榄香烯联合恩度及顺铂治疗非小细胞肺癌恶性胸腔积液的疗效观察

Observation on the efficacy of elemene combined with Enduin and cisplatin in the treatment of malignant pleural effusion in non-small cell lung cancer

目的分析榄香烯联合恩度(重组人血管内皮抑制素)、顺铂治疗非小细胞肺癌恶性胸腔积液的效果。方法纳入2020年10月至2023年10月于聊城市第二人民医院就诊的非小细胞肺癌恶性胸腔积液患者98例,电脑随机数字法分组,研究组、对照组各49例,均行恩度及顺铂治疗,研究组则再加用榄香烯,完成近期疗效评估,治疗前/后测量患者血清肿瘤标志物、T淋巴细胞亚群,评估其体力状态及生活质量,统计患者胸痛、发热、白细胞减少等不良反应。结果缓解率比较,研究组为73.47%,显著高于对照组的51.02%,差异有统计学意义(P<0.05);治疗后研究组血清鳞状上皮细胞癌抗原(squamous cell carcinoma antigen,SCC)及癌胚抗原(carcinoembryonic antigen,CEA)为(6.98±0.71)mg/L、(7.05±0.73)mg/L,显著低于对照组的(8.06±0.88)mg/L、(8.45±0.91)mg/L,差异有统计学意义(P<0.05);治疗后研究组CD4^(+)及CD4^(+)/CD8^(+)T细胞为(44.97±4.87)%、(2.24±0.22),高于对照组的(41.63±4.69)%、(1.80±0.19),CD8^(+)T细胞为(20.05±2.17)%,低于对照组的(23.12±2.69)%,差异有统计学意义(P<0.05);治疗后研究组美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)评分为(1.47±0.15)分,低于对照组的(1.83±0.19)分,卡氏功能状态量表(Karnofsky Function Status Score,KPS)评分为(80.93±8.14)分,高于对照组的(76.14±7.91)分,差异均有统计学意义(P<0.05);研究组胸痛、白细胞减少、血小板减少等不良反应总发生率为32.65%,与对照组(26.53%)相比,差异无统计学意义(P>0.05)。结论榄香烯联合恩度、顺铂治疗非小细胞肺癌恶性胸腔积液效果良好,可下调患者肿瘤标志物水平,恢复其T淋巴细胞亚群平衡,有利于患者生活质量的改善。

Objective:To analyze the efficacy of elemene combined with Endostatin(recombinant human endostatin)and cisplatin in the treatment of malignant pleural effusion in non-small cell lung cancer.Methods:98 patients with non-small cell lung cancer and malignant pleural effusion who were treated in Liaocheng Second People’s Hospital from October 2020 to October 2023 were included.They were divided into groups with computer random number method.There were 49 cases in the research group and the control group respectively,all of whom underwent Endo and Orthopedic Surgery.For platinum treatment,the research team added elemene to complete the short-term efficacy evaluation.The patients'serum tumor markers and Tlymphocyte subpopulations were measured before/after treatment,their physical status and quality of life were evaluated,and the adverse reactions of the patients'chest pain,fever,and white blood cells were counted.Results:Comparing the response rate,the study group was 73.47%,which was significantly higher than the 51.02%in the control group(P<0.05);after treatment,the serum squamous cell carcinoma antigen(SCC)and carcinoembryonic antigen(carcinoembryonic antigen)in the study group were antigen,(CEA)was(6.98±0.71)mg/L,(7.05±0.73)mg/L,and the study group was significantly lower than the(8.06±0.88)mg/L,(8.45±0.91)mg/L of the control group(P<0.05);after treatment the CD4^(+)and CD4^(+)/CD8^(+)ratios in the study group were(44.97±4.87)%and(2.24±0.22),which were higher than those in the control group(41.63±4.69)%and(1.80±0.19).The CD8^(+)ratio was(20.05±2.17)%,which was lower than the(23.12±2.69)%in the control group(P<0.05);after treatment,the Eastern Cooperative Oncology Group(ECOG)score of the study group was(1.47±0.15)points,which was lower than the(1.83±0.19)points of the control group,and the score of the Karnofsky Function Status Score(KPS)was(80.93±8.14)points,which was higher than the(76.14±7.91)points in the control group(P<0.05);the total incidence of adverse reactions such as chest pain,leukopenia,and thrombocytopenia in the study group was 32.65%,which was not significantly different from the 26.53%in the control group(P>0.05).Conclusion:Elemene combined with Endol and Cisplatin has a good effect in the treatment of malignant pleural effusion of non-small cell lung cancer.It can reduce the level of tumor markers in patients and restore the balance of T lymphocyte subpopulations,which is beneficial to improving the quality of life of patients.