基于临床受益反应评价扶正固本汤辅助治疗晚期肺癌疗效  

Evaluation of Fuzheng Guben Decoction in Treatment of Advanced Lung Cancer Based on Clinical Benefit Response

作　　者：李天传[1] 陈乃杰[1] 陈云莺[1] 张劭琴 LI Tianchuan;CHEN Naijie;CHEN Yunying;ZHANG Shaoqin(Fujian Cancer Hospital,Fujian Medical University Cancer Hospital,Fuzhou 350014,Fujian,China)

机构地区：[1]福建省肿瘤医院,福建医科大学附属肿瘤医院,福建福州350014

出　　处：《实用中医内科杂志》2021年第2期125-128,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：福建省中医药科研课题(2017FJZYZY206)。

摘　　要：目的探讨从临床受益反应评价扶正固本汤辅助治疗晚期肺癌的疗效。方法将90例晚期肺癌患者随机分为扶正固本组(化疗联合中药)45例与单纯化疗组45例,化疗方案采用顺铂/卡铂+紫杉醇/培美曲噻/依托泊苷。扶正固本组在单纯化疗组基础上再加服中药煎剂,200 m L/次,2次/d,早饭、晚饭后30 min温服,自化疗前一天开始口服至化疗二周期结束,共30 d,预防性止吐、保胃、保肝及水化、止痛等对症支持治疗两组相同。临床受益反应观察指标包括生活质量、临床症状、免疫与体质量变化。生活质量评价采用美国Rush-Pesbyterian-St.luke中心制定的肺癌治疗功能评价量表(FACT-L4.0)评估两组治疗前后变化、观察临床各症状改变及中医症状积分变化、体质量及免疫变化。结果治疗后扶正固本组FACT-L4.0量表中的躯体、功能活动、附加关注情况与治疗前相比,分值下降(P<0.05),情感与社会/家庭方面分值虽有下降。治疗后扶正固本组在社会/家庭生活,躯体,功能,情感及其他因素分值均低于化疗组,差异有统计学意义(P<0.05)。在中医症状、体质量、免疫方面,扶正固本组疗效高于化疗组。结论从临床受益反应评价扶正固本汤能提高晚期肺癌疗效,并能减轻化疗引起的骨髓抑制及肝功损害,使用安全。Objective To discuss the therapeutic effect of Fuzheng Guben Decoction for advanced lung cancerbased on the clinical benefit reaction.Methods Ninety patients with advanced lung cancer were randomly divided into two groups,45 in chemotherapy and Fuzheng Guben Decoction group and 45 in single chemotherapygroup.The chemotherapy was DDP(cisplatin)/CBP(carboplatin)combined with paclitaxel/pemetrexed/etoposide.Fuzheng Guben Decoctionand chemotherapy group was added Fuzheng Guben Decoction 200 mL each time,twice a day,taking in the morning and eveningthirty minutes after mealfrom the day before chemotherapy to the end of the second cycle,a total of 30 days.The best support care was the same in two groups,like vomit-stopping,gastricprotection,prechemotherapy hydration,protecting the liver,relieving pain,etc.The clinical benefit reaction was rated on grades in symptom,immunity,weight gain,survival quality with FACT-L4.0 of cancer treatment function evaluation systemdeveloped by Rush-Pesbyterian-st.Luke Center.Results According to the evaluation results of FACT-L4.0 scale,the improvement of physical,functional activities and related symptomsin the Fuzheng Guben Decoction and chemotherapy group was statistically significant compared with that before treatment(P<0.05).Emotion,social/family scores declined but were not statistically significant.The improvement of social/family,physical,functional activities,emotion and related symptoms,in the Fuzheng Guben Decoction and chemotherapy group were statistically significant compared with that of the single chemotherapygroup(P<0.05).In the aspects of symptoms,weight and immunity,the efficacy of Fuzheng Guben Decoction and chemotherapy group was also higher than that of the single chemotherapygroup.Conclusion Chemotherapy combined with Fuzheng Guben Decoction can improve the efficacy of advanced lung cancer,and can reduce myelosuppression and liver damage caused by chemotherapy and it is also safe.

关 键 词：临床受益反应 扶正固本汤 晚期肺癌 肺癌治疗功能评价量表 化疗 

分 类 号：R273[医药卫生—中西医结合]