沙参麦冬汤加减辅助纳武利尤单抗治疗非小细胞肺癌患者的临床疗效  

Clinical Efficacy of Modified Shashen Maidong Decoction Assisting Nabuliumab in the Treatment of Patients with Non-Small Cell Lung Cancer

作　　者：孔之华 李娟娟 洪强 梁丽春 KONG Zhihua;LI Juanjuan;HONG Qiang;LIANG Lichun(Guangdong Provincial Hospital of Integrated Chinese and Western Medicine,Foshan,528200,China)

机构地区：[1]广东省中西医结合医院,广东佛山528200

出　　处：《中医药学报》2024年第9期64-68,共5页Acta Chinese Medicine and Pharmacology

基　　金：广东省中医药管理局科研项目(20212038)。

摘　　要：目的:探讨沙参麦冬汤加减辅助纳武利尤单抗治疗气阴两虚型非小细胞肺癌(NSCLC)的疗效以及对血清癌胚抗原(CEA)、恶性肿瘤特异性生长因子(TSGF)的影响。方法:选择2020年1月—2022年1月广东省中西医结合医院收治的102例气阴两虚型NSCLC患者,采用随机数字表法将患者分为对照组和治疗组,每组51例。对照组采用纳武利尤单抗治疗,治疗组采用沙参麦冬汤加减辅助纳武利尤单抗治疗,两组均治疗至出现不可耐受的毒性作用或肿瘤进展。比较两组客观缓解率(ORR)和疾病控制率(DCR),中位无进展生存期(PFS),不良反应的差异,并观察两组治疗前后中医证候积分、外周血以及血清CEA、TSGF水平变化。结果:治疗组ORR、DCR均高于对照组(P<0.05,P<0.01),免疫相关不良反应发生率以及总不良反应发生率低于对照组(P<0.05,P<0.01)。两组治疗后中医证候积分、血清CEA、TSGF水平较治疗前降低(P<0.05),外周血CD3^(+)细胞占比、CD4^(+)细胞占比、CD4^(+)/CD8^(+)比值均较治疗前增高(P<0.05),治疗组治疗后中医证候积分、血清CEA、TSGF水平低于对照组(P<0.05),外周血CD3^(+)细胞占比、CD4^(+)细胞占比、CD4^(+)/CD8^(+)比值高于对照组(P<0.05)。结论:沙参麦冬汤加减辅助纳武利尤单抗治疗气阴两虚型NSCLC可提高疗效,减轻不良反应,改善细胞免疫功能,延长生存时间。Objective:To investigate the therapeutic effect of modified Shashen Maidong decoction(MSMD)assisting nabuliumab on the treatment of non-small cell lung cancer(NSCLC)with both qi and yin deficiency,and on serum carcinoembryonic antigen(CEA)and malignant tumor specific growth factor(TSGF).Methods:A hundred and two patients with qi-yin deficiency NSCLC admitted to Guangdong Provincial Hospital of Integrated Chinese and Western Medicine from January 2020 to January 2022 were selected and divided into two groups with 51 cases in each group by random number table method.The control group was treated with nabuliumab,and the treatment group was treated with the same plus MSMD.Both groups were treated until the occurrence of intolerable toxic effects or tumor progression.Objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS),and adverse reactions were compared between the two groups.Changes in TCM symptom scores,peripheral blood and serum CEA and TSGF levels before and after treatment were observed in two groups.Results:The ORR rate and DCR rate of treatment group were higher than those of control group(P<0.05,P<0.01),and the incidence of immune-related adverse reactions and the incidence of total adverse reactions were lower than those of control group(P<0.05).After treatment,Traditional Chinese medicine(TCM)symptom score,serum CEA and TSGF levels decreased(P<0.05),and the proportion of CD3^(+)cells,CD4^(+)cells and CD4^(+)/CD8^(+)ratio in peripheral blood increased(P<0.05).The TCM syndrome score,serum CEA and TSGF levels in the treatment group were lower than those in the control group(P<0.05),and the proportion of CD3^(+)cells in peripheral blood,the proportion of CD4^(+)cells and the ratio of CD4^(+)/CD8^(+)were higher than those in the control group(P<0.05).Conclusion:Modified Shashen Maidong decoction assisting nabuliumab in the treatment of NSCLC with qi and yin deficiency can improve the curative effect,reduce adverse reactions,improve cellular immune function and prolong survival ti

关 键 词：非小细胞肺癌 气阴两虚型 沙参麦冬汤 纳武利尤单抗 

分 类 号：R256.14[医药卫生—中医内科学]