摘要
[目的]观察中医辨证论治联合中药外洗治疗晚期非小细胞肺癌表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinaseinhibitor,EGFR-TKI)相关皮疹的临床疗效。[方法]入组出现EGFR-TKI相关皮疹的晚期非小细胞肺癌患者63例,随机分为中医治疗组32例和对照组31例,中医治疗组根据皮疹发展的不同阶段及表现,中医辨证分为风热型(初期)、湿热型(中期)、阴虚型(晚期),分别予消风散、萆薢渗湿汤、沙参麦冬汤内服1剂/日,同时予中药外洗2次/日;对照组予红霉素软膏外用2次/日,合并感染予米诺环素100mg 2次/日口服。治疗疗程均为6周。观察治疗前后皮疹分级与中医临床症状的变化。[结果]中医治疗组有效25例,稳定4例,无效3例,有效率78.13%;对照组有效7例,稳定11例,无效13例,有效率22.6%,中医治疗组较对照组EGFR-TKIs相关皮疹改善明显,差异有统计学意义(P<0.05)。中医治疗组与对照组治疗前肺癌中医症状评分分别为35.38±3.69与34.38±4.21,差异无统计学意义(P>0.05);中医治疗组治疗后中医症状评分为29.59±3.06,较治疗前降低,差异有统计学意义(P<0.05);对照组治疗后中医症状评分为33.29±4.08,较治疗前差异无统计学意义(P>0.05);治疗后中医治疗组中医症状评分优于对照组,差异有统计学意义(P<0.05)。[结论]中医分阶段辨证治疗联合中药外洗能显著改善晚期非小细胞肺癌患者EGFR-TKIs治疗相关皮疹,改善患者的中医临床症状。
[Objective]To observe the clinical efficacy of treatment based on syndrome differentiation combined with herbs external washing in the treatment of epidermal growth factor receptor tyrosine kinase inhibitor-related rash of advanced non-small cell lung cancer(NSCLC).[Methods]Sixty-three advanced non-small cell lung cancer patients with EGFR-TKIs-related rash were randomly divided into two groups. Thirty-two patients were divided into TCM group;thirty-one patients were divided into control group. The TCM group was divided into wind-heat type(initial stage), dampness-heat type(middle stage) and Yin-deficiency type(late stage) according to the differentiation of syndromes and different stages of rash. Xiaofeng Powder, Bixie Shenshi Decoction and Shashen Maidong Decoction were taken of oral administration once a day according to the syndromes differentiation, and herbs washing externally twice a day at the same time. The control group was treated with erythromycin ointment for external use twice a day and minocycline 100 mg twice a day for infection. The course of treatment was 6 weeks. The grade of rash and the change of clinical symptoms were observed before and after treatment. [Results]In the treatment group, 25 cases were effective, 4 cases were stable, 3 cases were ineffective, the efficiency was 78.13%.In the control group, 7 cases were effective, 11 cases were stable, 13 cases were ineffective, the efficiency was 22.6%. The TCM group was significantly better than the control group in EGFR-TKIs related rash(P<0.05).Before treatment, the TCM symptom scores of in TCM group and the control group were 35.38±3.69 and34.38±4.21(P>0.05). After treatment, the score of TCM symptoms in TCM group was 29.59±3.06, which was significantly different from before treatment(P<0.05). In control group, the score of TCM symptoms was 33.29±4.08 after treatment, and there was no significant difference between before and after treatment(P>0.05).After treatment, the TCM symptom scores was significantly different between the two groups(P <0.05). [Conclusion] TCM treatment based on differentiation of symptoms by different stages of rash combined with herbs external washing can significantly relieve the EGFR-TKIs-related rash in advanced non-small cell lung cancer, and relieve the clinical symptoms of TCM.
作者
黄挺
叶知锋
杨雪飞
张志娣
黄伶
郭俊华
HUANG Ting;YE Zhifeng;YANG Xuefei(Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou(310007))
出处
《浙江中医药大学学报》
CAS
2019年第12期1354-1357,1361,共5页
Journal of Zhejiang Chinese Medical University
关键词
非小细胞肺癌
皮疹
EGFR-TKIS
外治疗法
阶段
辨证论治
non-small cell lung cancer
rash
EGFR-TKIs
external therapy
treatment based on syndrome differentiation
