中药联合化疗在中晚期非小细胞肺癌治疗中减毒增效作用研究
|
摘要
目的探讨中药联合化疗在中晚期非小细胞肺癌治疗中的减毒增效作用。方法选择2016年1月至2018年1月辽宁省肿瘤医院及辽宁中医药大学附属第二医院收治的80例患者,随机分为治疗组及对照组。对照组40例,应用紫杉醇+卡铂方案化疗治疗;治疗组40例,应用中药联合化疗治疗。比较两组患者中医症状评分情况,T淋巴细胞亚群(CD3~+、CD4~+、CD4~+/CD8~+)及NK细胞,肿瘤标志物细胞角蛋白19片段(CYERA21-1)、鳞状细胞癌抗原(SCCA)、癌胚抗原(CEA)及毒副作用。结果治疗后,治疗组症状评分降低(P<0.01),而对照组症状评分升高(P<0.01),且组间比较差异有统计学意义(P<0.01)。治疗后,两组患者血红蛋白、白细胞及血小板值降低,且组间比较差异有统计学意义(P<0.05)。治疗后,治疗组CD3~+、CD4~+、CD4~+/CD8~+、NK细胞百分比均升高(P<0.05),且两组比较差异有统计学意义(P<0.05)。治疗前,两组患者肿瘤标志物(CEA、SCCA、CYERA21-1)比较差异无统计学意义(P>0.05);治疗后,两组上述指标水平均显著降低(P<0.05),组间比较差异无统计学意义(P>0.05)。结论中药联合化疗具有减毒增效的作用,对于改善临床症状、减轻毒副作用有一定的效果。
Objective To explore the attenuating and synergistic effect of traditional Chinese medicine(TCM) combined with chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC).Methods Totally 80 patients with advanced NSCLC admitted to Liaoning Cancer Hospital and the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were randomly divided into treatment group and control group,40 cases in each group.Control group was given Taxol and platinum chemotherapy,while treatment group was treated with TCM combined with chemotherapy.The TCM symptom scores,levels of T lymphocyte subsets(CD3~+,CD4~+ and CD4~+/CD8~+) and NK cells,tumor marker cytokeratin 19 fragment(CYERA21-1),squamous cell carcinoma antigen(SCCA) and carcinoembryonic antigen(CEA),and the toxic side effects were compared between the two groups.Results After treatment,the symptom score of treatment group was decreased significantly(P<0.01),while the score of control group was increased(P<0.01),there being significant differences between the two groups(P<0.01).After treatment,the value of hemoglobin,white blood cell and platelet in the two groups was significantly decreased(P<0.01),and the difference between the two groups was significant(P<0.01);the percentages of CD3~+,CD4~+,CD4~+/CD8~+ and NK cells in treatment group were increased(P<0.01),and the difference was significant compared with that in control group(P<0.05).There were no significant differences in tumor markers(CEA,SCCA and CYERA21-1) between the two groups before treatment(P>0.05),and the indexes in both groups were decreased after treatment(P<0.05),there being no significant difference between the two groups(P>0.05).Conclusion TCM combined with chemotherapy has attenuating and synergistic effect in the treatment of advanced NSCLC,which has certain effects on clinical symptoms and side effects.
Objective To explore the attenuating and synergistic effect of traditional Chinese medicine(TCM) combined with chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC).Methods Totally 80 patients with advanced NSCLC admitted to Liaoning Cancer Hospital and the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were randomly divided into treatment group and control group,40 cases in each group.Control group was given Taxol and platinum chemotherapy,while treatment group was treated with TCM combined with chemotherapy.The TCM symptom scores,levels of T lymphocyte subsets(CD3~+,CD4~+ and CD4~+/CD8~+) and NK cells,tumor marker cytokeratin 19 fragment(CYERA21-1),squamous cell carcinoma antigen(SCCA) and carcinoembryonic antigen(CEA),and the toxic side effects were compared between the two groups.Results After treatment,the symptom score of treatment group was decreased significantly(P<0.01),while the score of control group was increased(P<0.01),there being significant differences between the two groups(P<0.01).After treatment,the value of hemoglobin,white blood cell and platelet in the two groups was significantly decreased(P<0.01),and the difference between the two groups was significant(P<0.01);the percentages of CD3~+,CD4~+,CD4~+/CD8~+ and NK cells in treatment group were increased(P<0.01),and the difference was significant compared with that in control group(P<0.05).There were no significant differences in tumor markers(CEA,SCCA and CYERA21-1) between the two groups before treatment(P>0.05),and the indexes in both groups were decreased after treatment(P<0.05),there being no significant difference between the two groups(P>0.05).Conclusion TCM combined with chemotherapy has attenuating and synergistic effect in the treatment of advanced NSCLC,which has certain effects on clinical symptoms and side effects.
