复方黄芪口服液在晚期气阴两虚型肺癌化疗中减毒作用的观察
|
摘要
研究背景：肺癌是常见的恶性肿瘤之一。其中,非小细胞肺癌(non-small-cell lung cancer, NSCLC)约占80%,而80%的患者在初次确诊时已经进入中晚期阶段,总的5年生存率不足10%。近20年来,我国肺癌的发病率和死亡率呈上升趋势,其死亡率在所有恶性肿瘤中升幅最大,已居首位,且有持续上升之趋势。肺癌早期症状不明显,而且肺癌易发生转移,在初次诊断时多数已经到了中晚期,甚至出现转移,治疗上已失去手术机会,只能采用化放疗结合的综合治疗,预后极差。而化放疗常给患者带来一系列的毒副反应,使患者免疫功能紊乱,免疫机能下降。采用中医中药治疗对于减少化疗毒副反应,提高机体免疫力,改善患者生活质量和中医症状方面均有优势。为探讨中医药在该领域内的作用,本研究选择了扶正类中药制剂--复方黄芪口服液。给予晚期肺癌患者复方黄芪口服液联合TP方案化疗对肺癌患者进行临床观察。复方黄芪口服液主要由黄芪,人参,黄精,陈皮四药的水煎液中提取而成,为常州中医院经多年临床使用,验之有效的制剂。
研究目的：探讨复方黄芪口服液配合TP方案治疗晚期气阴两虚型肺癌减毒的临床疗效。
研究方法：共选择61例晚期肺癌患者,随机分为治疗组(复方黄芪口服液加TP化疗组)31例和对照组(单纯TP化疗方案)30例。对照组使用单纯TP方案化疗。治疗组：在TP方案的基础上,加用复方黄芪口服液10ml,3次/日,化疗前一周至化疗周期全部结束。两组病人其他处理相同。使用WHO抗癌药物毒副反应分度标准,T淋巴细胞亚群、生活质量指标、KPS评分及中医证候等来观察两组经过二个疗程后的化学治疗所引起的毒副作用的表现及症状的改善。采用SPSS17.0处理.
研究结果：治疗组外周血白细胞、血红蛋白下降程度明显好于对照组(p<0.05),恶心呕吐发生率降低(p<0.05),其它肝功能、肾功能损伤等与对照组相比无统计学意义。两组T淋巴细胞亚群治疗后组间比较,有统计学差异(p<0.05),治疗组免疫功能恢复好于对照组。两组化疗前后生命质量无区别(p<0.05),但治疗组化疗结束后第七天,三个月生命质量好于对照组,并有统计学差异(p<0.05)。治疗组的KPS评分明显高于对照组(p<0.05)。中医证候积分治疗组改善较对照组明显,但p>0.05,无统计学差异。口咽干燥,盗汗、神疲乏力等气阴两虚症状改善情况治疗组较为明显。
结论：复方黄芪口服液能减轻TP方案治疗晚期气阴两虚型肺癌时的血液学毒性和消化道毒性,促进机体免疫功能的增强,改善生活质量,改善症状,达到减毒的目的。
Background:Primary bronchial lung cancer is one of most common malignant tumors, among which, non-small-cell lung cancer accounts for 80%.80% of Patients are in the advanced stage (stagelllB or stagelV).It's 5-year survival rate less than 10%. The incidence of lung cancer and mortality rates are rising in the past 20 years.The mortality rate of it has been ranked first and shows the largest increase among all malignant tumors, and a continuous upward trend. It's not obvious of early symptoms, and prone to metastasis. Most patients has been in the advanced stage at the first time of diagnosis, or even the tumor has been transferred. No surgery can be obtained. The only way is the combination of chemotherapy and radiotherapy, but the effect is far from our expectation. The chemo-radiotherapy for patients often brings a series of toxicity, which lead to immune disorders and declination in immune in functions of patients.There are advantages in use of traditional Chinese medicine for reducing side effects of chemotherapy and improvement in life quality and symptoms of patients, the research is about the effect of Compound Astraguls Liquid combined with chemotherapy on advanced lung cancer treatment. Compound Astraguls Liquid is made of four kinds of herbs'extraction of water-Astragalus, Ginseng,Huang Jing,Citrus reticulate Bianco.It's a effective recipe which is examined by clinical use.
Objective:To explore the therapeutic effects with toxicity reducing on treating the advanced lung cancer of deficiency of QI and YIN with Compound Astraguls Liquid combined with chemotherapy.
Methods:61 cases confirmed primary advanced lung cancer patients were randomly divided into two groups.31 patients of the treated group were treated with Compound Astraguls Liquid and chemotherapy.30 patients in control group were treated with chemotherapy. The treated group:compound astraguls liquid was used about 10ml, three times of day. It applied from a week before chemotherapy to the end of treatment. All of other treatments were the same. The effects of treatment were be observed after two courses of chemotherapy through some stardards. Statistic was analyzed by spss 17.0.
Result:The level of peripheral blood leukocytes and hemoglobin in treatment group dropped letter than control group (p<0.05). The incidence of nausea and vomiting was reduced (p<0.05).Other toxicity was statistically significant. The change of T lymphocytes among two groups has significant difference.The immunity function in treatment group is better than the control one.The quality of life in treatment group is better than the other group. The KPS in former group is higher than the latter one (p<0.05).There was no significant difference in relieving TCM symptoms between two groups.However, the differdence of the symptoms on deficiency of QI and YIN is of significance in statistics science (p<0.05).
