四君子汤合沙参麦冬汤加减联合靶向治疗EGFR突变中晚期肺癌临床效果观察  

Clinical observation of modified Sijunzi Decoction and Shashen Maidong Decoction combined with target therapy in the treatment of EGFR-mutated advanced lung cancer

作　　者：张厚云 王胜菊 陈书凯 李学敏 于萍 吴相飞 ZHANG Hou-yun;WANG Sheng-ju;CHEN Shu-kai(Department of Oncology,Pengshui County People's Hospital,Chongqing 409600,China)

机构地区：[1]重庆市彭水县人民医院肿瘤科,409600

出　　处：《中国实用医药》2024年第9期34-37,共4页China Practical Medicine

基　　金：重庆市科卫联合一般项目资助(项目编号:2020ZY023965)。

摘　　要：目的探讨四君子汤合沙参麦冬汤加减联合靶向治疗表皮生长因子受体(EGFR)突变中晚期肺癌的效果。方法60例EGFR突变中晚期肺癌患者,按随机数字表法分为观察组和对照组,各30例。对照组患者接受吉非替尼靶向治疗,观察组在对照组的基础上给予四君子汤合沙参麦冬汤加减治疗。比较两组患者临床疗效、卡氏功能状态(KPS)评分改善情况、不良反应发生情况以及治疗前后的免疫学指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平。结果治疗结束后,观察组客观有效率为66.7%,高于对照组的40.0%,差异具有统计学意义(P<0.05)。治疗后,观察组和对照组KPS评分改善总有效率分别为60.0%、33.3%,观察组高于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较治疗前明显升高,CD8^(+)水平较治疗前下降,且观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平显著高于对照组,CD8^(+)水平显著低于对照组,差异具有统计学意义(P<0.05)。观察组胃肠道反应、皮疹、肝/肾损伤发生率分别为36.7%、30.0%、23.3%,对照组胃肠道反应、皮疹、肝/肾损伤发生率分别为63.3%、56.7%、50.0%,观察组低于对照组,差异具有统计学意义(P<0.05)。结论在EGFR突变中晚期肺癌患者的治疗过程中,四君子汤合沙参麦冬汤加减联合靶向治疗可以提高临床疗效,改善临床症状,提升机体免疫功能,且降低患者不良反应发生率,生活质量得到明显改善。Objective To explore the effect of modified Sijunzi Decoction and Shashen Maidong Decoction combined with target therapy in the treatment of epidermal growth factor receptor(EGFR)-mutated advanced lung cancer.Methods 60 patients with EGFR-mutated advanced lung cancer were divided into an observation group and a control group according to random number table,with 30 cases in each group.The control group was treated with gefitinib target therapy,and the observation group was treated with modified Sijunzi Decoction and Shashen Maidong Decoction on the basis of the control group.The clinical efficacy,improvement of Karnofsky performance status(KPS)score,occurrence of adverse reactions and immunological indicators(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))before and after treatment were compared between the two groups.Results After treatment,the objective effective rate of the observation group was 66.7%,which was higher than 40.0%of the control group,and the difference was statistically significant(P<0.05).After treatment,the total improvement rate of KPS score in the observation group and the control group were 60.0%and 33.3%;the observation group was higher than the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)increased significantly in both groups and CD8^(+)level decreased compared with those before treatment;the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group were significantly higher than those in the control group,and the level of CD8^(+)was significantly lower than that in the control group.The difference was statistically significant(P<0.05).The incidence rates of gastrointestinal reaction,rash and liver/kidney injury were 36.7%,30.0%and 23.3%in the observation group,and 63.3%,56.7%and 50.0%in the control group;the observation group was lower than the control group,and the difference was statistically significant(P<0.05).Conclusion In the treatment of patients with EGFR-mutated advanced lung cancer,mo

关 键 词：四君子汤 沙参麦冬汤 靶向治疗 肺癌 表皮生长因子受体突变 

分 类 号：R734.2[医药卫生—肿瘤]