大剂量加味四君子汤序贯治疗老年中晚期非小细胞肺癌临床研究  

Clinical Study on Sequential Therapy of High-Dose Modified Sijunzi Decoction for Non-Small Cell Lung Cancer in the Middle and Late Stage in the Senile

作　　者：廖荣鑫 廖佳颖 邓银河 赵鹏 巫剑鸣 方可仁 吴伟康[3] 彭康 LIAO Rongxin;LIAO Jiaying;DENG Yinhe;ZHAO Peng;WU Jianming;FANG Keren;WU Weikang;PENG Kang(Intergrated Traditonal and Western Medicine Hospital of Southern Medical University,Guangzhou Guangdong 510315,China;Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510006,China;The Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou Guangdong 510275,China)

机构地区：[1]南方医科大学中西医结合医院,广东广州510315 [2]广州中医药大学,广东广州510006 [3]中山大学第三附属医院,广东广州510275

出　　处：《新中医》2023年第18期112-117,共6页New Chinese Medicine

基　　金：广东省中医药局科研项目(20221279);彭康全国名老中医药专家传承工作室([2022]第75号)。

摘　　要：目的:观察大剂量加味四君子汤序贯治疗老年中晚期非小细胞肺癌(NSCLC)的临床疗效。方法:选取90例老年中晚期NSCLC患者,根据随机数字表法分为对照组和试验组,每组45例。对照组给予对症支持治疗,试验组在对照组基础上给予大剂量加味四君子汤序贯治疗,2组均治疗35 d。比较2组治疗前后中医证候积分、Karnofsky功能状态(KPS)评分、中文版癌症治疗功能评价系统-肺癌模块(FACT-L) V4.0评分及免疫功能指标水平,记录不良反应发生率。结果:治疗后,试验组中医证候积分较治疗前降低,且低于对照组(P<0.05),对照组中医证候积分与治疗前比较,差异无统计学意义(P>0.05)。试验组KPS评分较治疗前升高,且高于对照组(P<0.05),对照组KPS评分较治疗前降低(P<0.05)。试验组身体状况、功能状况评分均优于对照组(P<0.05),2组社会家庭状况、情感状况、附加的关注情况评分与治疗前比较,差异均无统计学意义(P>0.05)。试验组CD3^(+)、CD4^(+)水平均较治疗前升高(P<0.05),自然杀伤细胞(NK细胞)水平较治疗前降低(P<0.05),对照组CD3^(+)、CD4^(+)水平均较治疗前降低(P<0.05),NK细胞水平与治疗前比较,差异无统计学意义(P>0.05)。2组胃肠道反应、骨髓抑制、肝功能损害、肾功能损害程度分级比较,差异均无统计学意义(P>0.05)。结论:大剂量加味四君子汤序贯治疗老年中晚期NSCLC,可以缓解患者的临床症状,改善其生活质量,增强免疫功能,安全性好。Objective:To observe the clinical effect of sequential therapy of high-dose modified Sijunzi Decoction for non-small cell lung cancer(NSCLC) in the middle and late stage in the senile.Methods:A total of 90 cases of senile patients with NSCLC in the middle and late stage were selected and divided into the control group and the experiment group according to the random number table method,with 45 cases in each group.The control group was given symptomatic support treatment,and the experiment group was given sequential therapy of high-dose modified Sijunzi Decoction based on the treatment of the control group.Both groups were treated for 35 days.Before and after treatment,the traditional Chinese medicine(TCM) syndrome scores,Karnofsky Performance Status(KPS) scores,Chinese version of Functional Assessment of Cancer Therapy-Lung(FACT-L) V4.0 scores,and immune function index levels were compared between the two groups.The incidence of adverse reactions was recorded.Results:After treatment,the TCM syndrome score in the experiment group was decreased when compared with that before treatment,and lower than that in the control group(P<0.05);there was no significant difference in the TCM syndrome score before and after treatment in the control group(P>0.05).The KPS score in the experiment group was increased when compared with that before treatment,and was higher than that in the control group(P<0.05),and the KPS score in the control group was decreased when compared with that before treatment(P<0.05).The scores of physical and functional status in the experiment group were better than those in the control group(P<0.05),and the scores of social and family status,emotional status,and additional attention between the two groups showed no significant differences(P>0.05).The levels of CD3^(+) and CD4^(+) in the experiment group were increased when compared with those before treatment(P<0.05),and the level of natural killer cell(NK cell) was decreased when compared with that before treatment(P<0.05);the levels of CD3^(+) and CD4

关 键 词：非小细胞肺癌 中晚期 老年人 四君子汤 大剂量 序贯疗法 生活质量 免疫功能 

分 类 号：R273[医药卫生—中西医结合]