扶正运化方联合消融治疗肺部多发磨玻璃结节的前瞻性随机对照研究  

Fuzheng Yunhua formula combined with ablation in treatment of pulmonary multiple ground-glass nodules:a prospective randomized controlled study

作　　者：费鸿翔[1] 王菲[2] 申长兴[2] 李明[2] 曹传武[2] 范理宏[2] FEI Hongxiang;WANG Fei;SHEN Changxing;LI Ming;CAO Chuanwu;FAN Lihong(Department of Traditional Chinese Medicine,Shanghai Tenth People’s Hospital of Tongji University,Shanghai 200072,China;Department of Integrated Traditional Chinese and Western Medicine,Shanghai Tenth People’s Hospital of Tongji University,Shanghai 200072,China)

机构地区：[1]同济大学附属第十人民医院中医科,上海200072 [2]同济大学附属第十人民医院中西医整合医学科,上海200072

出　　处：《肿瘤》2022年第7期481-488,共8页Tumor

摘　　要：目的:探究消融联合扶正运化方治疗肺部多发磨玻璃结节(multiple ground-glass nodules,mGGNs)的临床疗效。方法:108例肺部mGGNs患者随机分为治疗组(消融联合扶正运化方治疗)和对照组(仅进行消融),每组各54例。扶正运化方治疗12个月。比较2组治疗12个月后主病灶以及合并结节的变化,检测血液T细胞计数以及血清Ig、炎症因子和肿瘤标志物水平的变化,观察不良反应。结果:消融联合扶正运化方可以显著提高原位腺癌合并低至中危GGNs的主病灶清除率(60.0%vs 13.3%,P=0.030)、ⅠA期的疾病控制率(100%vs 87.50%,P=0.047)和血液T细胞总数(P<0.001),降低血清IL-6和IL-17A的水平(P<0.001),降低血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)的水平(P=0.003)。2组常见的不良反应均为气胸、胸痛和咯血,差异无统计学意义(P=0.710)。结论:消融联合扶正运化方可以有效消除肺部mGGNs主病灶,抑制第二原发肺癌的发生,并且有助于提高机体免疫力,同时减轻炎症反应,值得临床推广应用。Objective:To explore the clinical effect of ablation combined with Fuzheng Yunhua formula in the treatment of pulmonary multiple ground-glass nodules(mGGNs).Methods:One hundred and eight patients with pulmonary mGGNs were randomly divided into treatment group(ablation combined with Fuzheng Yunhua formula)and control group(ablation alone),with 54 patients in each group.The patients were treated with Fuzheng Yunhua formula for 12 months.The changes in dominant focus and non-ablation nodules were compared between the two groups.The blood T cell count and the changes in serum Ig,inflammatory factors and tumor markers were detected,and the adverse reactions were observed.Results:After one-year follow-up,ablation combined with Fuzheng Yunhua formula can significantly improve the cure rate of dominant focus in adenocarcinoma in situ complicated with low-to-moderate risk GGNs(60.0%vs 13.3%,P=0.030),enhance the disease control rate of stageⅠA lung cancer(100%vs 87.50%,P=0.047),increase the blood T cell count(P<0.001),reduce the serum IL-6 and IL-17A levels(P<0.001),and reduce the serum neuron-specific enolase(NSE)level(P=0.003).The common adverse reactions in both groups were pneumothorax,chest pain and hemoptysis,and there was no significant difference between the two groups(P=0.710).Conclusion:Ablation combined with Fuzheng Yunhua formula can effectively eliminate the dominant focus of mGGNs,inhibit the occurrence of the second primary lung cancer lesions,and help to improve the immunity of the body and reduce the inflammatory reaction,which is worthy of clinical application.

关 键 词：肺部多发磨玻璃结节 mGGNs 消融 中西医结合 扶正运化方 随机对照试验 

分 类 号：R734.2[医药卫生—肿瘤]