中西医联合治疗非小细胞肺癌术后疗效观察  

Curative Effect of Combined Chinese and Western Medicine in the Treatment of Postoperative Non-small Cell Lung Cancer

作　　者：王鹏[1] 李星晶[1] 杨文林[1] 沈芳[1] 

机构地区：[1]上海市第一人民医院宝山分院呼吸内科,上海200940

出　　处：《辽宁中医药大学学报》2015年第6期138-140,共3页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：上海市自然科学基金资助项目(11ZR1429000)

摘　　要：目的：探讨中药联合GP方案对非小细胞肺癌（Non-small-cell lung cancer,NSCLC）术后辅助化疗的作用。方法：78例经手术治疗的NSCLC患者术后41例采用GP化疗（对照组）,37例采用中药方剂＋GP化疗（研究组）,21 d为1周期,化疗2个周期。比较两组1、2、3年生存率和中医证候积分改变情况,采用流式细胞仪检测化疗前后T细胞及其亚群CD3、CD4、CD8、CD4/CD8的改变,比较两组生活质量改善情况和毒副反应。结果：研究组1、2、3年生存率分别为86.49%（32/37）、64.86%（24/37）和48.65%（18/37）,对照组为78.05%（32/41）、53.66%（22/41）和26.83%（11/41）,两组1年和2年生存率比较差异无统计学意义（P〉0.05）,3年生存率比较具有统计学意义（P〈0.05）。研究组的中医证候积分除胸痛外,气短、乏力、咳嗽和纳差改善程度均好于对照组,差异均具有统计学意义（P〈0.05）。研究组化疗后CD3、CD4、CD8、CD4/CD8无明显变化（P〉0.05）,而对照组CD3、CD4、CD8和CD4/CD8均有显著改变（P〈0.05）,并且化疗后两组CD3、CD4、CD8、CD4/CD8比较差异均具有统计学意义（P〈0.05）。研究组生活质量提高21例、降低5例、稳定11例,对照组提高6例、降低19例、稳定16例,两组经非参数检验显示差异具有统计学意义（P〈0.05）。两组Ⅲ-Ⅳ度白细胞减少（13.51%vs 29.27%）、血小板减少（16.22%vs 36.59%）和胃肠道反应（13.51%vs 21.95%）的发生率比较差异具有统计学意义（P〈0.05）。结论：中药方剂配合GP方案用于NSCLC患者术后辅助化疗,可以明显提高远期生存率和生活质量,缓解临床症状,防止免疫功能降低,并能降低毒副反应。Objective ： To discuss the curative effect of combined Chinese medicine and GP regimens as adjuvant chemotherapy in the treatment of postoperative non-small cell lung cancer （ NSCLC ）. Methods ： Of 71 cases with NSCLC,41 cases were given GP regimens postoperatively （control group ）and 37 cases were treated with Chinese medicine plus GP regimens （ study group ）. They were all treated with 2 courses, which lasted for 21 d. The 1,2,3 year survival rates, TCM syndrome score, quality of life and toxic side effects were compared, and the immunologic function including CD3, CD4, CD8 and CD4/CD8 were tested by flow cytometry. Resluts ： The 1,2,3 year survival rates in study group were 86.49%（ 32/37 ）, 64.86%（ 24/37 ） and 48.65%（ 18/37 ）,and in control group they were 78.05%（ 32/41 ）,53.66%（ 22/41 ）and 26.83%（ 11/41 ）. The two groups showed signifieances in 3 years survival rates （ P〈0.05 ）, but no difference in 1 year and 2 years （ P〉0.05 ）. The TCM syndromes changed more in study group than control group in shortness of breath, fatigue, cough and poor appetite except chest pain （P〈0.05）. The levels of CD3, CD4, CDs and CDn/CDs changed more in control group（ P〈0.05 ）, but there were no obvious changes in study group（ P〉0.05 ）. In quality of life, in study,group 21 cases improved, 5 cases decreased and 11 cases with stability, while in control group 6 cases improved, 19 cases decreased and 16 cases with stability, where produced significance （P〈0.05）. The two groups showed significant differences in leukocytopenia （ 13.51% vs 29.27% ）, thrombocytopenia （ 16.22% vs 36.59% ）and gastrointestinal reaction （ 13.51% vs 21.95% ）. Conclusions： Traditional Chinese medicine （ TCM ） plus GP regimens used in postoperative NSCLC patients, can significantly improve the long-term survival rate and quality of life, relieve the clinical symptoms, prevent immune function, and reduce the adverse reaction.

关 键 词：非小细胞肺癌 生存率 辅助化疗 扶正祛邪 

分 类 号：R734.2[医药卫生—肿瘤]