引文
[1] 杜凤华,闵旭红,梅晓冬.肺腺癌靶向治疗药物的应用及耐药机制[J].临床肺科杂志,2018,23(1):168-172.
[2] 李治桦,刘晓晴,李俭杰,等.二线不同化疗方案治疗小细胞肺癌的疗效和安全性比较[J].中国肺癌杂志,2015,15(5):280-288.
[3] 吴涛.自拟益气扶正化毒汤联合NP方案化疗对晚期非小细胞肺癌的临床疗效及预后的影响[J].四川中医,2017,36(4):100-102.
[4] 李康.中药联合化疗改善晚期非小细胞肺癌患者生活质量临床观察[J].辽宁中医杂志,2016,43(3):523-526.
[5] 郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:5.
[6] 汪丛丛,刘洪星,庄静,等.中医药联合同步放化疗治疗晚期非小细胞肺癌疗效及安全性的 Meta 分析[J].中国全科医学,2015,18(12):1406-1414.
[7] 王雪冰,李康.自拟生血方加减联合铂类化疗方案治疗非小细胞肺癌临床疗效分析[J].中华中医药学刊,2017,35(8):2164-2167.
[8] 宋腾,梁绍平,王华庆,等.复方阿胶浆改善化疗后骨髓抑制的临床疗效观察[J].天津医科大学学报,2016,19(1):24-27.
[9] 裴俊文,孙太振.益气化痰方抗肺癌化疗多药耐药的作用[J].中医学报,2018,33(12):2285-2289.
[10] 曾涛,韩旭,杨桂学,等.肺腺癌患者表皮生长因子受体基因突变与肿瘤标志物关系研究[J].中国肿瘤外科杂志,2018,10(6):360-364.
[11] 李思运.中医补益法在肺癌化疗不良反应治疗中的运用[D].南京中医药大学,2013.
[12] Ji Z,Bi N,Wang J,et al.Risk factors for brain metastases in locally advanced non-small cell lung cancer with definitive chest radiation[J].Int J Radiat Oncol Biol Phys,2014,89(2):330-337.
[13] 郑舞,杨金坤.肿瘤微环境及其中医病机[J].中医杂志,2015,56(20):1720-1724.
[14] 徐泳,何海浪,武琦,等.参麦注射液联合含铂一线化疗方案治疗非小细胞肺癌的Meta分析[J].中成药,2018,40(10):2150-2157.
[15] 陈汉锐,田华琴,陈志明,等.康艾注射液联合单药化疗治疗老年晚期非小细胞肺癌的有效性和安全性[J].实用医学杂志,2018,34(2):316-319.
[16] 刘庆春,王爱民,刘德传,等.健脾益气中药联合化疗治疗晚期非小细胞肺癌临床疗效[J].临床军医杂志,2017,45(11):1186-1188.
[17] 王振华,郭玮,宫艳美,等.康艾注射液联合PC化学治疗方案对非小细胞肺癌晚期患者的影响[J].中国临床实用医学,2018,9(2):4-8.
[18] 周莉莉,张凤鸣,王红.中药联合化疗治疗中晚期非小细胞肺癌的近期临床疗效分析[J].世界中医药,2017,12(8):1796-1799.
[19] 朱大鹏,王实,刘永军.扶正固本汤对恶性肿瘤化疗后临床疗效观察[J].中华中医药学刊,2014,32(14):3053-3057.
[20] 徐泳,何海浪,武琦,等.参麦注射液联合含铂一线化疗方案治疗非小细胞肺癌的Meta分析[J].中成药,2018,40(10):2150-2157.
[21] 陈秀艳,华燕艳,李杰.紫杉醇联合顺铂化疗和低分子肝素钠治疗老年非小细胞肺癌患者的效果[J].中国医药,2018,13(11):1651-1654.
[22] 朱倩云,姜建东,陈玉超.陈玉超主任运用调理气机辨治肺癌的经验探析[J].浙江中医药大学学报,2018,42(11):922-925.
[23] 刘瑞,花宝金.调理脾胃法防治肿瘤的理论探讨与实践应用[J].中华中医药杂志,2014,29(4):991-994.
[24] 罗丽华.化疗联合参麦注射液对晚期非小细胞肺癌患者细胞免疫及肿瘤恶性程度的影响[J].世界中医药,2017,12(5):1085-1089,1093.
