固本化積湯聯(lián)合化療治療晚期非小細(xì)胞肺癌的臨床觀察

1、固本化積湯聯(lián)合化療治療晚期非小細(xì)胞肺癌的臨床觀察 11-05-17 15:14:00 編輯：studa20 作者：王宏樂 龍志芳 朱士奎 王貴辰 高社光 鄭金海 趙鐵英 康日新 陳金鵬【摘要】 目的 觀察固本化積湯聯(lián)合化療治療晚期非小細(xì)胞肺癌的近期療效。方法 將194例晚期非小細(xì)胞肺癌患者隨機(jī)分為2組。治療組102例采用固本化積湯(每日1劑，1個(gè)月為1個(gè)療程，共治療3個(gè)療程)配合化療(NP或VP方案，3周為1個(gè)療程，共治療3個(gè)療程)治療。對照組92例單純予化療，方法同治療組。觀察2組瘤體大小變化、生活質(zhì)量、體質(zhì)量、主要癥狀改善情況及不良反應(yīng)情況。結(jié)果 治療組瘤體變化有效率28.4%，對照組13

2、.0%，2組比較差異有統(tǒng)計(jì)學(xué)意義(P0.01)；治療組治療后卡氏評分與本組治療前及對照組治療后比較差異均有統(tǒng)計(jì)學(xué)意義(P0.01)；對照組治療后體質(zhì)量與本組治療前及治療組治療后比較差異均有統(tǒng)計(jì)學(xué)意義(P0.01)；治療組預(yù)后情況、癥狀改善情況均優(yōu)于對照組(P0.05，P0.01)。治療組不良反應(yīng)情況少于對照組(P0.05，P0.01)。結(jié)論 固本化積湯聯(lián)合化療治療晚期非小細(xì)胞肺癌近期療效優(yōu)于單純化療，可作為晚期非小細(xì)胞肺癌的有效治療方案。 【關(guān)鍵詞】 癌 非小細(xì)胞肺 抗腫瘤聯(lián)合化療方案 中藥療法 【Abstract】 Objective To observe the short term th

3、erapeutic efficacy of integrated Gubenhuaji Decoction and chemotherapy (IGDC) in treating non-small cell lung cancer(NSCLC) in and phase. Methods 194 patients with non-small cell cancer(NSCLC) in and phase were randomly divided into the IGDC group (n=102) and the Western medicine (WM) group (n=92).

4、Patients in the IGDC group were treated by integrated Gubenhuaji decoction and chemotherapy. Patients in WM group were treated by chemotherapy. The excluded or dropping off cases were 10 in IGDC and 15 in WM. Clinical trials were conducted in 3 hospitals and 3 months of treatment was taken as one th

5、erapeutic course. The main observation indexes were tumor size, quality of life, Karnofsky scores, body weight, adverse reaction, etc. Results The total effective rate of tumor remission in the IGDC group and WM group were 28.4 and 13.0, respectively. There was statistical significance between two g

6、roups (P0.01). Karnofksy score significantly raised in the IGDC group after treatment in comparison with that before treatment (P0.01). The karnofsky score in IGDC group was higher than that in WM after treatment (P0.01). The patients body weights in the 2 groups were all reduced. The reduction in t

7、he IGDC group was lower than that in WM group (P0.01). The effect in the IGDC group was better than that in WM group in aspects of improving such tumor related symptoms as cough, short breath, anorexia, fatigue, etc (P0.01, P0.05). Adverse reaction in the IGDC group was lesser than that in the WM gr

8、oup (P0.05, P3個(gè)月；不能或不愿手術(shù)者；卡氏評分360分；年齡1875歲；各項(xiàng)檢查指標(biāo)符合化療要求；停止放化療1個(gè)月；愿意接受本方案治療。1.3 排除標(biāo)準(zhǔn)無明確的腫瘤病灶（包括可測量和不可測量的）；不符合納入標(biāo)準(zhǔn)；妊娠期或哺乳期婦女；合并嚴(yán)重的心腦血管疾病，或精神障礙等疾?。环幰缽男圆?，不能堅(jiān)持完成治療的患者。1.4 一般資料 全部194例為河北省曲周縣內(nèi)科、河北省邯鄲市復(fù)興區(qū)中醫(yī)院內(nèi)科和河北省雞澤縣中西醫(yī)結(jié)合醫(yī)院內(nèi)科患者，隨機(jī)分為2組。治療組102例，男74例，女28例；病程（4.775.86）個(gè)月；卡氏評分（71.837.6）分；分期：a期9 例，b期42例， 期51例；解剖

9、類型：中央型34例，周圍型68例；病理類型：鱗癌38例，腺癌59例，其他5例。對照組92例，男75例，女17例；病程（4.466.02）個(gè)月；卡氏評分（71.748.28）分；分期：a期10例，b期38例， 期44例；解剖類型：中央型35例，周圍型56例，其它1例；病理類型：鱗癌26例，腺癌58例，其他8例。2組病例一般資料比較差異無統(tǒng)計(jì)學(xué)意義（P0.05），具有可比性。1.5 治療方法予化療，用NP或VP方案，酒石酸長春瑞濱25 mg/m2，或長春地辛（VDS）3 mg/m2，第1、8日靜脈注射；順鉑（DDP）20 mg/m2，第15日靜脈滴注。3周為1個(gè)療程，化療周期為3個(gè)療程。在對照組基

10、礎(chǔ)上配合固本化積湯加減?；痉剑狐S芪3060 g，問荊1525 g，浙貝母1030 g，白英15 g，龍葵15 g，半枝蓮30 g，丹參10 g。肺脾氣虛型，治宜健脾益肺，基本方加黨參、白術(shù)、茯苓、半夏、陳皮；陰虛痰熱型，治宜滋陰清肺、化痰散結(jié)，基本方加薏苡仁、生地黃、仙鶴草、黃芩、沙參；氣陰兩虛型，治宜益氣養(yǎng)陰、固本化積，基本方加人參、麥門冬、五味子、百合；痰濕瘀阻型，治宜化痰祛瘀、滲濕消積，基本方加薏苡仁、瓜蔞、薤白、半夏、當(dāng)歸尾。每日1劑，1個(gè)月為1個(gè)療程，共治療3個(gè)療程。1.6 觀察項(xiàng)目與檢測方法分為完全緩解（CR）、部分緩解（PR）、無變化（NC）、病變進(jìn)展（PD），有效=CR+PR，穩(wěn)定=CR+PR+NC。顯效：卡氏評分治療后比治療前提高20分；有效：卡氏評分治療后比治療前提高1020分；穩(wěn)定：卡氏評分治療后比治療前提高10分或無變化；無效：卡氏評分治療后比治療前下降。顯效率=顯效/總例數(shù)100%，有效率=(顯效+有效)/總例數(shù)100%，穩(wěn)定率=(顯效+有效+穩(wěn)定)/總例數(shù)