摘要
目的观察益气抗癌活血方联合同步放化疗治疗气虚血瘀型非小细胞肺癌患者临床疗效。方法选取2018年2月—2020年12月期间于商丘市第一人民医院就诊的96例气虚血瘀型非小细胞肺癌患者,按照随机数字表法分为对照组和治疗组。对照组48例患者给予放化疗治疗,治疗组48例患者在对照组基础上给予益气抗癌活血方治疗。观察两组患者临床疗效,治疗前后中医症状评分,血清鳞状细胞癌抗原(Squamous cell carcinoma antigen,SCC)、肿瘤特异性生长因子(Tumor Supplied Group of Factors,TSGF)、基质金属蛋白酶抑制剂-1(Tissue inhibitor of metalloproteinase-1,TIMP-1)水平,血清免疫功能指标[外周血细胞毒T细胞(Peripheral blood cytotoxic T cells,Tc)、自然杀伤细胞(Natural killer cell,NK)],卡氏生存质量(Karnofsky,KPS)评分、营养状况评估量表(Patient-Generated Subjective Global Assessment,PG-SGA)营养评分及不良反应。结果治疗后,治疗组临床有效率为85.11%,对照组临床有效率为68.09%,差异有统计学意义(P<0.05)。治疗后两组患者咳嗽咳痰、胸痛咯血、神疲乏力、形体消瘦、食欲减退、面色晦暗评分及血清SCC、TSGF、TIMP-1水平均较治疗前下降,差异有统计学意义(P<0.05);且治疗组咳嗽咳痰、胸痛咯血、神疲乏力、形体消瘦、食欲减退、面色晦暗评分及血清SCC、TSGF、TIMP-1水平均较对照组降低,差异有统计学意义(P<0.05)。治疗后治疗组Tc、NK水平均较治疗前升高,Tc、NK水平均高于对照组,差异有统计学意义(P<0.05)。治疗后对照组Tc、NK较治疗前无明显改变,差异无统计学意义(P>0.05)。两组患者治疗后PG-SGA评分均较治疗前降低,KPS评分均较治疗前升高(P<0.05)。治疗组治疗后PG-SGA评分较对照组低,KPS评分较对照组高,差异有统计学意义(P<0.05)。两组胃肠道损伤、骨髓抑制、脱发、放射性肺炎不良反应发生率比较,差异无统计学意义(P>0.05)。治疗组白细胞减少不良反应发生率低于对照组,差异有统计学意义(χ^(2)=5.817,P=0.016,P<0.05)。结论益气抗癌活血方联合同步放化疗治疗可改善气虚血瘀型非小细胞肺癌患者临床症状,降低血清SCC、TSGF及TIMP-1水平,提高患者免疫功能,改善患者的生活质量,中西医结合治疗可降低患者放化疗引起的毒副作用,延长患者的生存周期。
Objective To observe the clinical efficacy of Yiqi Kangai Huoxue Formula combined with concurrent radiochemotherapy in the treatment of non-small cell lung cancer(NSCLC)patients with qi deficiency and blood stasis.Methods Ninety-sixNSCLC patients with qi deficiency and blood stasis treated in the First People's Hospital of Shangqiu from February 2018 to December 2020 were enrolled and randomly divided into a treatment group and a control group according to a random number table.The 48 patients in the control group were treated with radiochemotherapy,and 48 patients in the treatment group received additional Yiqi Kangai Huoxue Formula on the basis of the therapeutic protocol of the control group.The clinical efficacy,traditional Chinese medicine(TCM)symptom scores,serum squamous cell carcinoma(SCC)antigen,tumor supplied group of factors(TSGF),tissue inhibitor of metalloproteinase-1(TIMP-1),serum immune function indexes[peripheral blood cytotoxic T cells(Tc)and natural killer cell(NK)],Karnofsky Performance Status(KPS)scores,Patient-Generated Subjective Global Assessment(PG-SGA)scores,and adverse reactions of the two groupswere observed.Results After treatment,the clinical effective rate of the treatment group was 85.11%,higher than 68.09% in the control group(P<0.05).After treatment,the scores of cough and expectoration,chest pain and hemoptysis,mental fatigue,body weight loss,loss of appetite,dull complexion,and serum SCC,TSGF,and TIMP-1 levels of the two groups were all lower than those before treatment(P<0.05),and the above indexes in the treatment group were lower than those in the control group(P<0.05).After treatment,the levels of Tc and NK in the treatment group were higher than those before treatment and also higher than those in the control group(P<0.05).After treatment,there was no significant change in Tc and NK in the control group as compared with those before treatment(P>0.05).After treatment,the PG-SGA scores of the two groups were lower and the KPS scores were higher than those before treatment(P<0.05).After treatment,the PG-SGA score in the treatment group was lower and the KPS score in the treatment group was higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions such as gastrointestinal injury,bone marrow suppression,alopecia,and radiation pneumonitis between the two groups(P>0.05).The incidence of leukopenia in the treatment group was lower than that in the control group(P<0.05).Conclusion Yiqi Kangai Huoxue Formula combined with concurrent radiochemotherapy can improve the clinical symptoms of NSCLC patients with qi deficiency and blood stasis,reduce serum SCC,TSGF,and TIMP-1 levels,and improve the immune function and the quality of life of the patients.Integrated TCM and western medicine treatment can reduce the radiochemotherapy-induced side effects and prolong the life cycle of patients.
作者
刘锋
王侃
周威
LIU Feng;WANG Kan;ZHOU Wei(Department of Thoracic Surgery,the First People's Hospital of Shangqiu,Shangqiu Henan 476000)
出处
《世界中西医结合杂志》
2022年第6期1242-1246,共5页
World Journal of Integrated Traditional and Western Medicine
基金
河南省卫生健康委员会文件(LHGJ20200832)。
关键词
益气抗癌活血方
气虚血瘀型
非小细胞肺癌
Yiqi Kangai Huoxue Formula
Qi Deficiency and Blood Stasis
Non-Small Cell Lung Cancer
