祛毒扶正汤联合紫杉醇化疗方案治疗Ⅳ期非小细胞肺癌的疗效

Effect of Qudu Fuzheng Decoction(祛毒扶正汤)Combined with TP Chemotherapy in Treatment of StageⅣNSCLC

目的探讨祛毒扶正汤联合顺铂+紫杉醇(paclitaxel,TP)化疗方案治疗Ⅳ期非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效。方法选取80例2021年1月—2022年8月北京中医药大学第三附属医院收治的Ⅳ期NSCLC患者作为研究对象,对其进行如下分组:观察组(40例)和对照组(40例),采用随机数字表法的分组方式。对照组予以TP方案化疗治疗,观察组在对照组基础上给予祛毒扶正汤治疗。以21 d为1个周期,两组均维持治疗4个周期。比较两组治疗后的临床疗效,治疗期间的不良反应,治疗前后的中医症状积分、Piper疲乏量表(Piper fatigue scale,PFS)评分、肿瘤标志物水平、免疫功能。结果与对照组进行对比,治疗后观察组患者的临床总有效率处于较高水平;相较于治疗前,两组患者治疗后的痰中带血、气喘气促、咳嗽咯痰、体倦神疲、胸胁胀满评分、PFS评分、血清细胞角蛋白19片段(levels of serum cytokeratin 19 fragment,CYFRA21-1)、人鳞状细胞癌相关抗原(human squamous cell carcinoma-associated antigen,SCCAg)、糖类抗原125(carbohydrate antigen 125,CA125)、癌胚抗原(carcinoembryonic antigen,CEA)、PPN/MG61水平均降低,且相较于对照组,观察组更低;相较于治疗前,两组患者外周血免疫球蛋白A(IgA)、免疫球蛋白G(IgG)水平均升高,且相较于对照组,观察组更高;相较于治疗前,观察组患者治疗后的外周血CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、自然杀伤(NK)细胞水平均升高,且相较于对照组,观察组更高;相较于对照组,观察组患者治疗期间的骨髓抑制、肝功能损伤、消化道反应发生率均更低,差异有统计学意义(P<0.05)。结论祛毒扶正汤联合TP化疗方案治疗Ⅳ期NSCLC可有效降低中医症状积分和肿瘤标志物水平,减轻疲乏程度,抑制肿瘤生长,增强机体免疫功能,提高化疗耐受性,减少不良反应的发生,疗效显著。

Objective To investigate the efficacy of Qudu Fuzheng Decoction(祛毒扶正汤)combined with cisplatin+paclitaxel(TP)chemotherapy in the treatment of stageⅣnon-small cell lung cancer(NSCLC).Methods Eighty patients with stageⅣNSCLC admitted to the Third Affiliated Hospital of Beijing University of Chinese Medicine from January 2021 to August 2022 were selected as research objects,and divided into the following groups:observation group(40 cases)and control group(40 cases),using random number table method.The control group was treated with TP regimen chemotherapy,and the observation group was treated with Qudu Fuzheng Decoction on the basis of control group.With 21 d as a cycle,both groups maintained the treatment for 4 cycles.The clinical efficacy after treatment,the scores of syndrome of traditional Chinese medicine,Piper fatigue scale(PFS),the level of tumor marker,immune function before and after treatment and adverse reactions during treatment of both groups were compared.Results The total clinical effective after treatment rates of the observation group and the control group were 95.00%(38/40)and 80.00%(32/40),respectively,which were higher in the observation group than that in the control group.Compared to those before treatment,the scores of blood,asthma and shortness of breath,cough and phlegm,fatigue and fatigue,thorax and hypochthymus bloating,PFS score,the levels of serum cytokeratin 19 fragment(CYFRA21-1),human squamous cell carcinoma-associated antigen(SCCAg),carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA)and PPN/MG61 decreased in both groups after treatment,and the scores and the levels of of the observation group were lower than those of the control group.Compared with those before treatment,the levels of peripheral blood immunoglobulin A(IgA)and immunoglobulin G(IgG)in both groups increased,and the levels were higher in the observation group than those in the control group.Compared with those before treatment,the levels of peripheral blood CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+) and natural killer(NK)cells in the observation group increased after treatment,and the levels were higher in the observation group than those in the control group.Compared with that in the control group,the incidence of myelosuppression,liver function injury and digestive tract reaction in the observation group was lower during treatment,with statistical significance(P<0.05).Conclusion Qudu Fuzheng Decoction combined with TP chemotherapy regimen in the treatment of stageⅣNSCLC could effectively reduce the scores of syndrome of traditional Chinese medicine and the levels of tumor markers,reduce fatigue degree,inhibit tumor growth,enhance immune function,improve chemotherapy tolerance and reduce the occurrence of adverse reactions,with significant efficacy.