肺岩宁方联合抗瘤增效方对中晚期肺腺癌患者化疗后癌因性疲乏、免疫功能及肿瘤标志物影响的临床研究
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摘要
目的观察肺岩宁方联合抗瘤增效方对中晚期肺腺癌患者化疗后癌因性疲乏、免疫功能及肿瘤标志物的影响。方法将132例中晚期肺腺癌化疗后患者随机分为治疗组和对照组,每组66例。对照组予抗瘤增效方,治疗组予肺岩宁方联合抗瘤增效方。两组疗程均为3个月,观察比较癌因性疲乏量表(CFS)与简易疲乏量表(BFI)评分、免疫相关指标[CD3~+、CD4~+、CD8~+、CD56~+16(NK)、CD19~+]、肿瘤标志物(CEA、CA199、CYFRA21-1、CA125)水平的变化情况。结果①最终完成试验者124例,其中治疗组63例,对照组61例。②组间治疗后比较,治疗组BFI评分及CFS评分中的躯体维度、情感维度、总分明显低于对照组(P<0.05)。③组间治疗后比较,治疗组CD3~+、CD4~+、CD8~+、CD56~+16(NK)水平明显高于对照组(P<0.05)。④组间治疗后比较,治疗组CYFRA21-1、CA125水平明显低于对照组(P<0.05)。结论与单用抗瘤增效方相比,肺岩宁方联合抗瘤增效方可更好地改善化疗后中晚期肺腺癌患者的癌因性疲乏程度,提高其外周血淋巴细胞水平,降低血清肿瘤标志物(CYFRA21-1、CA125)水平,从而改善患者的预后及生存质量。
Objective To observe the effects of Feiyanning Recipe combined with Kangliu Zengxiao Recipe on cancer-related fatigue,immune function and tumor markers in patients with intermediate-terminal lung adenocarcinoma after chemotherapy. Methods 132 patients with intermediate-terminal lung adenocarcinoma were randomly assigned into treatment group and control group,66 patients in each group. The control group was given Kangliu Zengxiao Recipe and the treatment group was given Feiyanning Recipe combined with Kangliu Zengxiao Recipe. Both groups were treated for 3 months.Scores on the cancer fatigue scale( CFS) and the brief fatigue inventory( BFI) and immune-related indicators [CD3~+,CD4~+,CD8~+,CD56~+16( NK),CD19~+] were observed. Changes in the levels of tumor markers( CEA,CA199,CYFRA21-1 and CA125) were also evaluated.Results(1)124 patients completed the trial,including 63 in the treatment group and 61 in the control group.(2) The body dimension,emotional dimension and total score in the BFI and CFS scores were significantly lower in the treatment group than in the control group after treatment( P<0.05).(3)The levels of CD3~+,CD4~+,CD8~+and CD56~+16( NK) were significantly higher in the treatment group than in the control group after treatment( P<0.05).(4)The levels of CYFRA21-1 and CA125 were significantly lower in the treatment group tha in the control group after treatment( P<0.05).Conclusion Compared with Kangliu Zengxiao Recipe alone,Feiyanning Recipe combined with Kangliu Zengxiao Recipe can better improve cancer-related fatigue in patients with intermediate-terminal lung adenocarcinoma after chemotherapy, increase the levels of peripheral blood lymphocytes and lower the levels of serum tumor markers(CYFRA21-1 and CA125),thereby improving prognosis and quality of life for the patients.
Objective To observe the effects of Feiyanning Recipe combined with Kangliu Zengxiao Recipe on cancer-related fatigue,immune function and tumor markers in patients with intermediate-terminal lung adenocarcinoma after chemotherapy. Methods 132 patients with intermediate-terminal lung adenocarcinoma were randomly assigned into treatment group and control group,66 patients in each group. The control group was given Kangliu Zengxiao Recipe and the treatment group was given Feiyanning Recipe combined with Kangliu Zengxiao Recipe. Both groups were treated for 3 months.Scores on the cancer fatigue scale( CFS) and the brief fatigue inventory( BFI) and immune-related indicators [CD3~+,CD4~+,CD8~+,CD56~+16( NK),CD19~+] were observed. Changes in the levels of tumor markers( CEA,CA199,CYFRA21-1 and CA125) were also evaluated.Results(1)124 patients completed the trial,including 63 in the treatment group and 61 in the control group.(2) The body dimension,emotional dimension and total score in the BFI and CFS scores were significantly lower in the treatment group than in the control group after treatment( P<0.05).(3)The levels of CD3~+,CD4~+,CD8~+and CD56~+16( NK) were significantly higher in the treatment group than in the control group after treatment( P<0.05).(4)The levels of CYFRA21-1 and CA125 were significantly lower in the treatment group tha in the control group after treatment( P<0.05).Conclusion Compared with Kangliu Zengxiao Recipe alone,Feiyanning Recipe combined with Kangliu Zengxiao Recipe can better improve cancer-related fatigue in patients with intermediate-terminal lung adenocarcinoma after chemotherapy, increase the levels of peripheral blood lymphocytes and lower the levels of serum tumor markers(CYFRA21-1 and CA125),thereby improving prognosis and quality of life for the patients.
引文
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[15] 徐振晔,金长娟,沈德义,等.中医药分阶段结合化疗治疗晚期非小细胞肺癌的临床研究[J].中国中西医结合杂志,2007,27(10):874- 878.