[25] 王煜坤,冯桂阳.中晚期非小细胞肺癌患者采用中西医结合疗法的临床治疗效果研究[J].世界中医药,2017,12(6):1310-1313,1316.
[2] 李治桦,刘晓晴,李俭杰,等.二线不同化疗方案治疗小细胞肺癌的疗效和安全性比较[J].中国肺癌杂志,2015,15(5):280-288.
[3] 吴涛.自拟益气扶正化毒汤联合NP方案化疗对晚期非小细胞肺癌的临床疗效及预后的影响[J].四川中医,2017,36(4):100-102.
[4] 李康.中药联合化疗改善晚期非小细胞肺癌患者生活质量临床观察[J].辽宁中医杂志,2016,43(3):523-526.
[5] 郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:5.
[6] 汪丛丛,刘洪星,庄静,等.中医药联合同步放化疗治疗晚期非小细胞肺癌疗效及安全性的 Meta 分析[J].中国全科医学,2015,18(12):1406-1414.
[7] 王雪冰,李康.自拟生血方加减联合铂类化疗方案治疗非小细胞肺癌临床疗效分析[J].中华中医药学刊,2017,35(8):2164-2167.
[8] 宋腾,梁绍平,王华庆,等.复方阿胶浆改善化疗后骨髓抑制的临床疗效观察[J].天津医科大学学报,2016,19(1):24-27.
[9] 裴俊文,孙太振.益气化痰方抗肺癌化疗多药耐药的作用[J].中医学报,2018,33(12):2285-2289.
[10] 曾涛,韩旭,杨桂学,等.肺腺癌患者表皮生长因子受体基因突变与肿瘤标志物关系研究[J].中国肿瘤外科杂志,2018,10(6):360-364.
[11] 李思运.中医补益法在肺癌化疗不良反应治疗中的运用[D].南京中医药大学,2013.
[12] Ji Z,Bi N,Wang J,et al.Risk factors for brain metastases in locally advanced non-small cell lung cancer with definitive chest radiation[J].Int J Radiat Oncol Biol Phys,2014,89(2):330-337.
[13] 郑舞,杨金坤.肿瘤微环境及其中医病机[J].中医杂志,2015,56(20):1720-1724.
[14] 徐泳,何海浪,武琦,等.参麦注射液联合含铂一线化疗方案治疗非小细胞肺癌的Meta分析[J].中成药,2018,40(10):2150-2157.
[15] 陈汉锐,田华琴,陈志明,等.康艾注射液联合单药化疗治疗老年晚期非小细胞肺癌的有效性和安全性[J].实用医学杂志,2018,34(2):316-319.
[16] 刘庆春,王爱民,刘德传,等.健脾益气中药联合化疗治疗晚期非小细胞肺癌临床疗效[J].临床军医杂志,2017,45(11):1186-1188.
[17] 王振华,郭玮,宫艳美,等.康艾注射液联合PC化学治疗方案对非小细胞肺癌晚期患者的影响[J].中国临床实用医学,2018,9(2):4-8.
[18] 周莉莉,张凤鸣,王红.中药联合化疗治疗中晚期非小细胞肺癌的近期临床疗效分析[J].世界中医药,2017,12(8):1796-1799.
[19] 朱大鹏,王实,刘永军.扶正固本汤对恶性肿瘤化疗后临床疗效观察[J].中华中医药学刊,2014,32(14):3053-3057.
[20] 徐泳,何海浪,武琦,等.参麦注射液联合含铂一线化疗方案治疗非小细胞肺癌的Meta分析[J].中成药,2018,40(10):2150-2157.
[21] 陈秀艳,华燕艳,李杰.紫杉醇联合顺铂化疗和低分子肝素钠治疗老年非小细胞肺癌患者的效果[J].中国医药,2018,13(11):1651-1654.
[22] 朱倩云,姜建东,陈玉超.陈玉超主任运用调理气机辨治肺癌的经验探析[J].浙江中医药大学学报,2018,42(11):922-925.
[23] 刘瑞,花宝金.调理脾胃法防治肿瘤的理论探讨与实践应用[J].中华中医药杂志,2014,29(4):991-994.
[24] 罗丽华.化疗联合参麦注射液对晚期非小细胞肺癌患者细胞免疫及肿瘤恶性程度的影响[J].世界中医药,2017,12(5):1085-1089,1093.
[25] 王煜坤,冯桂阳.中晚期非小细胞肺癌患者采用中西医结合疗法的临床治疗效果研究[J].世界中医药,2017,12(6):1310-1313,1316.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |