| 引用本文:蒋庆锋1，马东阳2，程金华1，邢文群1.小柴胡汤对肺癌晚期患者生命质量、免疫能力及炎性反应效应的影响[J].世界中医药,2019,(04):. |
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| 小柴胡汤对肺癌晚期患者生命质量、免疫能力及炎性反应效应的影响 |
| Effects of Xiaochaihu Decoction on Life Quality，Immunity and Inflammatory Effect in Patients with Advanced Lung Cancer |
| 投稿时间：2018-09-13 |
| DOI：10.3969/j.issn.1673-7202.2019.04.042 |
| 中文关键词: 肺癌晚期；小柴胡汤 加减辨治；炎性反应状态；免疫功能；生命质量；疗效；不良反应 |
| English Keywords:Advanced lung cancer Xiaochaihu Decoction Modified syndrome differentiation and treatment Inflammatory state Immune function Quality of life Curative effect Toxic and adverse effects |
| 基金项目:河南省医学教育研究项目（Wjlx2015242） |
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| 中文摘要: |
| 目的：分析小柴胡汤辅助化疗对肺癌晚期患者生命质量、免疫功能、炎性反应效应及化疗不良反应及临床预后的影响，为制定提升肺癌晚期患者生命质量方案提供参考。方法：选取2015年1月至2018年1月郑州大学附属肿瘤医院收治的非小细胞肺癌晚期全身化疗患者50例作为研究对象，按照入组顺序编号，以单双号分组，单号为对照组，双号为观察组，每组25例。2组患者均行GP化疗方案（吉西他滨+顺铂及抗药物不良反应的药物：昂丹司琼+胃复安+地塞米松+速尿+维生素C等）。观察组患者在上述治疗基础上，分别于化疗前、化疗过程中予以小柴胡汤化裁辨治至化疗结束。2组均以3周为1个疗程，连续治疗2个疗程。比较2组患者治疗前、肿瘤患者生命质量评分（KPS）及生命质量改善效果，以及免疫功能指标（CD3+、CD4+、CD8+、CD4+/CD8+），血清炎性反应指标（IL-6、IL-10、IL-13、S100A8、S100A9）的变化，收集患者治疗期间不良反应，评价2组患者临床疗效。结果：1）完成治疗后，观察组患者临床预后总有效率明显高于对照组（P<0.05）；2）完成治疗后，观察组患者KPS评分较治疗前明显提升，且明显高于对照组（P<0.05），对照组与治疗前比较，差异无统计学意义（P>0.05），观察组患者生命质量改善率明显高于对照组（均P<0.05）下降率明显低于对照组（均P<0.05）。3）2组患者完成治疗后血清炎性反应因子IL-6、IL-10、IL-13、S100A8、S100A9较治疗前降低（均P<0.05），且观察组明显低于对照组（均P<0.05）。4）观察组治疗后CD3+、CD4+、CD4+/CD8+均较治疗前明显升高（均P<0.05），CD8+较治疗前明显下降（P<0.05）；对照组治疗前后上述指标比较，差异无统计学意义（P>0.05）。5）治疗过程中，对照组不良反应率明显高于观察组（P<0.05）。结论：小柴胡汤可有效降低肺癌晚期患者炎性反应效应，提升免疫功能，提高临床疗效及患者生命质量，并有效降低全身化疗后患者的不良反应，是全身化疗肺癌晚期患者的有效辅助治疗措施，具有较好的临床价值。 |
| English Summary: |
| To analyze the effects of adjuvant chemotherapy with Xiaochaihu Decoction on life quality，immunity，inflammatory effect and toxic and adverse effects of chemotherapy in patients with advanced lung cancer and its clinical prognosis，and to provide reference for the making of plans for the improvement of life quality of advanced lung cancer patients.Methods:A total of 50 patients with advanced non-small cell lung cancer(NSCLC）receiving systemic chemotherapy in Henan Cancer Hospital from January 2015 to January 2018 were included in this study.They were numbered according to the inclusion order and divided into two groups：patients with odd numbers went to the control group and those with even numbers were in the observation group，with 25 cases in both groups.Both groups were treated with GP chemotherapy(gemcitabine+cisplatin and antitoxic drugs：ondansetron+metoclopramide+dexamethasone+furosemide+vitamin C）for three weeks per course and two consecutive courses.On the basis of the above treatment，the patients in the observation group were additionally treated with modified Xiaochaihu Decoction according to individual pattern before and during the course of chemotherapy until the end.Quality of life score(KPS）and the result of life quality improvement，immune function indexes(CD3+，CD4+，CD8+，CD4+/CD8+)，serum inflammatory indexes(IL-6，IL-10，IL-13，S100A8，S100A9）of the 2 groups were compared before and after treatment.Toxic and adverse effects were documented and compared between the 2 groups during the treatment.The clinical efficacy was evaluated and compared after the completion of treatment.Results:1）After treatment，the total effective rate of clinical prognosis of the observation group was significantly higher than that of the control group(P<0.05);2）After treatment，the KPS score of the observation group was significantly higher than that of the control group(P<0.05).The difference of KPS score before and after the treatment of the control group was of no statistical significance(P>0.05).The improvement rate of quality of life in the observation group was significantly higher than that in the control group，and the decrease rate was significantly lower than that in the control group(P<0.05).3）The levels of serum inflammatory factors IL-6，IL-10，IL-13，S100A8 and S100A9 were decreased after the treatment，and that of the observation group was significantly lower than the control group(P<0.05).4）After treatment，the levels of CD3+，CD4+，CD4+/CD8+ in the observation group were significantly higher than before，and the levels of CD8+ in the 2 groups were both significantly lower than before(P>0.05); there was no statistically significant difference in the control group before and after treatment(P>0.05).5）During the treatment，the adverse effect rate of the control group was significantly higher than that of the observation group(P<0.05).Conclusion:Xiaochaihu Decoction can effectively reduce the inflammatory effect，enhance immune function，improve the clinical efficacy and quality of life of patients with advanced lung cancer，and effectively reduce the toxicity and adverse effects of systemic chemotherapy.It is an effective adjuvant treatment for patients with advanced lung cancer in systemic chemotherapy and has high clinical value. |
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