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[19] LI X U,ZHU Y H.Prognostic value of determining serum CA125 and IL- 10 levels in patients with advanced non- mall cell lung cancer[J].J Clinical Pulmon Med,2016,21(4):616- 618.
[20] ABDALLAH A,BELAL M,BASTAWISY A E.Plasma CA 19- 9 in advanced non- small cell lung cancer[J].Cancer & Clinical Oncology,2013,2(2):11- 18.
[21] SATO Y,FUJIMOTO D,UEHARA K,et al.The prognostic value of serum CA 199 for patients with advanced lung adenocarcinoma[J].Bmc Cancer,2016,16(1):890.
[22] 张雁,王志群.肿瘤标志物对肺癌患者的诊断及预后预测的价值研究[J].实用癌症杂志,2015,30(9):1281- 1283.
[2] HOFMAN M,RYAN J L,FIGUEROA- MOSELEY C D,et al.Cancer- related fatigue:the scale of the problem[J].The Oncologist,2007,12(suppl 1):4- 10.
[3] 邓海滨,王中奇,吴继,等.抗瘤增效方结合化疗治疗中晚期非小细胞肺癌97例[J].上海中医药杂志,2014,48(4):848- 851,874.
[4] 严桂英.益气养精法对改善老年非小细胞肺癌患者介入治疗后癌因性疲乏的疗效研究[J].实用癌症杂志,2018,33(4):588- 591.
[5] TRAVIS W D,BRAMBILLA E,NOGUCHI M,et al.International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society:international multidisciplinary classification of lung adenocarcinoma:executive summary[J].J Thorac Oncol,2011,6(2):244- 285.
[6] RAMIPORTA R,CROWLEY J J,GOLDSTRAW P.The revised TNM staging system for lung cancer[J].Ann Thorac Cardiovasc Surg,2009,15(1):4- 9.
[7] MENDOZA T R,WANG X S,CLEELAND C S.The rapid assessment of fatigue severity in cancer patients:use of the Brief Fatigue Inventory[J].Cancer,1999,85(5):1186- 1196.
[8] 王中奇,邓海滨,吴继,等.双黄升白颗粒治疗肺癌化疗后骨髓抑制的临床研究[J].上海中医药杂志,2013,47(6):35- 37.
[9] 谭翔文,陈学芬,陈正,等.健脾益气化痰方辨证加减对肺癌化疗患者癌性疲乏的影响[J].中医杂志,2012,53(15):1301- 1304.
[10] 胡慧菁,刘苓霜,沈丽萍,等.扶正为主辨治晚期非小细胞肺癌的疗效研究[J].成都中医药大学学报,2014,37(2):76- 79.
[11] GONG Y B,XU Z Y,JIN C J.Treatment of advanced non- small- cell lung cancer with qi- nourishing essence- replenishing Chinese herbal medicine combined with chemotherapy[J].Biolog Proced Online,2018,20(9):1- 7.
[12] 邓海滨,王中奇,赵晓珍,等.肺岩宁方颗粒治疗精气两亏型中晚期非小细胞肺癌的临床随机安慰剂对照研究[J].上海中医药杂志,2016,50(6):40- 43.
[13] 王中奇,徐振晔,邓海滨,等.中医药结合化疗防治非小细胞肺癌术后复发转移的临床研究[J].上海中医药杂志,2011,45(5):36- 39.
[14] 王中奇,邓海滨,张铭,等.中药分阶段结合化疗治疗晚期肺腺癌临床研究[J].上海中医药杂志,2010,44(3):7- 11.
[15] 徐振晔,金长娟,沈德义,等.中医药分阶段结合化疗治疗晚期非小细胞肺癌的临床研究[J].中国中西医结合杂志,2007,27(10):874- 878.
[16] ANDERSON P,BLUE M L,SCHLOSSMAN S F.Comodulation of CD3 and CD4.Evidence for a specific association between CD4 and approximately 5% of the CD3:T cell receptor complexes on helper T lymphocytes[J].J Immunol,1988,140(6):1732- 1737.
[17] SAIZAWA K,ROJO J,JANEWAY C A.Evidence for a physical association of CD4 and the CD3:alpha:beta T- cell receptor[J].Nature,1987,328(6127):260- 263.
[18] YING L,WU J,LI Z.Preoperative serum CA125 is an independent predictor for prognosis in operable patients with non- small cell lung cancer [J].Neoplasma,2015,62(4):602- 609.
[19] LI X U,ZHU Y H.Prognostic value of determining serum CA125 and IL- 10 levels in patients with advanced non- mall cell lung cancer[J].J Clinical Pulmon Med,2016,21(4):616- 618.
[20] ABDALLAH A,BELAL M,BASTAWISY A E.Plasma CA 19- 9 in advanced non- small cell lung cancer[J].Cancer & Clinical Oncology,2013,2(2):11- 18.
[21] SATO Y,FUJIMOTO D,UEHARA K,et al.The prognostic value of serum CA 199 for patients with advanced lung adenocarcinoma[J].Bmc Cancer,2016,16(1):890.
[22] 张雁,王志群.肿瘤标志物对肺癌患者的诊断及预后预测的价值研究[J].实用癌症杂志,2015,30(9):1281- 1283.