健脾益肾解毒散结汤联合TP化疗方案治疗晚期非小细胞肺癌疗效观察及对血清肿瘤标志物、免疫功能的影响

Curative Effect of Jianpi Yishen Jiedu Sanjie Decoction Combined with TP Chemotherapy for Advanced Non-Small Cell Lung Cancer and Its Effect on Serum Tumor Markers and Immune Function

目的:观察健脾益肾解毒散结汤联合TP化疗方案治疗晚期非小细胞肺癌(NSCLC)临床疗效及对血清肿瘤标志物、免疫功能的影响。方法:选取90例晚期NSCLC患者,按随机数字表法分为对照组及治疗组各45例。对照组给予TP化疗方案治疗,治疗组在TP化疗方案基础上给予健脾益肾解毒散结汤治疗。2组均以21 d为1个疗程,治疗2个疗程。比较2组临床疗效及不良反应发生率,比较2组治疗前后血清肿瘤标志物[糖类抗原199(CA199)、细胞角蛋白19片段(CYFRA21-1)、神经烯醇化酶(NSE)]、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比值)的变化。结果:治疗后,治疗组临床疗效总有效率为84.44%,对照组为66.67%,2组比较,差异有统计学意义(P<0.05)。2组CA199、NSE、CYFRA21-1水平均较治疗前下降(P<0.05),治疗组CA199、NSE、CYFRA21-1水平均低于对照组(P<0.05)。治疗组CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)比值均较治疗前升高,CD8^(+)水平较治疗前下降(P<0.05);治疗组CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)比值均高于对照组(P<0.05),CD8^(+)水平低于对照组(P<0.05)。治疗组不良反应发生率24.44%,对照组57.78%,2组比较,差异有统计学意义(P<0.05)。结论:健脾益肾解毒散结汤联合TP化疗方案治疗晚期NSCLC可提升临床疗效,抑制肿瘤细胞转移及增殖,提高患者的免疫力,减少不良反应发生,用药安全性较高。

Objective:To observe the clinical effect of Jianpi Yishen Jiedu Sanjie Decoction combined with TP chemotherapy for advanced non-small cell lung cancer(NSCLC) and its effect on serum tumor markers and immune function. Methods: A total of 90 cases of patients with advanced NSCLC were selected and divided into the control group and the treatment group according to the random number table method, with 45 cases in each group. The control group was treated with TP chemotherapy, and the treatment group was additionally treated with Jianpi Yishen Jiedu Sanjie Decoction based on TP chemotherapy. Both groups were treated for two courses,with 21 days being a course of treatment. The clinical effects and the incidence of adverse reactions were compared between the two groups. The changes in serum tumor markers including carbohydrate antigen 199(CA199), cytokeratin 19 fragment antigen 21-1(CYFRA21-1) and neuron-specific enolase(NSE),and immune function(CD3^(+)+,CD4^(+)+,CD8^(+)and ratio of CD4^(+)+/CD8^(+)) before and after treatment were compared between the two groups. Results:After treatment,the total clinical effective rate was 84.44% in the treatment group and 66.67% in the control group, the difference being significant(P<0.05). After treatment, the levels of CA199, NSE and CYFRA21-1 in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of CA199,NSE and CYFRA21-1 in the treatment group were lower than those in the control group(P<0.05). The levels of CD3^(+)+,CD4^(+)+and CD4^(+)+/CD8^(+)in the treatment group were increased when compared with those before treatment,and the levels of CD8^(+)were decreased(P<0.05);the levels of CD3^(+)+,CD4^(+)+and CD4^(+)+/CD8^(+)in the treatment group were higher than those in the control group(P<0.05),and the level of CD8^(+)was lower than that in the control group(P<0.05). The incidence of adverse reactions was 24.44% in the treatment group and 57.78% in the control group,the difference being significant(P<0.05). Conclusion: Jianpi Yishen Jiedu Sanjie Decoction combined with TP chemotherapy for advanced NSCLC can improve the clinical effect,inhibit the metastasis and proliferation of tumor cells,enhance the body immunity and reduce the incidence of adverse reactions,with high medication safety.