标题：益气化痰解毒汤联合化疗治疗晚期非小细胞肺癌近期疗效及对临床症状积分和毒副反应的影响

      作者：曲萌，吴丹，李婧，苏垠旭    宝鸡市人民医院中医科，陕西 宝鸡 721000

      卷次： 2023年34卷11期

      【摘要】 目的 探究益气化痰解毒汤联合化疗治疗晚期非小细胞肺癌的近期疗效及对临床症状积分和毒副反应的影响。方法 选取2019年3月至2022年3月宝鸡市人民医院收治的112例晚期非小细胞肺癌患者为研究对象，按随机数表法将患者分为对照组和观察组各56例，对照组患者予以GP化疗方案(吉西他滨+顺铂)治疗，观察组在此基础上联合益气化痰解毒汤治疗，共治疗4个疗程，疗程结束后比较两组患者的近期疗效、疾病控制率、治疗前后免疫功能(外周血T细胞亚群)、临床症状积分以及治疗后的生活质量[卡氏评分(KPS)]和不良反应发生情况。结果 对照组患者治疗过程中6例脱落，最终纳入50例；观察组患者的治疗总有效率为64.29%，明显高于对照组的42.00%，差异有统计学意义(P<0.05)，但两组患者的疾病控制率比较差异无统计学意义(P>0.05)；观察组患者治疗后的CD3+、CD4+、CD4+/CD8+、自然杀伤细胞(NK)较同组治疗前均明显升高，且观察组患者的CD3+、CD4+、CD4+/CD8+、NK [(61.75±4.13)%、(35.15±4.25)%、1.14±0.10、24.26±2.98]明显高于对照组[(55.75±4.04)%、(26.17±4.41)%、0.82±0.03、22.02±2.54]，差异均有统计学意义(P<0.05)；治疗1个疗程、2个疗程、3个疗程和4个疗程后，两组患者的临床症状积分均较治疗前明显降低，且观察组患者的临床症状积分[(26.90±6.61)分、(22.69±6.03)分、(18.47±4.22)分、(16.39±3.61)分]明显低于对照组[(28.34±6.87)分、(26.77±6.43)分、(23.56±4.94)分、(20.34±4.16)分]，差异均有统计学意义(P<0.05)；治疗4个疗程后，观察组患者的生活质量提高率为55.36%，明显高于对照组的32.00%，差异有统计学意义(P<0.05)；治疗4个疗程后，观察组患者的白细胞计数(WBC)、血小板(PLT)和血红蛋白(Hb)的降低率明显低于对照组，差异均有统计学意义(P<0.05)。结论 益气化痰解毒汤与化疗联合应用治疗晚期非小细胞肺癌不仅能提高患者免疫功能，缓解临床症状，而且能提升患者生活质量，降低毒副反应，疗效确切，具有临床应用价值。
      【关键词】 非小细胞肺癌；化疗；益气化痰解毒汤；近期疗效；临床症状；毒副反应
      【中图分类号】 R734.2 【文献标识码】 A 【文章编号】 1003—6350（2023）11—1543—05

Short-term efficacy of Yiqi Huatan Jiedu Decoction combined with chemotherapy in the treatment of advancednon-small cell lung cancer and the influence on clinical symptom scores and toxicities.
QU Meng, WU Dan, LI Jing,SU Yin-xu. Department of Traditional Chinese Medicine, Baoji People's Hospital, Baoji 721000, Shaanxi, CHINA
【Abstract】 Objective To investigate the short-term efficacy of Yiqi Huatan Jiedu Decoction combined withchemotherapy in the treatment of advanced non-small cell lung cancer, and the influence on clinical symptom scores andtoxicities. Methods A total of 112 patients with advanced non-small cell lung cancer who were admitted to Baoji Peo-ple's Hospital from March 2019 to March 2022 were selected as the research subjects, and divided into the control groupand the observation group by random number table method, with 56 cases in each group. Patients in the control groupwere treated with GP (gemcitabine+cisplatin) chemotherapy, and those in the observation group were treated with YiqiHuatan Jiedu Decoction on this basis. Both groups of patients underwent 4 courses of treatment. The two groups werecompared in terms of short-term efficacy after treatment, disease control rate, immune function (peripheral blood T cellsubsets), clinical symptom scores, quality of life [Karnofsky Performance Scale (KPS)], and the incidence of adverse re-actions. Results There were 6 patients lost to follow up in the control group, and finally 50 patients were included. Thetotal treatment response rate in the observation group (64.29%) was significantly higher than that in the control group(42.00%), and the difference was statistically significant (P<0.05). There was no statistically significant difference in dis-ease control rate between the two groups (P>0.05). After treatment, CD3+, CD4+, CD4+/CD8+, and NK cells in the obser-vation group were (61.75±4.13)%, (35.15±4.25)%, 1.14±0.10, and 24.26±2.98, significantly higher than (55.75±4.04)%,(26.17±4.41)%, 0.82±0.03, and 22.02±2.54 in the control group (P<0.05). Clinical symptoms of the two groups de-creased significantly after 1 course, 2 courses, 3 courses, and 4 courses of treatment; the scores of the observation groupwere (26.90±6.61) points, (22.69±6.03) points, (18.47±4.22) points, and (16.39±3.61) points, significantly lower than(28.34±6.87) points, (26.77±6.43) points, (23.56±4.94) points, and (20.34±4.16) points of the control group; the differ-ences were statistically significant (P<0.05). The improvement rate of quality of life in the observation group was55.36%, significantly higher than 32.00% in the control group (P<0.05). The reduction rates of white blood cell count(WBC), platelet count (PLT), and hemoglobin (Hb) in the observation group were significantly lower than those in thecontrol group (P<0.05). Conclusion Yiqi Huatan Jiedu Decoction combined with chemotherapy for treating advancednon-small cell lung cancer can not only improve the patients’immune function and relieve clinical symptoms, but alsoimprove quality of life and reduce toxicity.
      【Key words】 Non-small cell lung cancer; Chemotherapy; Yiqi Huatan Jiedu Decoction; Short-term efficacy; Clin-ical symptom; Toxicity