复方斑蝥胶囊联合奥希替尼治疗晚期NSCLC患者的临床研究

Clinical Study of Compound Cantharidin Capsules Combined with Osimertinib in the Treatment of Advanced NSCLC Patients

目的:探讨复方斑蝥胶囊联合奥希替尼治疗晚期非小细胞肺癌(NSCLC)的效果及对患者血清、免疫相关指标的影响。方法:选取2021年9月—2022年9月九江市第一人民医院接收治疗的晚期NSCLC患者70例,按随机数字表法分为奥希替尼组和联合组。奥希替尼组(35例)给予口服奥希替尼治疗,联合组(35例)给予口服奥希替尼+复方斑蝥胶囊治疗。治疗8周后,比较两组疗效、血清相关指标[糖类抗原125(CA125)、基质金属蛋白酶9(MMP-9)、癌胚抗原(CEA)]、免疫相关指标[Ⅰ型辅助性T细胞(Th1)、Ⅱ型辅助性T细胞(Th2)及Th1/Th2]及毒副反应。结果:治疗后,联合组客观有效率(68.57%)高于奥希替尼组(42.86%);两组CA125、MMP-9、CEA均低于治疗前,且联合组上述指标均低于奥希替尼组(P<0.05)。治疗前,两组免疫相关指标比较差异均无统计学意义(P>0.05);治疗后,联合组Th1、Th1/Th2均高于奥希替尼组,Th2则低于奥希替尼组(P<0.05);联合组毒副反应(白细胞降低、腹泻、周围神经毒性、肝功能异常、乏力)发生率均低于奥希替尼组(P<0.05)。结论:复方斑蝥胶囊联合奥希替尼治疗晚期NSCLC可提高客观有效率,降低患者血清CA125、MMP-9、CEA,改善免疫功能,减少毒副反应,安全性良好。

Objective:To investigate the effect of Compound Cantharidin Capsules combined with Osimertinib in the treatment of advanced non-small cell lung cancer(NSCLC)and its influence on serum and immune related indexes of patients.Method:A total of 70 patients with advanced NSCLC who received treatment in Jiujiang NO.1 People's Hospital from September 2021 to September 2022 were selected and divided into the Osimertinib group and the combination group according to the random number table method.The Osimertinib group(35 cases)was treated with oral Osimertinib,and the combination group(35 cases)was treated with oral Osimertinib+Compound Cantharidin Capsules.After 8 weeks of treatment,the curative effect,serum related indexes[carbohydrate antigen 125(CA125),matrix metalloproteinase-9(MMP-9),carcinoembryonic antigen(CEA)],immune related indexes[typeⅠhelper T cell(Th1),typeⅡhelper T cell(Th2)and Th1/Th2]and toxicity of the two groups were compared.Result:After treatment,the objective effective rate of the combination group(68.57%)was higher than that of the Osimertinib group(42.86%),CA125,MMP-9 and CEA in two groups after treatment were lower than those before treatment,and the above indexes in the combination group were lower than those in the Osimertinib group(P<0.05).Before treatment,there were no significant differences in immune related indexes between the two groups(P>0.05);after treatment,Th1 and Th1/Th2 in the combination group were higher than those in the Osimertinib group,and Th2 was lower than that in the Osimertinib group(P<0.05).The incidences of toxicity effects(leukopenia,diarrhea,peripheral neurotoxicity,abnormal liver function,fatigue)in the combination group were lower than those in Osimertinib group(P<0.05).Conclusion:Compound Cantharidin Capsules combined with Osimertinib in the treatment of advanced NSCLC can improve the objective effective rate of treatment,reduce the serum CA125,MMP-9 and CEA,improve immune function and reduce toxicity and side effects,with good safety.