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目的:探讨绞股蓝抗癌方辨证同步化疗和维持治疗中晚期非小细胞肺癌(NSCLC)的近期和远期疗效。方法:将107例中晚期NSCLC患者按住院先后顺序随机分为对照组52例和观察组55例。对照组选择多西他赛注射液加顺铂(TP)方案进行治疗;观察组在对照组治疗的基础上加用绞股蓝抗癌方辨证内服,1剂/d。两组疗程直至出现病情进展后终止观察。于化疗前和化疗结束后1个月采用CT扫描实体瘤大小、进行生活质量Karnofsky评分、主要症状和体征评分、并检测T淋巴细胞亚群,NK细胞水平;记录无进展生存期(PFS)和进行安全性评价。结果:观察组实体瘤疗效总有效率为72.73%,高于对照组的53.85%(P<0.05);观察组PFS为(8.1±1.6)个月,优于对照组的(5.4±1.5)个月(P<0.01);治疗后观察组主要症状、体征均低于对照组,Karnofsky评分高于对照组(P<0.01);观察组生活质量提高+稳定率为87.27%,高于对照组的71.15%(P<0.05);治疗后观察组CD3~+,CD4~+,CD4~+/CD8~+和NK细胞水平均较治疗前上升(P<0.01),并高于治疗后对照组水平(P<0.01);治疗后观察组CD8+水平较治疗前下降(P<0.01),并低于对照组(P<0.05);化疗期间观察组Ⅲ和Ⅳ度不良反应的发生率为21.82%,低于对照组的40.38%(P<0.05)。结论:绞股蓝抗癌方辨证同步化疗和维持治疗中晚期NSCLC化疗患者能缩小瘤体、减轻化疗产生的毒副反应、改善临床症状、提高患者生活质量和免疫功能,并能延长无进展生存期,近期和远期疗效均显著。
Objective: To investigate the short-term and long-term effects of Gynostemma anti-cancer prescriptions on concurrent chemotherapy and maintenance of advanced non-small cell lung cancer (NSCLC). Methods: A total of 107 patients with advanced NSCLC were randomly divided into control group (n = 52) and observation group (n = 55) according to the order of hospitalization. The control group chose docetaxel injection plus cisplatin (TP) regimen for treatment; the observation group was treated with Gynostemma anti-cancer prescription based on the treatment of the control group, one dose / d. Two groups of treatment until the progression of the disease stopped after the observation. Before chemotherapy and one month after chemotherapy, CT scan of solid tumor size, quality of life Karnofsky score, the main symptoms and signs score, and T lymphocyte subsets, NK cell levels; record progression-free survival (PFS) and Safety evaluation. Results: The total effective rate of the observation group was 72.73%, higher than that of the control group (53.85%, P <0.05). The PFS of the observation group was (8.1 ± 1.6) months, which was significantly higher than that of the control group (5.4 ± 1.5) (P <0.01). After treatment, the main symptoms and signs of the observation group were lower than those of the control group, Karnofsky score was higher than that of the control group (P <0.01); the quality of life in the observation group was improved and the stability rate was 87.27% 71.15% (P <0.05). After treatment, the levels of CD3 +, CD4 +, CD4 + / CD8 + and NK cells in the observation group were significantly higher than those before treatment (P <0.01), and were higher than those in the control group (P <0.01). After treatment, the level of CD8 + in the observation group decreased significantly (P <0.01) and lower than that in the control group (P <0.05). The incidence of grade Ⅲ and Ⅳ adverse reactions in the observation group was 21.82% 40.38% lower than the control group (P <0.05). Conclusions: Gynostemma anti-cancer prescriptions of synchronous chemotherapy and maintenance treatment of patients with advanced NSCLC chemotherapy can reduce the tumor, reduce chemotherapy side effects, improve clinical symptoms, improve patient quality of life and immune function, and can prolong progression-free survival, Recent and long-term efficacy are significant.