中医综合方案维持治疗晚期非小细胞肺癌患者改善生活质量的临床疗效研究  

Clinical Study of Integrated Traditional Chinese Medicine Treatment as Maintenance Therapy for Patients with Advanced Non-small-cell Lung Cancer

作　　者：沈丽萍[1] 刘苓霜[1] 姜怡[1] 韩植芬[1] 简红[2] 

机构地区：[1]上海中医药大学附属龙华医院,上海200032 [2]上海交通大学附属胸科医院,上海200031

出　　处：《中华中医药学刊》2014年第7期1677-1681,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：上海市卫生局项目(2010L012A)

摘　　要：目的:观察中医综合方案维持治疗晚期非小细胞肺癌(Non-Small Cell lung cancer,NSCLC)患者的临床疗效,探讨中医综合方案在晚期NSCLC患者维持治疗中的作用。方法:采用前瞻性、随机对照研究方法,将88例晚期NSCLC一线治疗后疾病无进展者按1:1随机分成治疗组和对照组,21 d为1个周期,治疗直至疾病进展或出现不能耐受的不良反应或患者拒绝继续治疗。采用欧洲癌症研究与治疗组织的肺癌患者生存质量特异量表(EORTC QLQ-LC43)评定治疗前及2周期治疗后患者的生活质量(Quality of Life,QOL),并评价2周期治疗后患者的肿瘤客观疗效以及中医相关症状的变化。结果:①2周期维持治疗后治疗组各功能领域(除社会功能、认知功能)、总健康状况得分升高,各症状领域(除咯血、咽下困难、周围神经病、手臂或肩膀痛、其他部位痛)及经济困难领域得分下降,差异均有统计学意义(P<0.05)。②2周期治疗后,治疗组疾病控制率60.53%,对照组疾病控制率为30.77%,差异有统计学意义(P=0.002)。③2周期治疗后,治疗组症状积分下降,对照组症状积分上升,差异有统计学意义(5.84±3.49 vs.9.36±3.85,P=0.000)。结论:①中医综合方案维持治疗可以改善一线化疗后患者的生活质量和中医临床症状、提高病灶稳定率。②晚期NSCLC一线治疗病灶得到控制后可采取中医综合方案维持治疗。Objective：To observe clinical effects on integrated traditional Chinese medicine（TCM） treatment and chemotherapy in patients with non-progressive advanced non-small-cell lung cancer（NSCLC） after first-line chemotherapy.To discuss the role of integrated traditional Chinese medicine（TCM） treatment in maintenance therapy.Methods：The study was a prospective,randomized,controlled clinical trial.88 non-progressive patients with advanced NSCLC treated with first-line chemotherapy were randomized to the test group or the control group with the ratio of 1 ∶ 1.Each cycle was 21 days.Cycles were repeated until disease progression,unacceptable toxicity,or until the patients requested therapy discontinuation.The endpoints were quality of life（QOL）,TCM related symptoms,ECOG PS and disease control rate.Results：①The scores of all domains in the EORTC QLQ-LC43 at the end of the 2ndcycle treatment were statistically significantly higher in the test group than that in the control group except cognitive and social functions and the symptoms of dysphagia,hemoptysis,peripheral neuropathy and pain in arms,shoulder and other parts.②After two cycles treatment,disease control rates were 60.53% and 30.77%（P = 0.002） for the test group and the control group,respectively.（3） The total scores of the TCM related symptoms were decreased and the symptoms were relieved after treated with2 cycles of the integrated TCM treatment.It was statistically significantly better in the test group（P = 0.000）.Conclusion：It had higher disease control rate and can improve patients＇ symptoms,performance status and quality of life.

关 键 词：晚期非小细胞肺癌 维持治疗 中医综合方案 生活质量 

分 类 号：R258.8[医药卫生—中医内科学]