Conclusion:Compound Astraguls Liquid can dissolve the hmatologic toxicity and gastrointestinal toxicity, enhance the recovery of immune function, improve quality of life and relieve symptoms, which is to achieve the purpose of attenuated.
研究目的：探讨复方黄芪口服液配合TP方案治疗晚期气阴两虚型肺癌减毒的临床疗效。
研究方法：共选择61例晚期肺癌患者,随机分为治疗组(复方黄芪口服液加TP化疗组)31例和对照组(单纯TP化疗方案)30例。对照组使用单纯TP方案化疗。治疗组：在TP方案的基础上,加用复方黄芪口服液10ml,3次/日,化疗前一周至化疗周期全部结束。两组病人其他处理相同。使用WHO抗癌药物毒副反应分度标准,T淋巴细胞亚群、生活质量指标、KPS评分及中医证候等来观察两组经过二个疗程后的化学治疗所引起的毒副作用的表现及症状的改善。采用SPSS17.0处理.
研究结果：治疗组外周血白细胞、血红蛋白下降程度明显好于对照组(p<0.05),恶心呕吐发生率降低(p<0.05),其它肝功能、肾功能损伤等与对照组相比无统计学意义。两组T淋巴细胞亚群治疗后组间比较,有统计学差异(p<0.05),治疗组免疫功能恢复好于对照组。两组化疗前后生命质量无区别(p<0.05),但治疗组化疗结束后第七天,三个月生命质量好于对照组,并有统计学差异(p<0.05)。治疗组的KPS评分明显高于对照组(p<0.05)。中医证候积分治疗组改善较对照组明显,但p>0.05,无统计学差异。口咽干燥,盗汗、神疲乏力等气阴两虚症状改善情况治疗组较为明显。
结论：复方黄芪口服液能减轻TP方案治疗晚期气阴两虚型肺癌时的血液学毒性和消化道毒性,促进机体免疫功能的增强,改善生活质量,改善症状,达到减毒的目的。
Background:Primary bronchial lung cancer is one of most common malignant tumors, among which, non-small-cell lung cancer accounts for 80%.80% of Patients are in the advanced stage (stagelllB or stagelV).It's 5-year survival rate less than 10%. The incidence of lung cancer and mortality rates are rising in the past 20 years.The mortality rate of it has been ranked first and shows the largest increase among all malignant tumors, and a continuous upward trend. It's not obvious of early symptoms, and prone to metastasis. Most patients has been in the advanced stage at the first time of diagnosis, or even the tumor has been transferred. No surgery can be obtained. The only way is the combination of chemotherapy and radiotherapy, but the effect is far from our expectation. The chemo-radiotherapy for patients often brings a series of toxicity, which lead to immune disorders and declination in immune in functions of patients.There are advantages in use of traditional Chinese medicine for reducing side effects of chemotherapy and improvement in life quality and symptoms of patients, the research is about the effect of Compound Astraguls Liquid combined with chemotherapy on advanced lung cancer treatment. Compound Astraguls Liquid is made of four kinds of herbs'extraction of water-Astragalus, Ginseng,Huang Jing,Citrus reticulate Bianco.It's a effective recipe which is examined by clinical use.
Objective:To explore the therapeutic effects with toxicity reducing on treating the advanced lung cancer of deficiency of QI and YIN with Compound Astraguls Liquid combined with chemotherapy.
Methods:61 cases confirmed primary advanced lung cancer patients were randomly divided into two groups.31 patients of the treated group were treated with Compound Astraguls Liquid and chemotherapy.30 patients in control group were treated with chemotherapy. The treated group:compound astraguls liquid was used about 10ml, three times of day. It applied from a week before chemotherapy to the end of treatment. All of other treatments were the same. The effects of treatment were be observed after two courses of chemotherapy through some stardards. Statistic was analyzed by spss 17.0.
Result:The level of peripheral blood leukocytes and hemoglobin in treatment group dropped letter than control group (p<0.05). The incidence of nausea and vomiting was reduced (p<0.05).Other toxicity was statistically significant. The change of T lymphocytes among two groups has significant difference.The immunity function in treatment group is better than the control one.The quality of life in treatment group is better than the other group. The KPS in former group is higher than the latter one (p<0.05).There was no significant difference in relieving TCM symptoms between two groups.However, the differdence of the symptoms on deficiency of QI and YIN is of significance in statistics science (p<0.05).
Conclusion:Compound Astraguls Liquid can dissolve the hmatologic toxicity and gastrointestinal toxicity, enhance the recovery of immune function, improve quality of life and relieve symptoms, which is to achieve the purpose of attenuated.
引文
[1].杨亚琴.中医药在肿瘤化疗中增效作用的研究[J].中国中医药信息杂志,1997：4(11)：10-13
[2].李佩文.中医药治疗化疗毒副反应的现状与展望[J].中国中医药信息杂志,1996：3(1)：22-25
[3].田卫卫,王庆苗.肿瘤化疗毒副反应从脾论治探讨[J].陕西中医,2001：22(1)：32-33.
