百合固金汤联合化疗治疗晚期非小细胞肺癌肺肾阴虚证临床研究

Clinical Study on Baihe Gujin Decoction Combined with Chemotherapy for Advanced Non-Small Cell Lung Cancer with Lung-Kidney Yin Deficiency Syndrome

目的:观察百合固金汤联合TP化疗方案治疗晚期非小细胞肺癌(NSCLC)肺肾阴虚证的临床疗效。方法:以随机数字表法将84例NSCLC肺肾阴虚证患者分为观察组与对照组各42例。对照组给予紫杉醇与顺铂联合(TP)化疗方案治疗,观察组在TP化疗方案基础上给予百合固金汤治疗。治疗3个周期后,比较2组治疗前后的中医证候积分、Karnofsky功能状态(KPS)评分、血清肿瘤标志物[糖类抗原19-9(CA19-9)、糖类抗原12-5(CA12-5)、癌胚抗原(CEA)]及T淋巴细胞亚群指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比值)。比较2组的临床疗效与化疗毒副反应的发生率。结果:治疗后,观察组总有效率高于对照组(P<0.05)。2组中医证候积分均较治疗前降低(P<0.05),KPS评分均较治疗前升高(P<0.05)。观察组中医证候积分低于对照组(P<0.05),KPS评分高于对照组(P<0.05)。2组血清CA19-9、CA12-5及CEA水平均较治疗前降低(P<0.05),观察组3项指标的水平均低于对照组(P<0.05)。对照组CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)比值均较治疗前降低(P<0.05)。观察组CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)比值均高于对照组,CD8^(+)水平低于对照组,差异均有统计学意义,CD8^(+)水平较治疗前升高,差异均有统计学意义(P<0.05)。观察组肝肾功能损害、胃肠道反应、白细胞减少、血小板减少、骨髓抑制的发生率均低于对照组(P<0.05)。结论:采用百合固金汤联合TP化疗方案治疗晚期NSCLC肺肾阴虚证的疗效优于单纯采取TP化疗方案治疗,可更为有效地减轻症状,抑制病情进展,保护机体的免疫功能,减少化疗毒副反应的发生。

Objective:To observe the clinical efficacy of Baihe Gujin Decoction combined with a combination of Paclitaxel and Cisplatin(TP)chemotherapy on advanced non-small cell lung cancer(NSCLC)with lung-kidney yin deficiency syndrome.Methods:A total of 84 cases of NSCLC patients with lung�kidney yin deficiency syndrome were divided into the observation group and the control group according to the random number table method,with 42 cases in each group.The control group was treated with TP chemotherapy,and the observation group was additionally treated with Baihe Gujin Decoction based on TP chemotherapy.After three cycles of treatment,traditional Chinese medicine syndrome scores,Karnofsky Performance Status(KPS)scores,serum tumor markers[carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 12-5(CA12-5),carcinoembryonic antigen(CEA)]and T lymphocyte subgroup indicators(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)ratio)were compared before and after treatment in the two groups.The clinical efficacy and the incidence of chemotherapy toxic side effects were compared between the two groups.Results:After treatment,the total effective rate in the observation group was higher than that in the control group(P<0.05).Traditional Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the KPS scores were increased when compared with those before treatment(P<0.05).The traditional Chinese medicine syndrome score in the observation group was lower than that in the control group(P<0.05),and the KPS score was higher than that in the control group(P<0.05).The levels of CA19-9,CA12-5 and CEA in serum in the two groups were reduced when compared with those before treatment(P<0.05),and the levels of above three indexes in the observation group were lower than those in the control group(P<0.05).The levels of CD3^(+)and CD4^(+)and the CD4^(+)/CD8^(+)ratio in the control group were reduced when compared with those before treatment,and the level of CD8^(+)in the control group was elevated when compared with that before treamtnent,difference being significant(P<0.05).The levels of CD3^(+)and CD4^(+)and the CD4^(+)/CD8^(+)ratio in the observation group were higher than those in the control group,and the level of CD8^(+)was lower than that in the control group,difference being significant(P<0.05).The incidence rates of liver and kidney function damage,gastrointestinal reactions,leukopenia,thrombocytopenia,and bone marrow suppression in the observation group were all lower than those in the control group(P<0.05).Conclusion:Baihe Gujin Decoction combined with chemotherapy has a better clinical effect than simple chemotherapy in the treatment of advanced NSCLC with lung-kidney yin deficiency syndrome.It can more effectively alleviate symptoms,inhibit disease progression,protect the body's immune function,and reduce the occurrence of chemotherapy toxic side effects.