肺瘤消积方联合吉非替尼治疗痰瘀互结型晚期非小细胞肺癌的临床疗效

Clinical efficacy of Feiliu Xiaoji formula combined with gefitinib in treating advanced non-small cell lung cancer of phlegm and blood stasis type

目的探讨肺瘤消积方联合吉非替尼治疗痰瘀互结型晚期非小细胞肺癌(NSCLC)的临床疗效及对血清肿瘤标志物和炎性因子水平的影响。方法选取2019年2月—2021年2月于我院就诊的痰瘀互结型晚期NSCLC患者100例,根据随机数字表法分为对照组和治疗组(n=50)。对照组患者口服吉非替尼片,治疗组患者在对照组的基础上加用肺瘤消积方,以21 d为1个治疗周期,两组患者均治疗4周期。对比分析两组血清肿瘤标志物和炎性因子水平、生活质量评分、无进展生存期(PFS)、中医症状分级、临床疗效、不良反应。结果治疗后,两组细胞角质蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、白细胞介素-1(IL-1)、IL-6、肿瘤坏死因子-α(TNF-α)水平以及癌症患者生命质量测定量表(QLQ-C30)评分均低于治疗前,且治疗组低于对照组(P<0.05);治疗组PFS显著长于对照组(P<0.05);两组中医症状分级均显著改善,且治疗组优于对照组(P<0.05);治疗组客观缓解率(ORR)、疾病控制率(DCR)(68.00%、84.00%)均显著高于对照组(42.00%、62.00%)(P<0.05);治疗组皮肤反应、腹泻总发生率(22.00%、50.00%)均显著低于对照组(42.00%、74.00%)(P<0.05)。结论肺瘤消积方联合吉非替尼治疗痰瘀互结型晚期NSCLC患者疗效显著,可有效降低患者血清CYFRA21-1、CA19-9、CEA、IL-1、IL-6、TNF-α水平,改善患者病情,且安全性较高。

Objective To investigate the clinical efficacy of Feiliu Xiaoji formula combined with gefitinib in treating ad-vanced non-small cell lung cancer(NSCLC)patients of phlegm and blood stasis type and its influences on the levels of se-rum tumor markers and inflammatory factors.Methods One-hundred patients with advanced NSCLC of phlegm and blood stasis type who were treated in our hospital between February 2019 and February 2021 were included and grouped into con-trol group and treatment group(n=50)according to the random number table method.Patients in the control group took gefi-tinib tablets orally,and those in the treatment group received gefitinib tablets plus Feiliu Xiaoji formula.One treatment cy-cle took 21 days,and all patients were treated for 4 cycles.The levels of serum tumor markers and inflammatory factors,the score of quality of life,progression-free survival(PFS),TCM symptom grading,clinical efficacy,and adverse reactions were compared between the two groups.Results After treatment,the levels of cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen(CEA),interleukin-1(IL-1),interleukin-6(IL-6),tu-mor necrosis factor-α(TNF-α),and the score of Quality of Life Questionnaire(QLQ-C30)were lower than those before treatment in both groups,and those of the treatment group were lower than those of the control group(P<0.05).The PFS of the treatment group was obviously longer than that of the control group(P<0.05).The TCM symptom grades in both groups were obviously improved,and those in treatment group were better than in control group(P<0.05).The objective response rate(ORR)and disease control rate(DCR)of the treatment group(68.00%,84.00%)were obviously higher than those of the control group(42.00%,62.00%)(P<0.05).In addition,the total incidences of skin reactions and diarrhea of the treatment group(22.00%,50.00%)were obviously lower than those of the control group(42.00%,74.00%)(P<0.05).Conclusion Feiliu Xiaoji formula combined with gefitinib was effective in treating advanced NSCLC patients of phlegm and blood stasis type.It can effectively reduce the serum levels of CYFRA21-1,CA19-9,CEA,IL-1,IL-6,and TNF-αof the patients,and improve the patient's condition with high safety.