[4].Greenlee RT,Murray T, Bolden S, et al Cancer statistics [J].CA Cancer JClin,2000,50(1):7-33.
[5].Bunn PA Jr. Chemotherapy for advanced non-small-cell lung cancer:who, what, when, why[J].Clin Onco,l 2002,20(18):23-33.
[6].宋扬,冯英明,张贺龙,等.顺铂分别联合诺维本、健择、泰索帝治疗晚期非小细胞肺癌的临床研究[J].现代肿瘤医学,2005,13(4)：494-496.
[7].陈玲,赵新汉,李旭,等.晚期非小细胞肺癌不同治疗方案疗效的比较[J].现代肿瘤医学,2007,15(1)：38-40.
[8].AielloRJ, BreesD, Bourassa PA,etal. Increased atherosclerosis inhyperlipidemic mice with inactivation of ABCA1 in macrophages[J].ArteriosclerThromb Vasc Bio,l 2002,22(4):630-637.
[9].Ardizzoni A,Boni L,Tiseo M,et al.Cisplatin-versus car-boplatin-based chemotherapy in first-line treatment of ad-vanced non-small-cell lung cancenan individual patientdata meta-analysis[J].J Natl Cancer Inst,2007,99 (11):847-857.
[10].Scagliotti GV,Parikh P,von Pawel J,etal.PhaseIIIstudycomparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with ad-vanced-stage non-small-cell lung cancer[J].J Clin Oncol,2008,26(21):3543-3551.
[11].Sandler A,Gray R,Perry MC,etal.Paclitaxel-carboplatinalone or with bevacizumab for non-small-cell lung cancer[J].N Engl J Med,2006,355(24):2542-2550.
[12].Carinol,Mezger J,Griesinger F,et aI.MO19390(SAIL):Safety and efficacy of first-line bevacizumab-based therapy in advanced non-small-cell lung cancer [J],J Clin ONCOL,2009,17(15s):Abstr8043.
[13].Pirker R,Szczesna A,von Pawel J,etal.FLEX:A randomized,multicenter,phaseⅢstudy of cetuximab incombination with cisplatin/vinorelbine(CV)versus CValone in the first-line treatment of patients with advanced non-small cell lung cancer(NSCLC)[J].J Clin Oncol,2008,26(suppl):abstr 3.
[14].Leighl NB,Shepherd FA,Kwong R,etal.Economic analysis of the TAX317 trial:docetaxel versus best supportive care as second-line therapyof advanced non-small-cell lung cancer[J].J Clin Oncol,2002,20(5): 1344-1352.
[15].Fossella FV,DeVore R,Kerr RN,etal.Randomized phaseⅢtrial ofdocetaxel versus vinorelbine or ifosfamide in patients with advancednon-small-cell lung cancer previously treated with platinum-contain-ing chemotherapy regimens.The TAX 320 Non-Small Cell Lung CancerStudy Group[J].J Clin Oncol,2000,18(12): 2354-2362.
[16]. Di Maio M,Permne F,Chiodini P,etal.Individual patient data meta-analysis of docetaxel administered once every 3 weeks compared with once every week second line treatment of advanced non-small-cell lung cancer[J].J ClinOncol,2007,25(11):1377-1382.
[17].F.V. Fossella, D.A. Berry, S.Adachi, etal. Survival in previously treated advanced NSCLC:Pemetrexed versus best supportive care (BSC) [J]. ASCO Meeting Abstracts, Jun 2006;24:17015.
[18].De Boer R,Arrietao,Gottfried M,et al.Vandetanib plus pemetrexed versus pemetrexed as second-line therapy in patients with advanced non-small cell lung cancer(NSCLC):A randomized,double-blind phaseⅢtrial (ZEAL)[J].J Clin Oncol,27:15s,2009(suppl;abstr 8010).
[19].Shepherd FA,Rodrigues Pereira J,Ciuleanu T,etal.Erlotinib in previously treated non-small-cell lung cancer[J].N Engl J Med,2005,353(2):123-132.
[20].Ciuleanu TE,Brodowicz T,Belani CP,etal.Maintenancepemetrexed plus best supportive care(BSC)versus place-bo plus BSC:A phaseⅢstudy[J].J Clin Oncol,2008,26(suppl); abstr 8011.
[21].Takeda K,Hida T,Sato T,etal.Randomized phaseⅢstudy of platinum-doublet chemotherapy followed by gefi-tinib compared with continued platinum-doublet chemotherapy in Japanese patients with advanced non-small cell lung cancer(NSCLC):Results of a west Japan thoracic oncology group trial(WJTOG0203) [J].JClin Oncol,2010,28(5):753-760.
[22].Rowinsky EK,Eisenhause EA,Chaudhry V.etal.Clinical toxicities encountered with taxol [J].Semin oncol,1993;20(4,S3):1-15.
[23].Chen CH,Chang JW,Lee CH,et al.Dose-finding and phase 2 study of weekly paclitaxel (taxol) and cisplatin combination in treating Chinese patients with advanced non-small cell lung cancer[J].AmJ Chin.Oncol,2005;28(5):508-512.
