沙参麦冬汤加减辅助吉非替尼对老年晚期非小细胞肺癌患者免疫功能及不良反应的影响  

Effects of modified Shashen Maidong decoction combined with gefitinib on immune function and adverse reactions in elderly patients with advanced non-small cell lung cancer

作　　者：刘春燕 罗小燕[2] 刘慧玲[2] LIU Chunyan;LUO Xiaoyan;LIU Huiling(Department of Integrated Traditional Chinese and Western Medicine,Chengdu Shangjinnanfu Hospital,Chengdu 611730)

机构地区：[1]成都上锦南府医院中西医结合科,成都611730 [2]四川大学华西医院中西医结合科,成都610041

出　　处：《陕西中医》2020年第2期183-186,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：四川省科技基金资助项目(2019YFS0259)

摘　　要：目的:探究晚期非小细胞肺癌老年患者应用沙参麦冬汤加减辅助吉非替尼治疗对患者免疫功能以及不良反应的影响。方法:选择116例晚期非小细胞肺癌老年患者作为研究对象,依据随机分组以及患者实际情况按照1∶1原则将患者分为联合组和单一组,均为58例,单一组采用吉非替尼治疗,联合组在单一组治疗基础上应用沙参麦冬汤加减辅助治疗。比较两组患者治疗效果,治疗前后中医症状积分,免疫功能,不良反应以及远期疗效。结果:联合组治疗总有效率(94.83%)高于单一组(77.59%),差异有统计学意义(P<0.05);两组痰中带血、疲惫乏力、咳嗽、气短、头晕耳鸣、少气懒言、胸痛以及咯痰等中医症状评分较治疗前明显下降(P<0.05),联合组患者上述中医症状评分下降幅度明显高于单一组(P<0.05);两组患者治疗后CD4^+、CD8^+、CD4^+/CD8^+等指标较治疗前显著变化(P<0.05),治疗后联合组CD4^+、CD4^+/CD8^+指标明显高于单一组(P<0.05),CD8^+指标显著低于单一组(P<0.05);联合组和单一组患者治疗后不良反应发生率差异无统计学意义(10.34%与18.97%,P>0.05);联合组以及单一组患者半年复发率以及存活率差异比较无统计学意义(3.45%与10.34%,100%与93.10%;P>0.05),联合组患者1年复发率以及存活率显著优于单一组(13.79%与31.03%,96.55%与81.03%;P<0.05)。结论:晚期非小细胞肺癌老年患者采用沙参麦冬汤加减辅助吉非替尼治疗效果显著,可以改善患者免疫功能,同时未增加患者治疗不良反应。Objective:To investigate the effects of modified Shashen Maidong decoction combined with gefitinib on immune function and adverse reactions in elderly patients with advanced non-small cell lung cancer(NSCLC).Methods:A total of 116elderly patients with advanced NSCLC were selected as the subjects.They were randomly divided into the combined group and the single group according to the actual condition of the patient,with58patients in each group.Both groups were treated with gefitinib,and the combined group were additionally treated with modified Shashen Maidong decoction.The therapeutic effects,TCM symptom scores before and after treatment,immune function,adverse reactions and long-term curative effect were compared between the two groups.Results:The total effective rate of treatment in the combined group(94.83%)was higher than that in the single group(77.59%,P<0.05).The scores of TCM symptoms such as bloody sputum,fatigue,cough,shortness of breath,dizziness and tinnitus,lack of energy,chest pain and expectoration in both groups decreased significantly after treatment(P<0.05),and the decrease in the combined group was significantly greater than that in the single group(P<0.05).CD4^+,CD8^+and CD4^+/CD8+in both groups significantly changed after treatment(P<0.05).After treatment,CD4^+and CD4^+/CD8^+in the combined group were significantly higher than the single group(P<0.05),while CD8^+was significantly lower than the single group(P<0.05).There was no significant difference in the incidence of adverse reactions between the combined group and the single group(10.34%vs 18.97%,P>0.05).There was no statistical difference in the half-year recurrence rate or survival rate between the combined group and the single group(3.45%vs 10.34%,100%vs 93.10%,P>0.05).The 1-year recurrence rate and survival rate of the combined group were significantly better than the single group(13.79%vs 31.03%,96.55%vs 81.03%,P<0.05).Conclusion:Modified Shashen Maidong decoction combined with gefitinib is effective in the treatment of elderly patien

关 键 词：老年人 非小细胞肺癌 沙参麦冬汤加减 吉非替尼 免疫功能 不良反应 

分 类 号：R734.2[医药卫生—肿瘤]