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目的:研究中药治疗联合化疗较单用化疗治疗晚期非小细胞肺癌的疗效和总体生存期,初步评价参麦注射液联合化疗的临床疗效、毒副反应和对生存质量的影响。方法:将60例老年晚期非小细胞肺癌患者随机分为治疗组和对照组各30例,两组均给予化疗,腺癌和腺鳞癌采用多西他赛+顺铂(TP方案):多西他赛80mg/m2,第1天,顺铂30mg/m2,第1~3天;鳞癌采用吉西他滨+顺铂(GP方案):吉西他滨1.2/m2第1、8天,顺铂30mg/m2第1~3天。治疗组在治疗前加用参麦注射液合生理盐水静滴,3周为1个周期。记录两组中医证候评分、生活质量积分、卡氏评分和毒副反应,全组患者两个周期后行胸腹部增强CT、骨扫描、脑MRI等检查以评价近期疗效。结果:治疗组治疗后中医证候较本组治疗前、对照组治疗后明显改善(P<0.01),生存质量、卡氏评分均较本组治疗前、对照组治疗后明显改善(P<0.05);对照组治疗后中医证候积分改善不明显,生存质量、卡氏评分较本组治疗前明显改善(P<0.05),两组毒副反应比较差异有统计学意义(P<0.05),治疗组毒副反应低于对照组。结论:参麦注射液联合化疗治疗老年晚期非小细胞肺癌具有提高化疗耐受力、改善临床症状、降低毒副反应、提高生存质量的作用,值得临床推广应用。
Objective: To study the curative effect and overall survival of traditional Chinese medicine combined with chemotherapy and chemotherapy alone in the treatment of advanced non-small cell lung cancer (NSCLC). To evaluate the clinical efficacy, side effects and quality of life of Shenmai injection combined with chemotherapy. Methods: Sixty elderly patients with advanced non-small cell lung cancer were randomly divided into treatment group (n = 30) and control group (n = 30). Both groups were given chemotherapy, adenocarcinoma and adenosquamous carcinoma using docetaxel plus cisplatin (TP) The first day, cisplatin 30mg / m2, 1st to 3rd day; squamous cell carcinoma with gemcitabine + cisplatin (GP program): gemcitabine 1.2 / m2 on the first day, cisplatin 30mg / m2 The first ~ 3 days. Treatment group before treatment plus Shenmai injection of saline infusion, 3 weeks for a cycle. Two sets of TCM syndrome scores, QOL scores, Karnofsky scores and toxicities and side effects were recorded. All patients underwent two cycles of chest and abdomen enhanced CT, bone scan and brain MRI to evaluate the short-term effect. Results: After treatment, the TCM syndromes of the treatment group were significantly improved (P <0.01) and the quality of life and the Karnofsky score of the control group were significantly improved after treatment (P <0.05) ). After treatment, the improvement of TCM syndrome score was not obvious in the control group. The quality of life and the Karnofsky score were significantly improved compared with those before treatment in the control group (P <0.05). There was significant difference in the side effects between the two groups (P <0.05) Toxic side reactions in the treatment group were lower than those in the control group. Conclusion: Shenmai injection combined with chemotherapy for the treatment of advanced non-small cell lung cancer in elderly patients with chemotherapy to improve tolerance, improve clinical symptoms, reduce side effects and improve the quality of life, worthy of clinical application.