温补脾肾法改善肺癌免疫检查点抑制剂相关腹泻疗效观察  

Clinical observation of warming spleen and kidney to improve lung cancer immune checkpoint inhibitor associated diarrhea

作　　者：杨勃 卢霞 刘海阳 刘娜娜 王华中[2] YANG Bo;LU Xia;LIU Haiyang;LIU Nana;WANG Huazhong(The First Department of Oncology,Shaoyang Hospital of Traditional Chinese Medicine,Shaoyang 422000,China;The Second Department of Oncology,Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine,Changsha 410006,China)

机构地区：[1]邵阳市中医医院肿瘤内一科,湖南邵阳422000 [2]湖南省中医药研究院附属医院肿瘤二科,长沙410006

出　　处：《吉林中医药》2022年第7期792-795,共4页Jilin Journal of Chinese Medicine

基　　金：湖南省中医药科研计划项目(2021155)。

摘　　要：目的观察温补脾肾法对免疫检查点抑制剂(ICIs)治疗后出现腹泻症状的晚期非小细胞肺癌(NSCLC)患者的疗效。方法选择接受ICIs治疗并出现相关II级腹泻的晚期NSCLC患者100例,随机分为对照组与治疗组,各50例。对照组口服泼尼龙治疗,治疗组给予温肾补脾法,疗程均为4周。疗程结束后,评估2组临床疗效及中医证候评分变化,比较腹泻次数及大便性状改变,评估患者生活质量,记录疗程中不良反应发生情况。结果治疗4周后,2组疗效比较未见显著性差异(P>0.05);中医证候评分、大便次数、大便性状评分较治疗前均明显降低(P<0.05);与对照组比较,治疗组大便次数、大便性状评分差异未见统计学意义(P>0.05),治疗组KPS评分较对照组显著升高,中医证候积分及不良反应发生率较对照组明显降低(P<0.05)。结论温补脾肾法可有效改善ICIs导致的NSCLC腹泻症状,临床疗效与糖皮质激素相当,在提高患者生活质量及减少不良反应方面较激素治疗更具优势。Objective To observe the effect of the warmly invigorating the spleen and kidney method on advanced non-small cell lung cancer(NSCLC)patients with diarrhea after the immune checkpoint inhibitors(ICIs)therapy.Methods A total of 100 patients with advanced NSCLC who received an ICIs treatment and developed an associated grade II diarrhea were enrolled and divided into a control group and a treatment group,with 50 cases in each group.The control group was treated with prednisolone orally,while the treatment group was treated with the warmly invigorating the kidney and spleen method,both for 4 weeks.After the treatment,the clinical efficacy and TCM syndrome scores of the two groups were evaluated,the frequency of diarrhea and changes in stool character were compared,the quality of life of the patients was evaluated,and the occurrence of adverse reactions during treatment was recorded.Results After 4 weeks of treatment,there was no significant difference in the curative effect between the two groups(P>0.05).The scores of TCM syndromes,stool frequency,and stool character scores in the two groups were significantly decreased than before treatment(P<0.05),while compared with the control group,there was no significant difference in the stool frequency and the stool character scores in the treatment group(P>0.05).The KPS score in the treatment group was significantly increased than that in the control group,while the TCM syndrome score and adverse reaction rate were significantly decreased than those in the control group(P<0.05).Conclusion The method of warmly invigorating the spleen and kidney can effectively improve the ICIs-associated diarrhea symptoms of NSCLC patients,and its clinical efficacy is equivalent to that of glucocorticoids,yet it is more advantageous than the hormone therapy in improving the patients’quality of life and reducing adverse reactions.

关 键 词：温补脾肾法 免疫检查点抑制剂 腹泻 脾肾阳虚 肿瘤 

分 类 号：R273[医药卫生—中西医结合]