世界中医药

目的:观察利用化疗联合益气养阴化痰毒中药治疗中晚期非小细胞肺癌患者的疗效,并对治疗方法的机制进行分析探索。方法:选取2016年2月至2016年7月于商丘市中医院确诊收治的中晚期非小细胞肺癌患者96例作为研究对象,随机分为对照组和观察组,每组48例。对照组采用标准化疗手段治疗;观察组采用化疗手段联合益气养阴化痰毒中药进行治疗。分别选取2组患者的2个疗程后的病灶变化、中医候症积分、行为状况（Karnofsky评分）、外周血象及细胞因子SLR-2R及TNF-α作为治疗指标进行疗效比较。结果:2组患者分别经过各自治疗后:病灶变化上,观察组有效率（16.67%）高于对照组（14.58%）,但差异无有统计学意义（χ2=0.079,P=0.779）,观察组的病灶稳定率（81.25%）高于对照组（60.42%）,且差异有统计学意义（χ2=5.042,P=0.025）;中药候症积分上,观察组的改善率（87.50%）高于对照组（58.33%）,且差异有统计学意义（χ2=21.542,P=0.000）;Karnofsky评分改善情况上,观察组的增加稳定率（72.92%）高于对照组（40.00%）,且差异有统计学意义（χ2=32.928,P=0.000）;外周血象变化上,观察组骨髓抑制占比（10.42%）低于对照组（50.00%）,且差异有统计学意义（χ2=37.152,P=0.000）;细胞因子SLR-2R及TNF-α变化上,观察组患者治疗后的细胞因子SLR-2R及TNF-α情况均优于对照组,且差异具有统计学意义（t=3.956,P=0.000;t=3.797,P=0.000）。结论:对于中晚期非小细胞肺癌患者采用益气养阴化痰毒重要联合化疗相较于单独使用化疗手段能够更好地控制病灶情况,缓解患者病情,增强治疗效果,值得在临床推广使用。

English Summary:

To observe the curative effect of chemotherapy combined with traditional Chinese medicine （TCM） in the treatment of advanced non-small cell lung cancer （NSCLC）, and to explore the mechanism of the treatment. Methods: Ninety-six patients with advanced non-small cell lung cancer （NSCLC） diagnosed in our hospital from February 2016 to July 2016 were randomly divided into a control group （n=48） and a treatment group （n=48）. The patients in the control group were treated with standard chemotherapy. The treatment group was treated with chemotherapy combined with TCM which benefits qi, tonifies yin and eliminates toxity and phlegm. Lesion changes, TCM syndrome score, Karnofsky score, peripheral blood and cytokines （SLR-2R and TNF-α） after 2 courses were selected as the therapeutic indexes of the two groups, and the therapeutic effects were compared between the two groups. Results: For lesion changes, the effective rate of the treatment group （16.67%） was higher than that of the control group （14.58%）, but the difference was not statistically significant （χ2=0.079, P=0.779）.The stability rate of the treatment group（81.25%） was higher than that of the control group（60.42%）, and the difference was statistically significant（χ2=5.042,P=0.025）. For TCM syndrome score, the improvement rate of treatment group（87.50%） was higher than that of the control group（60.42%）, and the difference was statistically significant（χ2=21.542, P=0.000）; for Karnofsky score, the increasing stability rate of the treatment group（72.92%） was higher than that of the control group（40.00%）, and the difference was statistically significant（χ2=32.928, P=0.000）; for peripheral blood change, the bone marrow suppression ratio of the treatment group （10.42%） was lower than that of the control group （50.00%）, and the difference was statistically significant （χ2=37.152,P=0.000）; for changes of cytokine SLR-2R and TNF-α, the situation of treatment group was better than that of the control group, and the difference was statistically significant （t＝3.956,P=0.000;t＝3.797,P=0.000）. Conclusion: The combined use of TCM and chemotherapy can better control the lesion condition, relieve patient’s condition and enhance the treatment effect in advanced non-small cell lung cancer than treating with chemotherapy alone. It is worthy to be popularized in clinic.

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