参莲散结颗粒联合顺铂加培美曲塞对肺脾两虚型晚期非小细胞肺癌的疗效、TLR3和TLR7的影响  

Efficacy of Shenlian Sanjie Granules Combined with Cisplatin and Pemetrexed in the Treatment of Advanced Non-Small Cell Lung Cancer with Lung and Spleen Deficiency Syndrome and Its Effects on TLR3 and TLR7

作　　者：吴生保[1] 胡小莲 冯天明[1] WU Shengbao;HU Xiaolian;FENG Tianming(Dept.of Traditional Chinese Medicine Oncology,Tianchang Hospital of Tradition Chinese Medicine,Anhui Tianchang 239300,China)

机构地区：[1]天长市中医院中医肿瘤内科,安徽天长239300

出　　处：《中国医院用药评价与分析》2023年第10期1200-1205,共6页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：安徽省卫生健康委员会科研项目(No.20200317);安徽中医药大学临床科研项目(No.2016tclc003)。

摘　　要：目的:探讨参莲散结颗粒联合顺铂加培美曲塞对肺脾两虚型晚期非小细胞肺癌(NSCLC)的疗效、Toll样受体(TLR)3和TLR7的影响。方法:选择2018年6月至2020年11月该院收治的肺脾两虚型晚期NSCLC患者178例,通过随机数字表法分为观察组(参莲散结颗粒联合顺铂加培美曲塞治疗)和对照组(安慰剂颗粒联合顺铂加培美曲塞治疗),每组89例。比较两组患者的疗效、肿瘤标志物水平、免疫功能和生活质量,TRL3、TLR7水平以及不良反应发生情况。结果:观察组患者的总有效率、疾病控制率分别为49.44%(44/89)、83.15%(74/89),均高于对照组[28.09%(25/89)、53.93%(48/89)],差异均有统计学意义(P<0.001)。观察组患者治疗后的鳞状细胞癌相关抗原、细胞角蛋白19片段、糖类抗原125和癌胚抗原水平低于对照组(P<0.001),CD4^(+)、CD4^(+)/CD8^(+)、CD3^(+)和免疫球蛋白G水平高于对照组(P<0.01),总体健康状况、功能状况评分高于对照组(P<0.001),肺癌症状、一般症状评分低于对照组(P<0.001),TLR3水平高于对照组(P<0.001),TLR7水平低于对照组(P<0.001),上述差异均有统计学意义。观察组患者间质性肺炎、白细胞减少、恶心呕吐、皮疹、腹泻和贫血的发生率低于对照组,差异均有统计学意义(P<0.05)。结论:参莲散结颗粒能显著提高肺脾两虚型晚期NSCLC患者的疗效,降低肿瘤标志物水平,增强免疫功能,提高生活质量,升高TRL3水平,降低TRL7水平,减轻不良反应。OBJECTIVE:To probe into the efficacy of Shenlian Sanjie granules combined with cisplatin and pemetrexed in the treatment of advanced non-small cell lung cancer(NSCLC)with lung and spleen deficiency syndrome and its effects on Toll-like receptor 3(TLR3)and TLR7.METHODS:Totally 178 patients with NSCLC with lung and spleen deficiency syndrome admitted into this hospital from Jun.2018 to Nov.2020 were selected to be divided into observation group(treated with Shenlian Sanjie Granules combined with cisplatin and pemetrexed)and control group(treated with placebo granules combined with cisplatin and pemetrexed)via random number table method,with 89 cases in each group.The efficacy,tumor markers,immune function,quality of life,TRL3 and TLR7 levels,and incidences of adverse drug reactions were compared between two groups.RESULTS:The total effective rate and disease control rate were 49.44(44/89)and 83.15%(74/89)in the observation group,which were higher than 28.09%(25/89)and 53.93%(48/89)in the control group,with statistically significant differences(P<0.001).The squamous-cell carcinoma related antigen,cytokeratin 19 fragment,carbohydrate antigen 125 and carcino-embryonic antigen levels of the observation group were lower than those of the control group after treatment(P<0.001),the CD4^(+),CD4^(+)/CD8^(+),CD3^(+)and immune globulin G levels of the observation group were higher than those of the control group(P<0.01),scores of the overall health status and lung cancer symptom,function status and general symptoms of the observation group were higher than those of the control group(P<0.001),scores of the lung cancer symptoms and general symptoms of the observation group were lower than those of the control group(P<0.001),the TLR3 level was higher and the TLR7 level was lower in the observation group than those in the control group(P<0.001),with statistically significant differences.The incidences of interstitial pneumonia,leukocytopenia,nausea and vomiting,rash,diarrhea and anemia of the observation group were lower than tho

关 键 词：参莲散结颗粒 肺脾两虚型 晚期 非小细胞肺癌 TOLL样受体3 TOLL样受体7 

分 类 号：R932[医药卫生—生药学] R979.1[医药卫生—药学]