status and Symptoms of Patients with Advanced Non-small Cell Lung Cancer of Healthy Qi Deficiency and Toxin Accumulation

目的观察补肺消萎汤联合放射性粒子植入术对晚期非小细胞肺癌(Non-small Cell Lungcancer,NSCLC)患者免疫状态及症状负担的影响。方法选取2018年9月—2022年5月期间广西壮族自治区钦州市中医医院收治的晚期NSCLC患者80例,按随机数字表法分为对照组和观察组,每组各40例。对照组采用放射性粒子植入近距离治疗,观察组在对照组基础上加用补肺消萎汤治疗。治疗4周后,观察比较两组患者临床疗效及毒副作用发生情况,治疗前后外周T淋巴细胞百分含量[CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]、肺癌症状量表(Lung Cancer Symptom Scale,LCSS)[生活质量、活动状态、相关症状]评分情况。结果治疗后观察组总有效率47.50%(19/40)、疾病控制率87.50%(35/40)明显高于对照组总有效率27.50%(11/40)、疾病控制率65.00%(26/40),差异有统计学意义(P<0.05)。治疗后两组患者CD4^(+)含量、CD4^(+)/CD8比值均较治疗前升高,CD8^(+)含量均较治疗前降低,差异有统计学意义(P<0.05);且观察组CD4^(+)含量、CD4^(+)/CD8比值明显高于对照组,CD8^(+)含量明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者生活质量、活动状态、相关症状评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组生活质量、活动状态、相关症状评分明显低于对照组,差异有统计学意义(P<0.05)。治疗期间,观察组毒副作用发生率20.00%与对照组22.50%比较,差异无统计学意义(P>0.05)。结论补肺消萎汤联合放射性粒子植入术能进一步提升晚期NSCLC的治疗效果,明显改善患者免疫状态及症状,且不会增加用药风险。

Objective To investigate the effect of Bufei Xiaowei Decoction combined with radioactive particle implantation on the immune status and symptoms of patients with advanced non-small cell lung cancer(NSCLC).Methods A total of 80 patients with advanced NSCLC who were treated in Qizhou Hospital of Traditional Chinese Medicine,Guangxi Zhuang Autonomous Region from September 2018 to May 2022 were included and divided into the control group and observation group by random number table,with 40 cases in either group.The control group was treated with radioactive particle implantation(brachytherapy),and the observation group was treated with Bufei Xiaowei Decoction on the basis of the control group.After 4 weeks of treatment,the clinical efficacy and the occurrence of toxic and side effects were compared between the two groups,and the changes in levels of peripheral T lymphocytes(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))and Lung Cancer Symptom Scale(LCSS)(quality of life,activity state,related symptoms)score before and after treatment were observed.Results After treatment,the total effective rate[47.50%(19/40)]and disease control rate[87.50%(35/40)]in the observationgroup were higher than those[27.50%(11/40)and 65.00%(26/40),respectively]in the control group(P<0.05).After treatment,the CD4^(+)content and CD4^(+)/CD8^(+)ratio increased and the CD8^(+)content decreased in both groups compared with those before treatment(P<0.05).The CD4^(+)content and CD4^(+)/CD8^(+)ratio in the observation group were higher than those in the control group,while the CD8^(+)content was lower than that in the control group(P<0.05).After treatment,the scores of quality of life,activity state and related symptoms in both groups decreased compared with those before treatment(P<0.05),and the scores were lower in the observation group than in the control group(P<0.05).During treatment,there was no significant difference in the incidence of toxic and side effects between the observation group(20.00%)and the control group(22.50%)(P>0.05).Conclusion Bufei Xiaowei Decoction combined with radioactive particle implantation can further improve the therapeutic effect of advanced NSCLC,remarkably enhance the immunity,and alleviate the symptoms of patients without increasing the risk of medication.