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
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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。
Objective: 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,S100 A8,S100 A9) 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,S100 A8 and S100 A9 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.
Objective: 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,S100 A8,S100 A9) 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,S100 A8 and S100 A9 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.
引文
[1]熊绍权,李亚玲,王淑美,等.EGFR-TKIs联合中药与单纯EGFR-TKIs治疗晚期非小细胞肺癌的队列研究[J].四川大学学报:医学版,2018,49(4):566-569+586.
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[8]王丽丽,石磊,钱祥,等.清肺合剂对晚期非小细胞肺癌化疗患者免疫功能的影响[J].新中医,2018,50(1):105-107.
[9]胡建平,汤兵祥,韩俊垒.多西紫杉醇联合GP化疗方案对晚期非小细胞肺癌患者炎性因子、免疫功能及临床症状的影响[J].癌症进展,2017,15(10):1168-1170.
[10]潘龙赐,吴超民,葛婷,等.扶正固本Ⅰ号方对肺脾两虚型晚期非小细胞肺癌患者免疫功能及化疗副反应影响的临床观察[J].上海中医药杂志,2017,51(6):42-45.
[11]石织宏,黄织春.参芪散联合TP方案治疗晚期非小细胞肺癌患者的疗效及其对免疫功能的影响[J].世界中医药,2016,11(11):2340-2343+2347.
[12]丁惠卿,赵蜜,赵莹,等.扶正解毒汤对肺癌晚期患者生命质量影响的临床观察[J].中医临床研究,2016,8(33):138-139.
[13]朱佳佳,尤寅骏.康莱特注射液联合GP方案对晚期非小细胞肺癌患者免疫功能的改善作用[J].河南中医,2016,36(11):1943-1945.
[14]麦泽锋.乌苯美司联合紫杉醇与顺铂方案治疗晚期非小细胞肺癌的临床疗效及对免疫功能的影响[J].中国老年学杂志,2016,36(15):3731-3733.
[15]王金宝.中药联合化疗治疗晚期肺癌的临床疗效观察[J].数理医药学杂志,2018,31(6):871-873.
[2]方丽丽,王佛有.苦参注射液联合扶正抗癌类中药治疗晚期肺癌的临床观察[J].中国中医药现代远程教育,2018,16(13):116-117.
[3]张娟莉.消岩汤联合NP化疗方案治疗晚期肺癌临床疗效及对患者免疫功能的影响[J].四川中医,2018,36(6):127-129.
[4]杨美菊,程哲.复方中药联合TP方案治疗晚期非小细胞肺癌的临床疗效观察[J].癌症进展,2018,16(1):102-105.
[5]袁本超,王晓青.参芪扶正注射液应用于晚期非小细胞肺癌化疗患者对免疫功能的影响分析[J].基层医学论坛,2018,22(13):1751-1752.
[6]杨阳,王凡.厄洛替尼联合贝伐单抗治疗对老年晚期非小细胞肺癌患者免疫功能及血清肿瘤标志物的影响及作用机制[J].中国老年学杂志,2018,38(5):1098-1100.
[7]中国原发性肺癌诊疗规范(2015年版)[A].中国癌症基金会、中国抗癌协会肿瘤临床化疗专业委员会、中国医师协会肿瘤医师分会.第九届中国肿瘤内科大会、第四届中国肿瘤医师大会、中国抗癌协会肿瘤临床化疗专业委员会2015年学术年会论文集[C].中国癌症基金会、中国抗癌协会肿瘤临床化疗专业委员会、中国医师协会肿瘤医师分会,2015:15.
[8]王丽丽,石磊,钱祥,等.清肺合剂对晚期非小细胞肺癌化疗患者免疫功能的影响[J].新中医,2018,50(1):105-107.
[9]胡建平,汤兵祥,韩俊垒.多西紫杉醇联合GP化疗方案对晚期非小细胞肺癌患者炎性因子、免疫功能及临床症状的影响[J].癌症进展,2017,15(10):1168-1170.
[10]潘龙赐,吴超民,葛婷,等.扶正固本Ⅰ号方对肺脾两虚型晚期非小细胞肺癌患者免疫功能及化疗副反应影响的临床观察[J].上海中医药杂志,2017,51(6):42-45.
[11]石织宏,黄织春.参芪散联合TP方案治疗晚期非小细胞肺癌患者的疗效及其对免疫功能的影响[J].世界中医药,2016,11(11):2340-2343+2347.
[12]丁惠卿,赵蜜,赵莹,等.扶正解毒汤对肺癌晚期患者生命质量影响的临床观察[J].中医临床研究,2016,8(33):138-139.
[13]朱佳佳,尤寅骏.康莱特注射液联合GP方案对晚期非小细胞肺癌患者免疫功能的改善作用[J].河南中医,2016,36(11):1943-1945.
[14]麦泽锋.乌苯美司联合紫杉醇与顺铂方案治疗晚期非小细胞肺癌的临床疗效及对免疫功能的影响[J].中国老年学杂志,2016,36(15):3731-3733.
[15]王金宝.中药联合化疗治疗晚期肺癌的临床疗效观察[J].数理医药学杂志,2018,31(6):871-873.