[24].周际昌.实用肿瘤内科[M].北京：人民卫生出版社,2003,第2版：386-388.
[25].贾博琦,鲁云兰.现代临床实用药物手册[M].北京：北京医科大学出版社,2001,第2版：732-734.
[26].郑婉珍,丁纪元.百士欣胶囊对非小细胞肺癌化疗减毒作用的研究[J].现代中西医结合杂志,2005,14(4),437-438.
[27].申红霞,王蕾,赵娜.牛磺酸对化疗荷瘤小鼠增效减毒作用的研究[J].现代生物医学进展,2008；8(4)：640-642.
[28].托娅,张和平.益生菌Lb.casei Zhang对H22荷瘤小鼠化疗的减毒增效作用[J].内蒙古医学院学报,2011；33(2)：98-99.
[29].赵晓莹,张菁华,赵恩锋.亚硒酸钠对以铂类为基础的抗癌化疗减毒作用的观察[J].中国医师杂志,2002：4(10)：1152-1153.
[30].王英武,王鹏.恶性肿瘤放化疗后的中医辨证施治[J].中华中西医学杂志,2003,1(1)：61-62.
[31].吴继萍,朱丽文,杨晓红.中医药防治放化疗毒副反应的临床研究[J].光明中医,2000,15(5)：46-48
[32].王国庆.丁香柿蒂加半夏汤治疗化疗后消化道反应50例[J].中国民间疗法,2002,10(8)：40
[33].雷晓红,余守稚.参苓白术散加味治疗恶性肿瘤放化疗后腹泻[J].中成药,2007,29(10)：1419-1421
[34].李金臣.半夏泻心汤治疗肿瘤化疗致胃肠道反应28例[J].河南中医,2008,28(3)：23-24
[35].李仁延.半夏泻心汤治疗肿瘤化疗后消化道反应128例[J].陕西中医,2006,27(4)：425
[36].郭军.中药治疗消化道肿瘤化疗所致胃肠道反应的疗效观察[J].中国中医基础医学杂志,2008,14(7)：531.532
[37].赵华,雷成阳,齐芳迎.自拟升白汤治疗恶性肿瘤化疗后白细胞减少症临床研究[J].河南中医学院 学报.2008,23(3)：40,43
[38].文安怡.参芪地黄汤治疗恶性肿癌化疗后白细胞减少症32例[J].实用中医内科杂志,2009,23(1)：69-70
[39].陈红民.生血益元煎治疗放化疗后白细胞减少症临床观察[J].现代中西医结合杂志,2009,18(2)：157,165
[40].孔庆志,黄涛,费雁等.黄芪对大剂量顺铂所致肾毒性防护的临床研究[J].中国肿瘤临床与康复,1999,6(3)：9.
[41].全达芳,李佐清健脾补肾法防治顺铂为主化疗药所致肾功能损耗的临床观察[J].广西中医药,1994,17(5)：1,5,10.
[42].王建智,王建国.黄芪注射液拮抗阿霉素致小鼠心脏毒性的作用[J].第四军医大学学报,2006,27(4)：366.
[43].安军海,崔建欣.参麦注射液保护阿霉素致心肌损害[J].中医研究.2001.14(2)：46.
[44].顾晓怡,姜藻,董丽钧.参芪扶正液抗蒽环类化疗药物所致心脏毒性的作用[J].东南大学学报(医学版),2008,27(5)：375.
[45].赵增虎,李成云,付显成等.固发汤预防化疗引起脱发39例观察[J].实用中医药杂志,1999,15(1)：12.
[46].周岱翰,林丽珠,周宜强,等.中医药对提高非小细胞肺癌中位生存期的作用研究[J].广州中医药大学学报,2005,22(4)：255-258.
[47].张中华,任清宇.中药消癌平口服液治疗晚期肺癌的疗效观察.中华医学实践杂志,2007,6(7)：640-64.
[48].刘嘉湘,潘敏求,黎月恒,等.金复康口服液治疗原发性非小细胞肺癌临床研究.肿瘤,2001,21(6)：463-465.
[49].郭素敏.中药扶正联合放射治疗肺癌的临床研究[J].河北医药,2008,30(8)：1164.
[50].张霆.解毒疏络法对肺癌放疗减毒作用的临床研究[J].武警医学,2008,19(1)：53-57.
[51].郝迎旭,崔惠娟,蔡光蓉,等.扶正增效方对肺癌放射增效作用的临床观察.中医杂志,1997,38(2)：8.
[52].蔡红兵,代方国,闵清芬,等.中医药配合放疗治疗肺癌的临床研究.第一军医大学学报,2002,22(12)：1112.
[53].易成,黄晓兵,侯梅.化疗联合人参皂甙Rg3治疗肺癌的实验研究[J].中国中西医结合杂志,2005,25(1)：58-59.
[54].李柳宁,刘伟胜,徐凯等.中医辨证综合治疗Ⅲ、Ⅳ期非小细胞肺癌生存质量及疗效的研究[J].中国肺癌杂志,20036(3)：216-219.
[55].黄群.益气养阴方合用化疗治疗60例非小细胞肺癌临床观察.中国临床医药研究杂志,2005,(140)：53-54.
[56].刘嘉湘,施志明,李和根,等.益肺抗癌饮治疗271例肺癌研究.医学研究通讯,2003,32(3)：23-24.
