清燥救肺汤联合银翘三黄膏治疗肺腺癌靶向药物相关性皮疹的临床研究

Clinical Research on Qingzao Jiufei Decoction Combined with Yinqiao Sanhuang Ointment in the Treatment of Rash Related to Target Drugs for Lung Adenocarcinoma

目的:观察清燥救肺汤联合银翘三黄膏对肺腺癌靶向药物相关性皮疹的影响。方法:选择2021年2月至2022年2月于该院治疗的76例肺癌靶向药物所致相关性皮疹患者,以随机数字表法分组。对照组38例患者,给予常规西医治疗;观察组38例患者,在常规西医治疗基础上给予清燥救肺汤联合银翘三黄膏治疗。治疗前后检测两组患者肿瘤坏死因子α(TNF-α)、可溶性细胞间黏附分子-1(sICAM-1)、白细胞介素1β(IL-1β)、核因子κB(NF-κB)、巨噬细胞集落刺激因子(M-CSF)、趋化因子10(CXCL10)、胸腺基质淋巴细胞生成素(TSLP)、转化生长因子-α(TGF-α)、细胞角蛋白19片段抗原21-1(CYFRA21-1)和细胞角蛋白19降解片段-2G2(CK19-2G2)水平,进行皮疹面积、瘙痒评价,记录皮疹首次改善时间,检测角质层含水量、皮脂含量,观察皮疹分级,比较临床疗效。结果:治疗后,观察组患者的TNF-α、sICAM-1和IL-1β水平低于对照组,M-CSF、CXCL10、NF-κB和TSLP水平低于对照组,CYFRA21-1、CK19-2G2和TGF-α水平低于对照组,皮疹面积、瘙痒评分低于对照组,皮疹首次改善时间短于对照组,角质层含水量、皮脂含量高于对照组,皮疹分级优于对照组,差异均有统计学意义(P<0.05)。观察组患者的总有效率为97.37%(37/38),较对照组(81.58%,31/38)更高,差异有统计学意义(P<0.05)。结论:清燥救肺汤联合银翘三黄膏治疗肺腺癌靶向药物相关性皮疹,可抑制患者机体炎症,改善表皮生长因子受体信号传导,降低TSLP、肿瘤标志物水平,缩短皮疹首次改善时间,改善临床症状,提高皮肤屏障功能,改善皮疹分级,提高临床疗效。

OBJECTIVE:To observe the effects of Qingzao Jiufei decoction combined with Yinqiao Sanhuang ointment in the treatment of rash related to target drugs for lung adenocarcinoma.METHODS:A total of 76 patients with rash induced by target drugs for lung adenocarcinoma admitted into the hospital from Feb.2021 to Feb.2022 were selected and divided via random number table method,38 patients in the control group were given conventional western medicine therapy,and 38 patients in the observation group was given Qingzao Jiufei decoction combined with Yinqiao Sanhuang ointment based on conventional Western medicine therapy.The tumor necrosis factorα(TNF-α),soluble intercellular adhesion molecule-1(sICAM-1),interleukin-1β(IL-1β),nuclear factorκB(NF-κB),macrophage colony stimulating factor(M-CSF),chemokine 10(CXCL10),thymic stromal lymphopoietin(TSLP),transforming growth factor-α(TGF-α),cytokeratin 19 fragment antigen 21-1(CYFRA21-1)and cytokeratin 19 degradation fragment-2G2(CK19-2G2)levels of the two groups were detected before and after treatment,the rash area and pruritus of patients were evaluated,the first improvement time of rash was recorded,the water content and sebum content in stratum corneum of the two groups were detected,the rash classification and clinical efficacy were compared.RESULTS:After treatment,the TNF-α,sICAM-1 and IL-1βlevels of the observation group were lower than those of the control group,the M-CSF,CXCL10,NF-κB and TSLP levels of the observation group were lower than those of the control group,the CYFRA21-1,CK19-2G2 and TGF-αlevels of the observation group were lower than those of the control group,the rash area and pruritus score of the observation group were lower than those of the control group,the first improvement time of rash of the observation group was shorter than that of the control group,the water content and sebum content in stratum corneum of the observation group were higher than those of the control group,the rash classification of the observation group was better than that of the control group,all with statistically significant differences(P<0.05).The overall effective rate of the observation group was 97.37%(37/38),which was higher than that of the control group(81.58%,31/38),with statistically significant difference(P<0.05).CONCLUSIONS:Qingzao Jiufei decoction combined with Yinqiao Sanhuang ointment in the treatment of rash related to target drugs for lung adenocarcinoma can inhibit body inflammation,improve EGFR signal transduction,reduce TSLP and tumor marker levels,shorten the first improvement time of rash,improve clinical symptoms,enhance skin barrier function,improve rash classification and promote clinical efficacy.