[1]刘春燕,罗小燕,刘慧玲.沙参麦冬汤加减辅助吉非替尼对老年晚期非小细胞肺癌患者免疫功能及不良反应的影响*[J].陕西中医,2020,(2):183-186.
　LIU Chunyan,LUO Xiaoyan,LIU Huiling..Effects of modified Shashen Maidong decoction combined with gefitinib on immune function and adverse reactions in elderly patients with advanced non-small cell lung cancer[J].,2020,(2):183-186.
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沙参麦冬汤加减辅助吉非替尼对老年晚期非小细胞肺癌患者免疫功能及不良反应的影响*
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2020年2期
页码:
183-186
栏目:
临床研究
出版日期:
2020-02-05

文章信息/Info

Title:
Effects of modified Shashen Maidong decoction combined with gefitinib on immune function and adverse reactions in elderly patients with advanced non-small cell lung cancer
文章编号:
DOI:〖HT5K〗10.3969/j.issn.10007369.2020.02.012
作者:
刘春燕1; 罗小燕2; 刘慧玲2
1.成都上锦南府医院中西医结合科(成都 611730); 2.四川大学华西医院中西医结合科(成都 610041)
Author(s):
LIU Chunyan; LUO Xiaoyan; LIU Huiling.
Department of Integrated Traditional Chinese and Western Medicine,Chengdu Shangjinnanfu Hospital(Chengdu 611730)
关键词:
老年人;  非小细胞肺癌;  沙参麦冬汤加减;  吉非替尼;  免疫功能;  不良反应
Keywords:
Elderly advanced non-small cell lung cancer;  Modified Shashen Maidong decoction;  Gefitinib;  Immune function;  Adverse reaction
分类号:
R734.2
文献标志码:
A
摘要:
目的:探究晚期非小细胞肺癌老年患者应用沙参麦冬汤加减辅助吉非替尼治疗对患者免疫功能以及不良反应的影响。方法:选择116例晚期非小细胞肺癌老年患者作为研究对象,依据随机分组以及患者实际情况按照1:1原则将患者分为联合组和单一组,均为58例,单一组采用吉非替尼治疗,联合组在单一组治疗基础上应用沙参麦冬汤加减辅助治疗。比较两组患者治疗效果,治疗前后中医症状积分,免疫功能,不良反应以及远期疗效。结果:联合组治疗总有效率(94.83%)高于单一组(77.59%),差异有统计学意义(P<0.05); 两组痰中带血、疲惫乏力、咳嗽、气短、头晕耳鸣、少气懒言、胸痛以及咯痰等中医症状评分较治疗前明显下降(P<0.05),联合组患者上述中医症状评分下降幅度明显高于单一组(P<0.05); 两组患者治疗后CD4+、CD8+、CD4+/CD8+等指标较治疗前显著变化(P<0.05),治疗后联合组CD4+、CD4+/CD8+指标明显高于单一组(P<0.05),CD8+指标显著低于单一组(P<0.05); 联合组和单一组患者治疗后不良反应发生率差异无统计学意义(10.34%与18.97%,P>0.05); 联合组以及单一组患者半年复发率以及存活率差异比较无统计学意义(3.45%与10.34%,100%与93.10%; P>0.05),联合组患者1年复发率以及存活率显著优于单一组(13.79%与31.03%,96.55%与81.03%; P<0.05)。结论:晚期非小细胞肺癌老年患者采用沙参麦冬汤加减辅助吉非替尼治疗效果显著,可以改善患者免疫功能,同时未增加患者治疗不良反应。
Abstract:
Objective:To investigate the effects of modified Shashen Maidong decoction combined with gefitinib on immune function and adverse reactions in elderly patients with advanced non-small cell lung cancer(NSCLC).Methods:A total of 116 elderly patients with advanced NSCLC were selected as the subjects.They were randomly divided into the combined group and the single group according to the actual condition of the patient,with 58 patients in each group.Both groups were treated with gefitinib,and the combined group were additionally treated with modified Shashen Maidong decoction.The therapeutic effects,TCM symptom scores before and after treatment,immune function,adverse reactions and long-term curative effect were compared between the two groups.Results:The total effective rate of treatment in the combined group(94.83%)was higher than that in the single group(77.59%,P<0.05).The scores of TCM symptoms such as bloody sputum,fatigue,cough,shortness of breath,dizziness and tinnitus,lack of energy,chest pain and expectoration in both groups decreased significantly after treatment(P<0.05),and the decrease in the combined group was significantly greater than that in the single group(P<0.05).CD4+,CD8+ and CD4+/CD8+ in both groups significantly changed after treatment(P<0.05).After treatment,CD4+ and CD4+/CD8+ in the combined group were significantly higher than the single group(P<0.05),while CD8+ was significantly lower than the single group(P<0.05).There was no significant difference in the incidence of adverse reactions between the combined group and the single group(10.34% vs 18.97%,P>0.05).There was no statistical difference in the half-year recurrence rate or survival rate between the combined group and the single group(3.45% vs 10.34%,100% vs 93.10%,P>0.05).The 1-year recurrence rate and survival rate of the combined group were significantly better than the single group(13.79% vs 31.03%,96.55% vs 81.03%,P<0.05).Conclusion:Modified Shashen Maidong decoction combined with gefitinib is effective in the treatment of elderly patients with advanced NSCLC.It can improve the immune function of patients without increasing adverse reactions.