[57].刘展华,史建文.复方阿胶浆对肺癌化疗增效减毒作用的临床观察.中华中医药学刊,2007,25(11)：2427-2429.
[58].范先基,冯献斌,宁雪坚,等.中药健脾益肾方治疗中晚期肺癌临床观察.华夏医学,2008,21(1)：74-75.
[59].李道睿,崔太荣,吴皓,林洪生.辨治肿瘤学术思想初探[J].中国中医药信息杂志,2008,15(6)：86.
[60].Swith W,KHuri FR.The care of the lung cancer patient in the 21st century:a new age [J].Semin Oncol.2004,21 (14):11-15.
[61].孙立红,季淑玉等.艾迪注射液加NP方案治疗中晚期非小细胞肺癌临床疗效观察[J].使用肿瘤杂志.2005：20(4)：349-350.
[62].吴万垠,王斌等.参附注射液对NP方案治疗非小细胞肺癌患者生活质量影响的研究[J].中成药.2007：29(1)：14-18.
[63].柏长青,宋颖芳,王德堂,等.黄芪、党参提取物增强紫杉醇抑制肿瘤血管生成和转移的实验研究[J].细胞与分子免疫学杂志,2008,24(4)：375-377.
[64].李成云.黄芪注射液预防大剂量顺铂对肾功能损害的效果观察[J].中国基层医药,2007,14(8)：1359.
[65].张志翔,戚峰,周德俊,等.氟尿嘧啶联合黄芪对小鼠胃癌组织氨基酸代谢的影响[J].中国胃肠外科杂志,2006,9(5)：445-447.
[66].赵美蓉,周洁.黄芪多糖对恶性肿瘤化疗后骨髓抑制的影响.天津中医药,2007,24(2)：114-115.
[67].肖月升,杨振玲,耿建芳,等.黄芪党参蘑菇煎在大肠癌治疗中的辅助作用[J].时珍国医国药,2008,19(7)：1683-1684.
[68].Wd X,Zhang J.Astragal us mongholieus and polygonum multiflorm's protective function against cyclophosphamide inhibitory effect on thymns[J].Am J Chin Med,2004,32(5):669.
[69].单俊杰,王顺春.黄芪多糖的化学和药理作用研究进展[J].上海中医药大学学报,2000,12(3)：61-65.
[70].甘宁,陈焕朝等.黄芪注射液辅助化疗治疗老年肺癌的疗效观察[J].肿瘤防治研究.2004,31(7)：433-434.
[71].耿长山,等.黄芪多糖对去T细胞小鼠促进抗体产生机理探讨[J].中国药理通讯,1985,2(2)：14.
[72].沈映君.中药药理学[M].第一版,上海.上海科学技术出版社.1997：160,163.
[73].朱瑾波,王慧贤,焦炳忠,等.黄精调节免疫及防治肿瘤作用的实验研究[J].中国中医药科技,1994,1(6)：31
[74].钱士辉,王佾先等,陈皮提取物体外抗肿瘤作用的研究[J].中药材.2003,26(10)：744-755.
[75].孟志强,郭伟剑,于尔辛,等·健脾理气方药物血清对肝癌细胞端粒酶活性及凋亡的影响[J].世界华人消化杂志,2000,8(8)：879-882.
[76].周振华,宋明志,于尔辛,等·健脾理气方对小鼠HAC肝癌细胞凋亡和bax基因蛋白表达影响的实验研究[J].中国中西医结合脾胃杂志,2000,8(2)：78-79.
[77].陈涛,陈茂华.原发性支气管肺癌临床证型的文献统计分析[J].时珍国医国药,2006,17(5)：854-855.
[78].张子理,杜兰宁,李睦昭,等.扶正补血冲剂128例临床研究.实用中西医结合杂志,1996；9(5)：262-263.
[79].Fast LD,Palmall SR,Evidence for T cell nature and leterogeneity within natural killer and antibody-dependent cellular cytotoxicity effecters:a comparision with cytolytic T lymphocytes.J.Immunol,1981;(2):448.
[80].Memichael FABRE.Monocloal antibody in clinical medicine[M],London:Academic Press Ine LTD,1982;24.
[81].汤钊猷.现代肿瘤学[M].上海科技出版社,1993.638.
[82].孙刚.肺癌的中医药治疗研究进展与思考[J].江苏中医,2000,21(1)：44.
[83].易成,黄晓兵,侯梅.化疗联合人参皂甙Rg3治疗肺癌的实验研究[J].中国中西医结合杂志,2005,25(1)：58-59.
[84].宋国红,邸立军.艾迪.注射液合并化疗治疗晚期恶性肿瘤疗效观察[J].肿瘤防治杂志,2004,11(6)： 650-651.
[85].高鹏,许远朋,蒋红心,等.扶正消瘤液对肿瘤患者生活质量影响的临床研究[J].现代肿瘤医学,2003,11(4)：263-264.
[86].刘嘉湘,潘敏求,黎月恒,等.金复康口服液治疗非小细胞肺癌临床研究.中医杂志,1997,38(12)：727.
