摘要
目的探讨复肺方辅助TP方案(紫杉醇+顺铂)在中晚期非小细胞肺癌(Non-small-cell lung cancer,NSCLC)中的治疗价值。方法选取2017年1月—2020年8月期间张家港市中医医院收治的中晚期NSCLC患者90例,采用随机数字表法分对照组和试验组,每组各45例。两组患者均给予TP化疗方案(完成4个化疗周期,历时12周),在此基础上,试验组自拟复肺方辅助治疗12周。治疗12周后,观察比较两组患者肿瘤疗效、中医证候疗效、治疗前后血清肿瘤标志物[细胞角蛋白19可溶性片段(Cytokeratin 19 soluble fragment,CYFRA21-1)、糖蛋白抗原125(Glycoprotein antigen 125,CA125)、癌胚抗原(Carcinoembryonic antigen,CEA)]水平及生活质量(European Organization for Research and Treatment of Cancer quality of life questionnaire core 30,EORTC QLQ-C30)评分变化、不良反应发生率,随访12个月,统计两组患者生存情况。结果(1)肿瘤疗效:治疗后试验组疾病控制率91.11%(41/45)高于对照组75.56%(34/45),差异有统计学意义(P<0.05);试验组治疗总有效率55.56%(25/45)高于对照组42.22%(19/45),差异有统计学意义(P<0.05);(2)证候疗效:治疗后试验组中医证候疗效总有效率88.89%(40/45)高于对照组57.78%(26/45),差异有统计学意义(P<0.05);(3)肿瘤标志物:治疗后两组患者肿瘤标志物均低于治疗前,差异有统计学意义(P<0.05);且试验组低于对照组,差异有统计学意义(P<0.05);(4)生活质量:治疗后两组患者总体健康状况领域、功能领域评分较治疗前升高,症状领域评分较治疗前降低,差异有统计学意义(P<0.05);且试验组总体健康状况领域、功能领域评分高于对照组,症状领域评分低于对照组,差异有统计学意义(P<0.05);(5)毒副作用:试验组血小板减少、白细胞减少、血清肌酐升高、丙氨酸氨基转移酶升高、便秘、口腔炎、周围神经异常发生率均低于对照组,差异有统计学意义(P<0.05);(6)生存情况:试验组中位生存时间较对照组长,且12个月生存率较对照组高,差异有统计学意义(P<0.05)。结论复肺方辅助TP方案治疗中晚期NSCLC效果明显,有利于提高疾病控制率,下调血清肿瘤标志物表达,改善患者生活质量,延长生命期限,且能够降低化疗不良反应发生率。
Objective To investigate the therapeutic value of Fufei Recipe-assisted TP regimen(paclitaxel+cisplatin)in advanced non-small cell lung cancer(NSCLC).Methods Ninety patients with advanced NSCLC treated in Pulmonary Disease Department of Zhangjiagang Traditional Chinese Medicine Hospital from January 2017 to August 2020 were divided into a control group and an experimental group by random number table,with 45 cases in each group.Bothgroups were given TP chemotherapy(completed 4 cycles of chemotherapy,lasting 12 weeks),and on this basis,the experimental group was given the adjuvant therapy of Fufei Recipe for 12 weeks.After 12 weeks of treatment,the tumor curative effect,traditional Chinese medicine(TCM)syndrome curative effect,levels of serum tumor markers[cytokeratin 19 soluble fragment(CYFRA21-1),glycoprotein antigen 125(CA125),and carcinoembryonic antigen(CEA)],changes in European Organization for Research and Treatment of Cancer quality of life questionnaire core 30(EORTC QLQ-C30)scores,and the incidence of adverse reactions before and after treatment of the two groups were compared.Both groups were followed up for 12 months,and the survival of the two groups was analyzed.Results(1)In terms of tumor efficacy,the disease control rate of the experimental group was 91.11%(41/45),which was higher than that of the control group[75.56%(34/45),P<0.05].The total effective rate of the experimental group was 55.56%(25/45),which was higher than that of the control group[42.22%(19/45),P<0.05].(2)In terms of the syndrome efficacies,the total effective rate of TCM syndromes in the experimental group was 88.89%(40/45),which was higher than that in the control group[57.78%(26/45),P<0.05].(3)In terms of tumor markers,the tumor markers in the two groups were decreased after treatment(P<0.05),and the experimental group was lower than the control group(P<0.05).(4)In terms of the quality of life,the overall health status score and functional score in the two groups were higher than those before treatment,and the syndrome score was lower than that before treatment(P<0.05).The overall health status score and functional score in the experimental group were higher than those in the control group,whereas the syndrome score was lower than that in the control group(P<0.05).(5)In terms of toxic and side effects,the incidence of thrombocytopenia,leukopenia,elevated serum creatinine,elevated alanine aminotransferase,constipation,stomatitis,and abnormal peripheral nerves in the experimental group were lower than those in the control group(P<0.05).(6)In terms of the survival,the median survival time of the experimental group was longer than that of the control group,and the 12-month survival rate was higher than that of the control group(P<0.05).Conclusion Fufei Recipe-assisted TP regimen has a significant effect in the treatment of advanced NSCLC,which is beneficial to improve the disease control rate,down-regulate the expression of serum tumor markers,improve the quality of life of patients,prolong the life span,and reduce the incidence of adverse reactions.
作者
曹健
成怡楠
梁小红
高海建
CAO Jian;CHENG Yi-nan;LIANG Xiao-hong;GAO Hai-jian(Pulmonary Disease Department,Zhangjiagang Traditional Chinese Medicine Hospital,Zhangjagang Jiangsu 215600;Oncology Department,Zhangjiagang Traditional Chinese Medicine Hos pital,Zhangjiagang Jiangsu 215600)
出处
《世界中西医结合杂志》
2023年第1期173-178,共6页
World Journal of Integrated Traditional and Western Medicine
基金
苏州市科技计划项目(SYS2020041)
张家港市科技支撑计划(社会发展)(ZKS2038)
张家港青年科技项目(ZJGQNKJ201929)。
作者简介
通信作者:高海建,Email:haijian2019@126.com。