参考文献/References:

[1] Jacob H,Tellervo K,Klaus H,et al.Lung cancer,genetic predisposition and smoking:the nordic twin study of cancer[J].Thorax,2017,72(11):1021-1027.
[2] Carbone DP,Reck M,Paz-Ares L,et al.First-line nivolumab in stage iv or recurrent non-small-cell lung cancer[J].N Engl J Med,376(25):2415-2426.
[3] Scott JA,Augusto V,Davey D,et al.Durvalumab after chemoradiotherapy in stage iii non-small-cell lung cancer[J].N Engl J Med,2017,377(20):1919-1929.
[4] 冯谢敏,赵 红,崔 洁,等.同步放化疗治疗局部晚期非小细胞肺癌疗效观察[J].陕西医学杂志,2016,45(9):1126-1128.
[5] 中国抗癌协会.新编常见恶性肿瘤诊治规范[M].北京:中国协和医科大学出版社,1999:773.
[6] 中华人民共和国卫生部.原发性肺癌诊疗规范(2011年版)[M].北京:中国标准出版社,2011:2.
[7] 王雪冰,李 康.自拟生血方加减联合铂类化疗方案治疗非小细胞肺癌临床疗效分析[J].中华中医药学刊,2017,35(8):2164-2167.
[8] 王慧芳,宋利刚.贝伐珠单抗注射液辅助规范化疗治疗非小细胞肺癌的临床效果[J].中国老年学杂志,2018,38(21):79-81.
[9] 许海柱,孙建立,张 璇.EGFR-TKI治疗后非小细胞肺癌中医证候研究[J].中国中西医结合杂志,2017,37(9):1050-1053.
[10] 蒋海蓉,毛 蓓,邓 炜.老年非小细胞肺癌根治术患者抑郁对其预后及免疫功能的影响[J].实用癌症杂志,2016,32(2):249-251.
[11] 曾 瑞,钟红卫.益气养阴法治疗中晚期非小细胞肺癌的临床疗效观察[J].陕西中医,2016,37(2):164-165.
[12] 杨忠光,梁 鑫,赵远桥.沙参麦冬汤联合化疗对气阴两虚型肺癌患者免疫功能及炎性反应的影响[J].中国实验方剂学杂志,2017,23(16):158-163.
[13] 孙雅丽,张明晖,杨 艳.扶正润肺汤联合TP方案化疗对非小细胞肺癌的临床疗效[J].实用癌症杂志,2019,34(6):956-959.
[14] 韩燕鸿,揭 珂,张 荷,等.沙参麦冬汤加减联合化疗治疗非小细胞肺癌的Meta分析[J].中国实验方剂学杂志,2016,22(7):218-222.
[15] 周卫东,刘元铃,张 雪,等.补中益气汤合沙参麦冬汤加减联合化疗治疗非小细胞肺癌临床疗效观察[J].实用医学杂志,2015,31(21):3597-3600.
[16] 石 磊,王丽丽,胡 魁,等.沙参麦冬汤联合化疗对肺癌患者免疫功能的影响研究[J].中华中医药学刊,2015,33(6):1363-1366.
[17] 邹芬芳,张健鹏,常 德, 等.TP63基因多态性位点rs4488809与肺癌易感性关联的meta分析[J].中国急救复苏与灾害医学杂志,2018,13(6):549-552.

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备注/Memo

备注/Memo:
*四川省科技基金资助项目(2019YFS0259)
更新日期/Last Update: 2020-03-31