[2].李佩文.中医药治疗化疗毒副反应的现状与展望[J].中国中医药信息杂志,1996：3(1)：22-25
[3].田卫卫,王庆苗.肿瘤化疗毒副反应从脾论治探讨[J].陕西中医,2001：22(1)：32-33.
[4].Greenlee RT,Murray T, Bolden S, et al Cancer statistics [J].CA Cancer JClin,2000,50(1):7-33.
[5].Bunn PA Jr. Chemotherapy for advanced non-small-cell lung cancer:who, what, when, why[J].Clin Onco,l 2002,20(18):23-33.
[6].宋扬,冯英明,张贺龙,等.顺铂分别联合诺维本、健择、泰索帝治疗晚期非小细胞肺癌的临床研究[J].现代肿瘤医学,2005,13(4)：494-496.
[7].陈玲,赵新汉,李旭,等.晚期非小细胞肺癌不同治疗方案疗效的比较[J].现代肿瘤医学,2007,15(1)：38-40.
[8].AielloRJ, BreesD, Bourassa PA,etal. Increased atherosclerosis inhyperlipidemic mice with inactivation of ABCA1 in macrophages[J].ArteriosclerThromb Vasc Bio,l 2002,22(4):630-637.
[9].Ardizzoni A,Boni L,Tiseo M,et al.Cisplatin-versus car-boplatin-based chemotherapy in first-line treatment of ad-vanced non-small-cell lung cancenan individual patientdata meta-analysis[J].J Natl Cancer Inst,2007,99 (11):847-857.
[10].Scagliotti GV,Parikh P,von Pawel J,etal.PhaseIIIstudycomparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with ad-vanced-stage non-small-cell lung cancer[J].J Clin Oncol,2008,26(21):3543-3551.
[11].Sandler A,Gray R,Perry MC,etal.Paclitaxel-carboplatinalone or with bevacizumab for non-small-cell lung cancer[J].N Engl J Med,2006,355(24):2542-2550.
[12].Carinol,Mezger J,Griesinger F,et aI.MO19390(SAIL):Safety and efficacy of first-line bevacizumab-based therapy in advanced non-small-cell lung cancer [J],J Clin ONCOL,2009,17(15s):Abstr8043.
[13].Pirker R,Szczesna A,von Pawel J,etal.FLEX:A randomized,multicenter,phaseⅢstudy of cetuximab incombination with cisplatin/vinorelbine(CV)versus CValone in the first-line treatment of patients with advanced non-small cell lung cancer(NSCLC)[J].J Clin Oncol,2008,26(suppl):abstr 3.
[14].Leighl NB,Shepherd FA,Kwong R,etal.Economic analysis of the TAX317 trial:docetaxel versus best supportive care as second-line therapyof advanced non-small-cell lung cancer[J].J Clin Oncol,2002,20(5): 1344-1352.
[15].Fossella FV,DeVore R,Kerr RN,etal.Randomized phaseⅢtrial ofdocetaxel versus vinorelbine or ifosfamide in patients with advancednon-small-cell lung cancer previously treated with platinum-contain-ing chemotherapy regimens.The TAX 320 Non-Small Cell Lung CancerStudy Group[J].J Clin Oncol,2000,18(12): 2354-2362.
[16]. Di Maio M,Permne F,Chiodini P,etal.Individual patient data meta-analysis of docetaxel administered once every 3 weeks compared with once every week second line treatment of advanced non-small-cell lung cancer[J].J ClinOncol,2007,25(11):1377-1382.
[17].F.V. Fossella, D.A. Berry, S.Adachi, etal. Survival in previously treated advanced NSCLC:Pemetrexed versus best supportive care (BSC) [J]. ASCO Meeting Abstracts, Jun 2006;24:17015.
[18].De Boer R,Arrietao,Gottfried M,et al.Vandetanib plus pemetrexed versus pemetrexed as second-line therapy in patients with advanced non-small cell lung cancer(NSCLC):A randomized,double-blind phaseⅢtrial (ZEAL)[J].J Clin Oncol,27:15s,2009(suppl;abstr 8010).
[19].Shepherd FA,Rodrigues Pereira J,Ciuleanu T,etal.Erlotinib in previously treated non-small-cell lung cancer[J].N Engl J Med,2005,353(2):123-132.
[20].Ciuleanu TE,Brodowicz T,Belani CP,etal.Maintenancepemetrexed plus best supportive care(BSC)versus place-bo plus BSC:A phaseⅢstudy[J].J Clin Oncol,2008,26(suppl); abstr 8011.
[21].Takeda K,Hida T,Sato T,etal.Randomized phaseⅢstudy of platinum-doublet chemotherapy followed by gefi-tinib compared with continued platinum-doublet chemotherapy in Japanese patients with advanced non-small cell lung cancer(NSCLC):Results of a west Japan thoracic oncology group trial(WJTOG0203) [J].JClin Oncol,2010,28(5):753-760.
[22].Rowinsky EK,Eisenhause EA,Chaudhry V.etal.Clinical toxicities encountered with taxol [J].Semin oncol,1993;20(4,S3):1-15.
[23].Chen CH,Chang JW,Lee CH,et al.Dose-finding and phase 2 study of weekly paclitaxel (taxol) and cisplatin combination in treating Chinese patients with advanced non-small cell lung cancer[J].AmJ Chin.Oncol,2005;28(5):508-512.
