沙参麦冬汤加减联合卡瑞利珠单抗加化疗治疗晚期非小细胞肺癌患者的临床疗效及对其生活质量的影响

Clinical Efficacy of Modified Shashen Maidong Decoction Combined with Carrelizumab Plus Chemotherapy in the Treatment of Advanced NSCLC and Its Impact on the Quality of Life of Patients

目的探讨沙参麦冬汤加减联合卡瑞利珠单抗+化疗治疗晚期非小细胞肺癌(Non-Small Cell Lung Cancer,NSCLC)患者的临床疗效及对其生活质量的影响。方法选取2018年9月—2019年8月期间华北理工大学附属邯郸明仁医院收治的晚期NSCLC患者78例作为研究对象,按随机数字表法分为对照组和观察组,每组各39例。对照组患者采用卡瑞利珠单抗+化疗治疗,观察组在对照组治疗基础上联合沙参麦冬汤加减治疗,以21 d为1个疗程,连续治疗4个疗程。观察比较两组患者无进展生存期、总生存期、临床疗效总有效率及不良反应发生率,治疗前后中医症状积分、生活质量改善情况。结果治疗后两组患者中医症状胸闷、咳嗽、乏力、气短懒言、自汗盗汗、口干咽燥积分均较治疗前明显降低,差异有统计学意义(P<0.05),且观察组积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者角色功能、躯体功能、情绪功能、认知功能及社会功能评分均较治疗前明显升高,差异有统计学意义(P<0.05);且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后观察组无进展生存期和总生存期均高于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床总有效率82.05%(32/39)明显高于对照组61.54%(24/39),差异有统计学意义(P<0.05)。治疗期间,观察组不良反应总发生率28.20%(11/39)明显低于对照组56.41%(22/39),差异有统计学意义(P<0.05)。结论采用沙参麦冬汤加减联合卡瑞利珠单抗+化疗治疗晚期NSCLC,能够显著改善患者临床症状,降低不良反应,改善患者生活质量,延长患者生存期,提高临床疗效。

Objective To explore the clinical efficacy of modified Shashen Maidong decoction combined with carrelizumab plus chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC)and its impact on the quality of life of patients.Methods A total of 78 patients with advanced NSCLC admitted to the Handan Mingren Hospital Affiliated to North China University of Science and Technology from September 2018 to August 2019 were selected as the study subjects.They were randomly divided into a control group and an observation group according to the random number table method,with 39 cases in each group.The patients in the control group were treated with carrelizumab combined with chemotherapy,and the patients in the observation group were treated with modified Shashen Maidong Decoction on the basis of the treatment in the control group,with 21 days as one course and 4 consecutive courses of treatment.The progression-free survival,overall survival,the total effective rate of clinical efficacy,the incidence of adverse reactions,the improvement of traditional Chinese medicine(TCM)symptom score and quality of life before and after treatment were observed and compared between the two groups.Results After the treatment,the scores of TCM symptoms such as chest tightness,cough,fatigue,shortness of breath and lazy speech,spontaneous sweating and night sweating,dry mouth and throat dryness in the two groups of patients were significantly reduced compared to those before treatment,with a statistically significant difference(P<0.05).Moreover,the scores in the observation group were significantly lower than those in the control group,with a statistically significant difference(P<0.05).After treatment,the scores of role function,physical function,emotional function,cognitive function,and social function of the two groups of patients were significantly higher than those before treatment,and the difference was statistically significant(P<0.05);and the scores in the observation group were higher than those in the control group,with a statistically significant difference(P<0.05).After treatment,the progression-free survival and overall sur5vival of the observation group were higher than those of the control group,with statistically significant differences(P<0.05).After treatment,the total effective rate of 82.05%(32/39)in the observation group was significantly higher than that in the control group(61.54%,24/39),with a statistically significant difference(P<0.05).The total incidence of adverse reactions during treatment in the observation group was 28.20%(11/39),which was significantly lower than that in the control group(56.41%,22/39),with a statistically significant difference(P<0.05).Conclusion Modified Shashen Maidong decoction combined with carrelizumab plus chemotherapy in the treatment of advanced NSCLC can significantly improve patients′clinical symptoms,reduce adverse reactions,improve patients′quality of life,prolong patients′survival time and improve clinical efficacy.