消岩汤调整黄芪剂量联合GP方案治疗非小细胞肺癌的临床观察

Clinical observation of Xiaoyan decoction adjusted dose of Astragalus combined with GP regimen in the treatment of non-small cell lung cancer

关键词:  黄芪  剂量  骨髓抑制  化疗  非小细胞肺癌

Key words:  Astragalus  dosage  bone marrow suppression  chemotherapy  non-small cell lung cancer

摘要:

[目的]观察不同剂量黄芪组方的消岩汤对非小细胞肺癌化疗患者不良反应的影响。[方法]采用完全随机化方法，将90例天津中医药大学第一附属医院非小细胞肺癌患者随机分成治疗组（60 g黄芪组方的消岩汤+GP方案化疗组）和对照组（消岩汤+GP方案化疗组），观察不同剂量黄芪组方的消岩汤对气虚毒瘀型非小细胞肺癌化疗的骨髓抑制发生率（白细胞水平）及分级、免疫功能、细胞因子、生活质量的影响。[结果]化疗1周期后评价，2组在近期疗效上治疗组有效率为62.2%，对照组为55.6%，比较无统计学差异，（P>0.05）；在骨髓抑制方面，治疗组白细胞下降水平、回升程度及骨髓抑制发生率均优于对照组（P<0.05），治疗组骨髓抑制分级均明显优于对照组；免疫功能方面，治疗后治疗组与对照组比较，CD3⁺、CD4⁺及CD4⁺/CD8⁺均明显升高（P<0.05）；在细胞因子方面，治疗后治疗组白介素-6（IL-6）、粒细胞-巨噬细胞集落刺激因子（GM-CSF）较对照组升高明显，有统计学差异（P<0.05）；在生活质量方面，两组间患者卡氏评分变化比较具有统计学意义（P<0.05）。[结论]重用黄芪用量的消岩汤联合化疗治疗非小细胞肺癌，对于改善化疗所致的骨髓抑制、免疫功能下降、细胞因子减少疗效更佳，且对生活质量的改善更加明显。

Abstract:

[Objective] To observe Xiaoyan decoction adjusted dose of Astragalus combined with GP regimen in the treatment of non-small cell lung cancer.[Methods] Using completely randomized method, 90 patients in The First Affiliated Hospital of Tianjin University of traditional Chinese medicine of non-small cell lung cancer were randomly divided into treatment group (Xiaoyan decoction 60 g of Astragalus combined with GP) and control group (Xiaoyan decoction combined with GP). Different doses of Astragalus in Xiaoyan decoction of qi deficiency and stasis type of non-small cell lung cancer incidence of bone marrow suppression (level of WBC) and the influence of grading, cytokines, immune function, quality of life were observed.[Results] After 1 cycles of chemotherapy, the efficiency rate was 62.2% in the treatment group and 55.6% in the control group. There was no significant difference between two groups (P>0.05). In the aspect of suppression in bone marrow, WBC decreased level, recovery degree and incidence of bone marrow suppression in the treatment group was better than the control group (P<0.05). Treatment group was significantly better than the control group in bone marrow suppression grading. In immune function, level of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in treatment group were significantly increased than control group (P<0.05). In the cytokine after treatment, IL-6, GM-CSF of treatment group compared with the control group were increased significantly. There were statistically significant differences (P<0.05). In terms of quality of life, the change of KPS score between the two groups was statistically significant (P<0.05).[Conclusion] Increase the dosage of Astragalus in Xiaoyan decoction combined with chemotherapy in the treatment of non-small cell lung cancer can improve chemotherapy-induced bone marrow suppression, decreased immune function, cytokines reduce and the quality of life. Clinical efficiency is more obvious.