[24].周际昌.实用肿瘤内科[M].北京：人民卫生出版社,2003,第2版：386-388.
[25].贾博琦,鲁云兰.现代临床实用药物手册[M].北京：北京医科大学出版社,2001,第2版：732-734.
[26].郑婉珍,丁纪元.百士欣胶囊对非小细胞肺癌化疗减毒作用的研究[J].现代中西医结合杂志,2005,14(4),437-438.
[27].申红霞,王蕾,赵娜.牛磺酸对化疗荷瘤小鼠增效减毒作用的研究[J].现代生物医学进展,2008；8(4)：640-642.
[28].托娅,张和平.益生菌Lb.casei Zhang对H22荷瘤小鼠化疗的减毒增效作用[J].内蒙古医学院学报,2011；33(2)：98-99.
[29].赵晓莹,张菁华,赵恩锋.亚硒酸钠对以铂类为基础的抗癌化疗减毒作用的观察[J].中国医师杂志,2002：4(10)：1152-1153.
[30].王英武,王鹏.恶性肿瘤放化疗后的中医辨证施治[J].中华中西医学杂志,2003,1(1)：61-62.
[31].吴继萍,朱丽文,杨晓红.中医药防治放化疗毒副反应的临床研究[J].光明中医,2000,15(5)：46-48
[32].王国庆.丁香柿蒂加半夏汤治疗化疗后消化道反应50例[J].中国民间疗法,2002,10(8)：40
[33].雷晓红,余守稚.参苓白术散加味治疗恶性肿瘤放化疗后腹泻[J].中成药,2007,29(10)：1419-1421
[34].李金臣.半夏泻心汤治疗肿瘤化疗致胃肠道反应28例[J].河南中医,2008,28(3)：23-24
[35].李仁延.半夏泻心汤治疗肿瘤化疗后消化道反应128例[J].陕西中医,2006,27(4)：425
[36].郭军.中药治疗消化道肿瘤化疗所致胃肠道反应的疗效观察[J].中国中医基础医学杂志,2008,14(7)：531.532
[37].赵华,雷成阳,齐芳迎.自拟升白汤治疗恶性肿瘤化疗后白细胞减少症临床研究[J].河南中医学院 学报.2008,23(3)：40,43
[38].文安怡.参芪地黄汤治疗恶性肿癌化疗后白细胞减少症32例[J].实用中医内科杂志,2009,23(1)：69-70
[39].陈红民.生血益元煎治疗放化疗后白细胞减少症临床观察[J].现代中西医结合杂志,2009,18(2)：157,165
[40].孔庆志,黄涛,费雁等.黄芪对大剂量顺铂所致肾毒性防护的临床研究[J].中国肿瘤临床与康复,1999,6(3)：9.
[41].全达芳,李佐清健脾补肾法防治顺铂为主化疗药所致肾功能损耗的临床观察[J].广西中医药,1994,17(5)：1,5,10.
[42].王建智,王建国.黄芪注射液拮抗阿霉素致小鼠心脏毒性的作用[J].第四军医大学学报,2006,27(4)：366.
[43].安军海,崔建欣.参麦注射液保护阿霉素致心肌损害[J].中医研究.2001.14(2)：46.
[44].顾晓怡,姜藻,董丽钧.参芪扶正液抗蒽环类化疗药物所致心脏毒性的作用[J].东南大学学报(医学版),2008,27(5)：375.
[45].赵增虎,李成云,付显成等.固发汤预防化疗引起脱发39例观察[J].实用中医药杂志,1999,15(1)：12.
[46].周岱翰,林丽珠,周宜强,等.中医药对提高非小细胞肺癌中位生存期的作用研究[J].广州中医药大学学报,2005,22(4)：255-258.
[47].张中华,任清宇.中药消癌平口服液治疗晚期肺癌的疗效观察.中华医学实践杂志,2007,6(7)：640-64.
[48].刘嘉湘,潘敏求,黎月恒,等.金复康口服液治疗原发性非小细胞肺癌临床研究.肿瘤,2001,21(6)：463-465.
[49].郭素敏.中药扶正联合放射治疗肺癌的临床研究[J].河北医药,2008,30(8)：1164.
[50].张霆.解毒疏络法对肺癌放疗减毒作用的临床研究[J].武警医学,2008,19(1)：53-57.
[51].郝迎旭,崔惠娟,蔡光蓉,等.扶正增效方对肺癌放射增效作用的临床观察.中医杂志,1997,38(2)：8.
[52].蔡红兵,代方国,闵清芬,等.中医药配合放疗治疗肺癌的临床研究.第一军医大学学报,2002,22(12)：1112.
[53].易成,黄晓兵,侯梅.化疗联合人参皂甙Rg3治疗肺癌的实验研究[J].中国中西医结合杂志,2005,25(1)：58-59.
[54].李柳宁,刘伟胜,徐凯等.中医辨证综合治疗Ⅲ、Ⅳ期非小细胞肺癌生存质量及疗效的研究[J].中国肺癌杂志,20036(3)：216-219.
[55].黄群.益气养阴方合用化疗治疗60例非小细胞肺癌临床观察.中国临床医药研究杂志,2005,(140)：53-54.
