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加减沙参麦冬汤辅助治疗肺癌患者对免疫功能及不良反应的影响
郑和平,黄梅,蒲廷,郑劲松,郑惠之
0
(南充市中心医院中医科;四川省肿瘤医院·电子科技大学医学院;仪陇县永乐中心卫生院)
摘要:
目的 探讨加减沙参麦冬汤辅助治疗对肺癌患者免疫功能及不良反应的影响。方法 遴选非小细胞肺癌(NSCLC)患者106例随机分为对照组和观察组各53例,对照组给予GP方案化疗(顺铂注射液+盐酸吉西他滨),观察组在对照组治疗基础上给予加减沙参麦冬汤辅助治疗,对比两组临床疗效,观察治疗前及治疗8w后的中医症状积分、T细胞亚群水平和不良反应。结果 观察组的临床总有效率和病灶稳定率分别为5283%和8302%,显著高于对照组的32.08%和62.26%(P<0.05);治疗后,两组中医症状积分中咳嗽、痰血、神疲乏力、心烦不眠、低热盗汗、大便干结的积分显著降低(P<0.05),观察组变化幅度显著大于对照组(P<0.05);治疗后,分析T细胞亚群指标发现,观察组的CD3+、CD4+占比及CD4+/CD8+值显著增加(P<0.05),对照组CD8+占比显著增加(P<0.05),CD4+/CD8+值有所降低(P<0.05),组间治疗后对比,差异有统计学意义(P<0.05);观察组的骨髓抑制、胃肠道反应及感染发生率分别为15.09%、5.66%及0.00%,显著低于对照组的32.08%、22.64%及9.43%(P<0.05)。结论 加减沙参麦冬汤辅助GP化疗方案治疗对阴虚内热型NSCLC患者疗效显著,不良反应少,可有效改善患者相关症状,提高免疫系统功能。
关键词:  肺癌  阴虚内热型  加减沙参麦冬汤  免疫功能  不良反应
DOI:
基金项目:
Effects of adjuvant treatment of modified Shashen Maidong decoction on immune function and adverse reactions in patients with lung cancer
ZHENG Heping,HUANG Mei,PU Ting,ZHENG Jingsong,ZHENG Huizhi
(Traditional Chinese Medicine Department, Nanchong Central Hospital;The Affiliated Cancer Hospital, School of Medicine, UESTC;Yilong County Yongle Center Health)
Abstract:
Objective To explore the effects of adjuvant treatment of modified Shashen Maidong decoction on immune function and adverse reactions of patients with lung cancer (Yin deficiency and internal heat syndrome).Methods 106 patients with nonsmall cell lung cancer (NSCLC)(Yin deficiency and internal heat syndrome) were randomly divided into control group and observation group with 53 cases in each group. Control group was given GP regimen chemotherapy (cisplatin injection+ gemcitabine hydrochloride), and observation group was given adjuvant treatment of modified Shashen Maidong decoction on the basis of control group. The clinical efficacy of the two groups was compared. TCM symptoms scores, Tcell subsets levels and adverse reactions were observed before treatment and after 8 weeks of treatment. Results The clinical total effective rate and stable rate of lesion in observation group were significantly higher than those in control group[(52.83% and 83.02%) vs (32.08% and 62.26%)] (P<0.05). After treatment, the scores of cough, bloody phlegm, fatigue, upset and sleeplessness, lowtemperature and night sweats, and dry stools of TCM symptoms scores were significantly decreased in the two groups (P<0.05), and the changes in observation group were significantly greater than those in control group (P<0.05). After treatment, the Tcell subsets indexes found that the proportions of CD3+and CD4+and CD4+/CD8+were significantly increased in observation group (P<0.05), and the proportion of CD8+was significantly increased in control group (P<0.05), while the CD4+/CD8+value was decreased(P<0.05), and the difference between groups was statistically significant after treatment(P<0.05). The incidence rates of myelosuppression, gastrointestinal reactions and infection were 15.09%,5.66% and 0.00%respectively in observation group, which were significantly lower than those in control group with 32.08%,22.64% and 9.43%(P<0.05). Conclusion Modified Shashen Maidong decoction assisted with GP chemotherapy for patients with NSCLC (Yin deficiency and internal heat syndrome) can have significant efficacy. It can effectively improve the related symptoms, and enhance the immune system function, and has few adverse reactions in clinical application.
Key words:  Lung cancer  Yin deficiency and internal heat syndrome  Modified Shashen Maidong decoction  Immune function  Adverse reactions

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