基于"久病及肾"理论论治扶正抑癌1号方联合GP化疗治疗晚期非小细胞肺癌的临床观察
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摘要
目的:基于"久病及肾"理论,观察扶正抑癌1号方联合GP化疗与单纯化疗对比治疗晚期非小细胞肺癌的临床疗效、安全性及对患者生活质量的影响。方法:选取2017年9月1日至2018年9月1日于成都中医药大学附属医院及四川省肿瘤医院就诊的晚期非小细胞肺癌患者86例,随机分为两组,试验组46例,对照组40例,对照组给予GP方案化疗,试验组在对照组基础上联合中药扶正抑癌1号方治疗,4周期后,比较两组实体瘤目标病灶疗效、中医临床证候疗效、生活质量及毒副反应。结果:试验组实体瘤目标病灶总有效率有大于对照组的趋势;而在生活质量及中医临床证候疗效方面,试验组均优于对照组,化疗毒副作用的发生率明显低于对照组。结论:基于"久病及肾",以扶正抑癌1号方联合GP化疗治疗晚期非小细胞肺癌,在客观疗效上与单纯GP方案化疗相比可能相当,但可提高患者生活质量,减少化疗毒副作用的发生。
Objective: Based on Jiubingjishen theory,we compared the clinical efficacy, safety and the quality of life of patients with late stage non-small cell lung cancer(NSCLC) after the treatment by GP chemotherapy and GP chemotherapy combined with Fuzhengyiai prescription No.1, respectively. Methods: 86 patients with late stage non-small cell lung cancer from Hospital of Chengdu University of Traditional Chinese Medicine and Sichuan provincial tumor hospital from September 1,2017 to September 1, 2018. All patients were randomly divided into two groups, 46 in the treatment group and 40 in the control group. Patients in the control group were given GP chemotherapy, while those in the treatment group were treated with Fuzhengyiai prescription No.1 combined with GP chemotherapy. After 4 cycles of the treatment,the solid tumor target lesion curative effect, TCM clinical syndrome effect, quality of life and toxic side effects in these two groups were compared. Results:Compared with the control group, the total effective rate of the target lesion of solid tumor was increased in the treatment group, but there was no statistically significant difference. Life quality and TCM clinical syndrome in the treatment group showed better effects than those in the control group, also it showed less side or toxic effects of chemotherapy in the treatment group than that in the control group.Conclusion: Based on Jiubingjishen theory, Fuzhengyiai prescription No.1 combined with GP chemotherapy for the treatment of late stage non-small cell lung cancer may have similar efficacy as GP chemotherapy applied alone, but it can improve the quality of patients life and reduce the occurrence of toxic or side effects of chemotherapy.
Objective: Based on Jiubingjishen theory,we compared the clinical efficacy, safety and the quality of life of patients with late stage non-small cell lung cancer(NSCLC) after the treatment by GP chemotherapy and GP chemotherapy combined with Fuzhengyiai prescription No.1, respectively. Methods: 86 patients with late stage non-small cell lung cancer from Hospital of Chengdu University of Traditional Chinese Medicine and Sichuan provincial tumor hospital from September 1,2017 to September 1, 2018. All patients were randomly divided into two groups, 46 in the treatment group and 40 in the control group. Patients in the control group were given GP chemotherapy, while those in the treatment group were treated with Fuzhengyiai prescription No.1 combined with GP chemotherapy. After 4 cycles of the treatment,the solid tumor target lesion curative effect, TCM clinical syndrome effect, quality of life and toxic side effects in these two groups were compared. Results:Compared with the control group, the total effective rate of the target lesion of solid tumor was increased in the treatment group, but there was no statistically significant difference. Life quality and TCM clinical syndrome in the treatment group showed better effects than those in the control group, also it showed less side or toxic effects of chemotherapy in the treatment group than that in the control group.Conclusion: Based on Jiubingjishen theory, Fuzhengyiai prescription No.1 combined with GP chemotherapy for the treatment of late stage non-small cell lung cancer may have similar efficacy as GP chemotherapy applied alone, but it can improve the quality of patients life and reduce the occurrence of toxic or side effects of chemotherapy.
引文
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[2]凌华晃,黄锡梅,李涛,等.恩度联合化疗治疗中晚期非小细胞肺癌的疗效及相关因素分析.中国肿瘤临床与康复,2015,22(3)∶ 295 ～ 297.
[3]Wang J,Wang K,Xu J,et al.Correction:Prognostic Significance of Circulating Tumor Cells in Non-Small-Cell Lung Cancer Patients:A Meta-Analysis.Plos One,2013,8(11)∶ e78070.
[4]Rossi A,Chiodini P,Sun J M,et al.Six versus fewer planned cycles of first-line platinum-based chemotherapy for non-small-cell lung cancer∶ a systematic review and meta-analysis of individual patient data.Lancet Oncology,2014,15(11)∶ 1254 ～ 1262.
[5]宋勇,杨雯.2014年晚期非小细胞肺癌内科治疗进展.解放军医学杂志,2015,40(1)∶ 10 ～ 15.
[6]张金忠,牟坤,王继松.紫杉醇、顺铂联合重组人血管内皮抑制素对非小细胞肺癌患者的疗效及相关指标的影响.中国药房,2016,27(30)∶ 4218 ～ 4220.
[7]汤锡锋,纪新尊,吉晓天.川芎嗪联合贝伐单抗治疗晚期非小细胞肺癌脑转移的临床观察.中药药理与临床,2018,34(2)∶ 115 ～ 118.
[8]陆晔,陈美云,许尤琪."益肺散结方"联合化疗治疗晚期肺癌30例临床研究.江苏中医药,2017,49(3)∶ 32 ～ 35.
[9]苏兆田.中药益肺平癌方联合化疗治疗晚期非小细胞肺癌的效果探析.当代医药论丛,2017,15(5)∶ 31 ～ 32.
[10]苏婉.徐振晔.历代中医医籍中肺癌相关文献概述.中医文献杂志,2010,28(1)∶53 ～ 55.
[11]朱明章,吴万垠.中医专病专方联合化疗治疗Ⅲ～Ⅳ期非小细胞肺癌的Meta分析.肿瘤,2013,33(6)∶534～540.
[12]Zhi X Y,Shi Y K,Yu J M,et al.Standards for the diagnosis and treatment of primary lung cancer(2015 version) in China.Zhonghua Zhong Liu Za Zhi,2015,37(1)∶ 67 ～ 78.
[13]郑筱萸.中药新药临床研究指导原则(试行).北京:中国医药科技出版社.第1版,2002∶ 216 ～ 221.
[14] Eisenhauer E A,Therasse P,Bogaerts J,et al.New response evaluation criteria in solid tumours:revised RECIST guideline (version 1.1).Eur J Cancer,2009,45(2)∶ 228 ～ 247.
[15]抗癌药急性及亚急性毒性反应分度标准(WHO标准).癌症,1992,(3)∶ 254.
[16]聂娟,谢丽华,马港圆,等.中药黄芪的化学成分及药理作用研究进展.湖南中医杂志,2018,34(7)∶ 228 ～ 231.
[17]李乃谦.熟地黄活性成分药理作用的研究进展.中国处方药,2017,15(1)∶ 14 ～ 15.
[18]贾羲,苏成福,董诚明.山茱萸提取物抗肿瘤作用及机制探讨.中国实验方剂学杂志,2016,22(20)∶ 117 ～ 121.
[19]路宇仁,陈昳冰,崔元璐,等.淫羊藿苷药理作用研究进展.中国实验方剂学杂志,2018,24(17)∶ 209 ～ 220.