[56].刘嘉湘,施志明,李和根,等.益肺抗癌饮治疗271例肺癌研究.医学研究通讯,2003,32(3)：23-24.
[57].刘展华,史建文.复方阿胶浆对肺癌化疗增效减毒作用的临床观察.中华中医药学刊,2007,25(11)：2427-2429.
[58].范先基,冯献斌,宁雪坚,等.中药健脾益肾方治疗中晚期肺癌临床观察.华夏医学,2008,21(1)：74-75.
[59].李道睿,崔太荣,吴皓,林洪生.辨治肿瘤学术思想初探[J].中国中医药信息杂志,2008,15(6)：86.
[60].Swith W,KHuri FR.The care of the lung cancer patient in the 21st century:a new age [J].Semin Oncol.2004,21 (14):11-15.
[61].孙立红,季淑玉等.艾迪注射液加NP方案治疗中晚期非小细胞肺癌临床疗效观察[J].使用肿瘤杂志.2005：20(4)：349-350.
[62].吴万垠,王斌等.参附注射液对NP方案治疗非小细胞肺癌患者生活质量影响的研究[J].中成药.2007：29(1)：14-18.
[63].柏长青,宋颖芳,王德堂,等.黄芪、党参提取物增强紫杉醇抑制肿瘤血管生成和转移的实验研究[J].细胞与分子免疫学杂志,2008,24(4)：375-377.
[64].李成云.黄芪注射液预防大剂量顺铂对肾功能损害的效果观察[J].中国基层医药,2007,14(8)：1359.
[65].张志翔,戚峰,周德俊,等.氟尿嘧啶联合黄芪对小鼠胃癌组织氨基酸代谢的影响[J].中国胃肠外科杂志,2006,9(5)：445-447.
[66].赵美蓉,周洁.黄芪多糖对恶性肿瘤化疗后骨髓抑制的影响.天津中医药,2007,24(2)：114-115.
[67].肖月升,杨振玲,耿建芳,等.黄芪党参蘑菇煎在大肠癌治疗中的辅助作用[J].时珍国医国药,2008,19(7)：1683-1684.
[68].Wd X,Zhang J.Astragal us mongholieus and polygonum multiflorm's protective function against cyclophosphamide inhibitory effect on thymns[J].Am J Chin Med,2004,32(5):669.
[69].单俊杰,王顺春.黄芪多糖的化学和药理作用研究进展[J].上海中医药大学学报,2000,12(3)：61-65.
[70].甘宁,陈焕朝等.黄芪注射液辅助化疗治疗老年肺癌的疗效观察[J].肿瘤防治研究.2004,31(7)：433-434.
[71].耿长山,等.黄芪多糖对去T细胞小鼠促进抗体产生机理探讨[J].中国药理通讯,1985,2(2)：14.
[72].沈映君.中药药理学[M].第一版,上海.上海科学技术出版社.1997：160,163.
[73].朱瑾波,王慧贤,焦炳忠,等.黄精调节免疫及防治肿瘤作用的实验研究[J].中国中医药科技,1994,1(6)：31
[74].钱士辉,王佾先等,陈皮提取物体外抗肿瘤作用的研究[J].中药材.2003,26(10)：744-755.
[75].孟志强,郭伟剑,于尔辛,等·健脾理气方药物血清对肝癌细胞端粒酶活性及凋亡的影响[J].世界华人消化杂志,2000,8(8)：879-882.
[76].周振华,宋明志,于尔辛,等·健脾理气方对小鼠HAC肝癌细胞凋亡和bax基因蛋白表达影响的实验研究[J].中国中西医结合脾胃杂志,2000,8(2)：78-79.
[77].陈涛,陈茂华.原发性支气管肺癌临床证型的文献统计分析[J].时珍国医国药,2006,17(5)：854-855.
[78].张子理,杜兰宁,李睦昭,等.扶正补血冲剂128例临床研究.实用中西医结合杂志,1996；9(5)：262-263.
[79].Fast LD,Palmall SR,Evidence for T cell nature and leterogeneity within natural killer and antibody-dependent cellular cytotoxicity effecters:a comparision with cytolytic T lymphocytes.J.Immunol,1981;(2):448.
[80].Memichael FABRE.Monocloal antibody in clinical medicine[M],London:Academic Press Ine LTD,1982;24.
[81].汤钊猷.现代肿瘤学[M].上海科技出版社,1993.638.
[82].孙刚.肺癌的中医药治疗研究进展与思考[J].江苏中医,2000,21(1)：44.
[83].易成,黄晓兵,侯梅.化疗联合人参皂甙Rg3治疗肺癌的实验研究[J].中国中西医结合杂志,2005,25(1)：58-59.
[84].宋国红,邸立军.艾迪.注射液合并化疗治疗晚期恶性肿瘤疗效观察[J].肿瘤防治杂志,2004,11(6)： 650-651.
[85].高鹏,许远朋,蒋红心,等.扶正消瘤液对肿瘤患者生活质量影响的临床研究[J].现代肿瘤医学,2003,11(4)：263-264.
[86].刘嘉湘,潘敏求,黎月恒,等.金复康口服液治疗非小细胞肺癌临床研究.中医杂志,1997,38(12)：727.