中医综合疗法治疗晚期非小细胞肺癌临床研究

目的通过前瞻性研究,与单纯化疗组比较,观察中药与中药加化疗治疗晚期非小细胞肺癌(NSCLC)的临床疗效.方法将136例晚期NSCLC住院患者随机分为中药组、化疗组、中药加化疗组(联合组),分别给予相应治疗,观察各组临床疗效、证型变化、生活质量、远期生存等指标.结果中药组、化疗组、联合组肿瘤缓解率分别为2.1%、27.2%、44.4%,化疗组、联合组优于中药组;而获益率中药组与化疗组无差别,联合组则优于以上两组(P＜0.05).中药组、联合组在缓解咳嗽、咯痰、乏力、胸闷、舌紫黯等症状以及稳定生活质量方面均优于单纯化疗组(P＜0.05,P＜0.01).与单纯化疗组比较,中药联合化疗能明显减轻化疗相关毒副反应.与中药组比较,化疗可加重患者气虚证与血瘀证(P＜0.05).中药组、联合组中位生存期和1年生存率分别为11.5个月、36.1%与1 2.3个月、48.9%,明显高于化疗组的9.2个月、27.3%(P＜0.05).结论中医综合治疗能够稳定和缩小NSCLC局部病灶、提高患者生活质量、延长患者生存期,与化疗伍用具有增效减毒效应.

Study on TCM Comprehensive Therapy in the Treatment of Advanced Non-small Cell Lung Cancer

Objective To compare the therapeutic effect among the group of chemotherapy alone, TCM and TCM plus chemotherapy, through the prospective clinical research. Methods 136 cases with advanced non-small cell lung cancer (ANSCLC) were allocated randomly into three groups, they were treated by TCM alone(47), chemotherapy alone(44) and chemotherapy plus TCM(45). The response rate, changing of TCM differentiation, quality of life and long-term survival were employed as observation indexes. Results The response rate in the group of chemotherapy alone and chemotherapy plus TCM were 27.2% and 44.4%, higher than that in TCM group (P <0.05). Compared with chemotherapy alone, TCM and TCM plus chemotherapy achieved greater effective in relieving tumor related symptoms such as cough, sputum, fatigue, breathlessness and quality of life (P <0.05, P <0.01). TCM might relieve the side effects of chemotherapy. It had been found that chemotherapy might aggravate TCM differentiation of Qi deficient and blood stagnant (P <0.05). Survival analysis showed that the median survival in TCM and TCM plus chemotherapy were 11.5 months and 12.3 months respectively, longer than that in chemotherapy alone(9.2 months), P <0.05. 1-year survival rates in TCM(36.1%) and TCM plus chemotherapy(48.9%) were higher than that in chemotherapy alone(27.3%), P <0.05. Conclusion TCM might inhibit the progression of tumor, promote the quality of life and prolong the long-term survival. Furthermore, TCM might enhance therapeutic effect and relieve the side effect of chemotherapy.