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目的:观察鸦胆子油乳胸腔注射联合吉非替尼治疗肺腺癌恶性胸腔积液的疗效和安全性。方法:38例肺腺癌恶性胸腔积液患者随机分为两组,各19例。观察组予以鸦胆子油乳胸腔灌注联合吉非替尼组治疗,对照组单用吉非替尼组治疗,比较两组患者临床疗效和不良反应。结果:(1)胸腔积液的控制率:观察组和对照组分别为84.2%和52.6%,差异有统计学意义。(2)可测量病灶:有效率(CR+PR)观察组和对照组分别为76.5%和50.0%,差异无统计学意义;疾病控制率(CR+PR+SD)观察组和对照组分别为94.1%和88.9%,差异无统计学意义。(3)生活质量评分:两组治疗后整体状况(躯体功能、社会功能、情绪功能、整体生活质量方面)及症状方面(疼痛、疲乏、呼吸困难、食欲减退、睡眠困难、便秘)较治疗前改善,差异有统计学意义;与对照组比较,观察组患者改善更明显,差异具有统计学意义。(4)不良反应:主要为皮疹,皮肤瘙痒和腹泻,两组差异无统计学意义。结论:鸦胆子油乳胸腔注射联合吉非替尼可以更早有效地控制肺腺癌恶性胸腔积液,不良反应低,并能提高患者生活质量。
Objective: To observe the efficacy and safety of Brucea javanica oil emulsion combined with gefitinib in the treatment of malignant pleural effusion of lung adenocarcinoma. Methods: Thirty-eight patients with malignant pleural effusion of lung adenocarcinoma were randomly divided into two groups, 19 cases each. The observation group was treated with Brucea javanica oil emulsion combined with gefitinib and the control group with gefitinib alone. The clinical efficacy and side effects of the two groups were compared. Results: (1) The control rate of pleural effusion: the observation group and the control group were 84.2% and 52.6% respectively, the difference was statistically significant. (2) measurable lesions: effective rate (CR + PR) observation group and control group were 76.5% and 50.0%, the difference was not statistically significant; disease control rate (CR + PR + SD) observation group and control group were 94.1% and 88.9%, the difference was not statistically significant. (3) Quality of life score: The overall status (physical function, social function, emotional function, overall quality of life) and symptom (pain, tiredness, dyspnea, loss of appetite, sleep difficulty, constipation) Improvement, the difference was statistically significant; compared with the control group, the observation group patients improved more significantly, the difference was statistically significant. (4) Adverse reactions: mainly rash, pruritus and diarrhea, no significant difference between the two groups. Conclusion: Brucea javanica breast injection combined with gefitinib can control the malignant pleural effusion of lung adenocarcinoma earlier and with lower adverse reactions, and can improve the quality of life of patients.