晚期非小细胞肺癌安罗替尼治疗前后中医证素、证型演变特征  

Evolution of Syndrome Elements and Syndrome Types of Advanced Non-small Cell Lung Cancer Before and After Treatment with Arotinib

作　　者：肖琳 王志武[2] 刘春秋[2] 李昕 张静[2] 么娇子 XIAO Lin;WANG Zhi-wu;LIU Chun-qiu;LI Xin;ZHANG Jing;ME Jiao-zi(School of Traditional Chinese Medicine,North China University of Science and Technology,Tangshan Hebei 063210,China;Tangshan Peopled Hospital,Tangshan Hebei 063000,China)

机构地区：[1]华北理工大学中医学院,河北唐山063210 [2]唐山市人民医院,河北唐山063000

出　　处：《中医药导报》2020年第2期28-31,34,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(81603475)。

摘　　要：目的:分析晚期非小细胞肺癌(NSCLC)经安罗替尼治疗前后中医证素、证型演变特征,为肺癌的中西医结合治疗提供新的研究思路。方法:选取2018年9月至2019年6月在本院接受安罗替尼治疗的120例晚期NSCLC患者。通过问卷调查收集其治疗前后的中医证候要素变化。结果:咳嗽(83.8%)、倦怠乏力(70.0%)、气短懒言(61.7%)、纳少(51.7%)、自汗(45.8%)、有齿痕(40.0%)、苔薄白(51.7%)和脉细(40.0%)占的证候较多,与治疗前比较,显著改善(P<0.05)。但五心烦热、口干、低热盗汗、两颊潮红、舌红少苔等阴虚证候与治疗前比较,呈现加重的趋势(P<0.05);治疗后,红舌、紫暗舌的比例上升(P<0.05),少苔的比例上升;治疗后,细滑脉、滑脉的比例下降(P<0.05),细数脉的比例显著上升(P<0.05),沉细脉和弦脉变化较小。结论:接受安罗替尼治疗的NSCLC患者治疗后,肺气虚和痰湿证候有所减轻,但气阴两虚和阴虚内热加重,建议辅以中医滋阴清热治疗。Objective: To analyze the evolution characteristics of TCM syndromes before and after the treatment of amroitinib in advanced non-small cell lung cancer(NSCLC), and to provide new research ideas for the treatment with integrated traditional Chinese and western medicine. Methods: A total of 120 patients with advanced NSCLC treated in our hospital from September 2018 to June 2019 were selected. The changes of TCM syndromes before and after treatment were collected by questionnaire survey. Results: The frequency was cough(83.8%), fatigue(70.0%), short breath and lazy speech(61.7%), sodium(51.7%), spontaneous sweat(45.8%), tooth mark(40.0%), thin white moss(51.7%) and fine pulse(40.0%) after treatment, which was better than that before treatment(P <0.05). However, symptoms of Yin deficiency, such as heat of the five nerves, dry mouth, night sweats of low heat, flush on both cheeks, red tongue and less moss, showed an aggravating trend compared with that before treatment(P<0.05). The distribution of tongue image also changed significantly after treatment. After treatment, the proportion of fine and smooth veins decreased(P<0.05), the proportion of fine veins increased significantly(P<0.05), and the changes of chord veins and sink veins were small. Conclusion: Lung qi deficiency and phlegm dampness is alleviated in NSCLC patients treated with anrotenil, but the symptoms of qi-Yin deficiency and Yin deficiency internal fever is aggravated. So the treatment of traditional Chinese medicine to clear heat and detoxify is necessary.

关 键 词：非小细胞肺癌 安罗替尼 证素 证候 早期干预 

分 类 号：R273[医药卫生—中西医结合]