下气汤对中晚期非小细胞肺癌癌因性疲乏的防治作用研究  

Preventive and Therapeutic Effect of Xiaqi Decoction on Cancer-related Fatigue in Advanced Non-small Cell Lung Cancer

作　　者：高海利[1] 吴晋芳 陈尧[2] 谢壁元 GAO Hai-Li;WU Jin-Fang;CHEN Yao;XIE Bi-Yuan(Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510095 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广东省第二中医院,广东广州510095 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2022年第4期769-775,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20201025)。

摘　　要：【目的】观察下气汤对中晚期非小细胞肺癌癌因性疲乏(CRF)的防治作用和安全性。【方法】将60例中晚期非小细胞肺癌患者随机分为试验组和对照组,每组各30例。2组患者均按期正常化疗,对照组于化疗当天开始给予止呕、护肝、护胃治疗,以减轻及预防化疗副反应;试验组在对照组用药的基础上加用下气汤颗粒剂口服治疗,2组患者均连续治疗1个化疗周期(21 d)。观察2组患者治疗前后简易疲乏量表中文版(BFI-C)评分、食欲减退评分、中医肺癌症状分级评分、Karnofsky功能状态(KPS)评分的变化情况,并比较2组患者的骨髓抑制和胃肠道不良反应发生情况。【结果】(1)研究期间,对照组脱落2例,试验组脱落1例;最终试验组完成29例,对照组完成28例。(2)治疗后,2组患者的BFI-C评分、食欲减退评分均较治疗前升高(P<0.01),但试验组的BFI-C评分、食欲减退评分均明显低于对照组(P<0.01)。(3)治疗后,2组患者的中医肺癌症状分级评分均较治疗前降低(P<0.01),且试验组的降低作用明显优于对照组(P<0.01)。(4)治疗后,试验组的KPS评分较治疗前略升高,但差异无统计学意义(P>0.05),而对照组的KPS评分较治疗前明显降低(P<0.01);组间比较,试验组的KPS评分明显高于对照组(P<0.01)。(5)治疗后,2组患者的白细胞计数(WBC)、血小板计数(PLT)及对照组的血红蛋白(HGB)水平均较治疗前下降(P<0.01),但试验组的WBC、HGB和PLT水平均高于对照组(P<0.01)。(6)治疗期间,试验组的胃肠道不良反应发生率为34.5%(10/29),对照组为53.6%(15/28),组间比较,试验组的胃肠道不良反应发生率明显低于对照组(P<0.05)。【结论】下气汤防治中晚期非小细胞肺癌CRF疗效确切,能有效减轻患者肺癌症状,提高患者生活质量,并可在一定程度上减缓骨髓抑制发生速度,同时具有较高的安全性。Objective To observe the preventive and therapeutic effect as well as the safety of Xiaqi Decoction in treating cancer-related fatigue(CRF)of advanced non-small cell lung cancer(NSCLC).Methods Sixty patients with advanced NSCLC were randomly divided into trial group and control group,with 30 cases in each group.Patients in both groups received routine chemotherapy regularly,and additionally,the control group was given anti-emetic drugs and treatment for protecting liver and stomach on the first day of chemotherapy to reduce and prevent chemotherapy-induced side effects.The trial group was given oral administration of Xiaqi Decoction granules on the basis of treatment for the control group.The patients in two groups were treated for one cycle of chemotherapy(21 continuous days).The changes of Chinese version of the Brief Fatigue Inventor(BFI-C)scores,anorexia scores,lung cancer TCM symptom grading scores and Karnofsky Performance Status(KPS)scores were observed in the two groups before and after treatment,and the occurrence of bone marrow suppression and gastrointestinal adverse reactions in the two groups were also compared.Results(1)During the trial,2 cases in the control group and one case in the trial group fell off,and finally,29 cases in the trial group and 28 cases in the control group completed the trial.(2)After treatment,the BFI-C scores and anorexia scores in the two groups were increased compared with those before treatment(P<0.01),but the BFI-C scores and anorexia scores in the trial group were significantly lower than those in the control group(P<0.01).(3)After treatment,the grading scores of lung cancer TCM symptoms in both groups were lower than those before treatment(P<0.01),and the effect of trial group was significantly superior to that of the control group(P<0.01).(4)After treatment,the KPS scores of trial group were slightly increased compared with those before treatment,but the difference was not statistically significant(P>0.05).The KPS scores of the control group were significantly decrease

关 键 词：下气汤 中晚期非小细胞肺癌 化疗 癌因性疲乏 生活质量 骨髓抑制 胃肠道不良反应 临床研究 

分 类 号：R273.342[医药卫生—中西医结合]