健脾益肺散结方联合隔物灸治疗晚期非小细胞肺癌临床观察  

Clinical Observation of Advanced Non-small Cell Lung Cancer Treated with Jianpi Yifei Sanjie Decoction(健脾益肺散结方)and Indirect Moxibustion

作　　者：郭婷婷[1] 张国铎[1] 胡陵静[1] 苏立[1] 白平[1] 何苗[1] 陈皎皎[1] GUO Tingting;ZHANG Guoduo;HU Lingjing;SU Li;BAI Ping;HE Miao;CHEN Jiaojiao(Chongqing Hospital of Traditional Chinese Medicine,Chongqing 400011,China)

机构地区：[1]重庆市中医院,重庆400011

出　　处：《辽宁中医药大学学报》2022年第9期88-91,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：重庆市科研院所绩效激励引导专项项目(cstc2018jxjl130005)。

摘　　要：目的观察健脾益肺散结方联合隔物灸治疗晚期非小细胞肺癌的临床疗效。方法对100例该院确诊为非小细胞肺癌的患者采用随机数字表法分为试验组和对照组,每组50例,每组均接受标准方案化疗(方案包括非鳞非小细胞肺癌用培美曲塞+顺铂、鳞癌用吉西他滨+顺铂),常规给予预处理,每21 d为1周期。试验组在对照组化疗基础上口服中药汤剂并使用隔物灸法,两组均分别于第1、3、5周期前及末次化疗4周后行CT或MRI检查,并于每周期前复查一般情况、血常规、大便常规、尿常规、肝肾功能、心电图、肿瘤标记物、凝血功能、T淋巴细胞功能检测等,评价疗效及不良反应。结果试验组和对照组患者的疾病控制率、中位无进展生存期(progression-free survival,PFS)等指标的差异无统计学意义,提示该中医疗法对晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者化疗的近期疗效无明显影响;试验组治疗后中医临床证候评分降低、体力状况评分提高较对照组明显,差异有统计学意义,提示该中医疗法可有效缓解患者临床症状,改善患者的体力状况,提高其生活质量;治疗后试验组CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)值均提高,而对照组均有降低,两组差异有统计学意义(P<0.05),两组CD8+在治疗后均有所下降,且试验组下降更为明显(P<0.05),提示化疗对患者的免疫功能有抑制作用,而该中医疗法可有效改善患者的免疫功能;试验组治疗后白细胞减少、血小板减少、贫血、胃肠道反应等较对照组少,差异有统计学意义(P<0.05),两组肝肾功能损害的不良反应相当,差异无统计学意义(P>0.05),试验组Ⅲ、Ⅳ度等严重不良反应较对照组少,提示该中医疗法可降低化疗所致的骨髓抑制、消化道反应等不良反应。结论健脾益肺散结方联合隔物灸治疗晚期非小细胞肺癌临床效果明显,可改善化疗药物导致的不良反�Objective To observe the clinical effect of Jianpi Yifei Sanjie Decoction(健脾益肺散结方)combined with indirect moxibustion in the treatment of advanced non-small cell lung cancer(NSCLC).Methods 100 patients with NSCLC were randomly divided into experimental group and control group,50 cases in each group.Each group received standard chemotherapy(pemetrexed+cisplatin for nonsquamous NSCLC and gemcitabine+cisplatin for squamous cell carcinoma).They were given routine pretreatment every 21 days as a cycle.On the basis of control chemotherapy,the experimental group was treated with TCM Decoction and indirect moxibustion.CT or MRI examination was performed before the first,third and fifth cycle and 4 weeks after the last chemotherapy in both groups.The general condition,blood routine,stool routine,urine routine,liver and kidney function,ECG,tumor markers,coagulation function and T lymphocyte function were reexamined before each cycle.The efficacy and adverse reactions were evaluated.Results There was no significant difference in disease control rate,median PFS and other indicators between the experimental group and the control group,suggesting that the TCM therapy had no significant effect on the short-term efficacy of chemotherapy in patients with advanced NSCLC;After treatment,the TCM clinical syndrome score of the experimental group decreased and the physical condition score increased significantly compared with the control group,the difference was statistically significant,suggesting that the TCM therapy can effectively alleviate the clinical symptoms of patients,improve the physical condition of patients and improve their quality of life;After treatment,the CD3+,CD4+,CD4+/CD8+values of the experimental group were increased,while those of the control group were decreased,the difference was statistically significant(P<0.05).The CD8+values of the two groups were decreased after treatment,and the decrease of the experimental group was more obvious(P<0.05),suggesting that chemotherapy can inhibit the immune fun

关 键 词：健脾益肺散结方 隔物灸 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]