沙参麦冬汤与康莱特注射液联合治疗中晚期非小细胞肺腺癌临床研究

目的:回顾分析沙参麦冬汤联合康莱特注射液治疗非小细胞肺腺癌中晚期化疗患者的临床疗效。方法:选取2012年6月—2014年6月中晚期非小细胞肺腺癌患者72例的临床资料进行回顾性分析,根据治疗方案分为对照组36例与研究组36例。对照组采取常规化疗治疗;研究组于对照组化疗方案的基础上加用沙参麦冬汤口服并静脉滴注康莱特注射液。疗程结束后统计2组临床疗效、治疗前及疗程结束后血清细胞角蛋白19片段Cyfra21-1、癌胚抗原(CEA)水平、毒副反应、免疫功能指标(CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺),并于疗程结束后随访1~3年,统计2组生存情况。结果:研究组总有效率75.00%高于对照组50.00%,差异有统计学意义(P<0.05);疗程结束后,2组血清Cyfra21-1、CEA水平较治疗前降低,且研究组Cyfra21-1、CEA低于对照组,差异有统计学意义(P<0.05);2组均未发生Ⅳ度毒副反应,且研究组腹泻率(16.67%)、呕吐恶心率(19.44%)、骨髓抑制率(22.22%)、白细胞减少率(19.44%)低于对照组(P<0.05);疗程结束后,研究组CD3⁺、CD4⁺、CD4⁺/CD8⁺高于对照组,CD8⁺低于对照组(P<0.05);研究组中位生存期为23.1个月,无进展生存期为20.6个月;对照组中位生存期为18.0个月,无进展生存期为15.7个月。研究组1年生存率86.11%高于对照组61.11%,差异有统计学意义(P<0.05);2年生存率研究组及3年生存率分别与对照组比较,差异均无统计学意义(P>0.05)。结论:化疗基础上联合采取沙参麦冬汤及康莱特注射液治疗中晚期非小细胞肺腺癌,可有效降低患者血清CEA、Cyfra21-1水平,改善其机体免疫功能,提高治疗效果,并能降低毒副反应发生率、提高近期生存率。

Clinical Study on Shashen Maidong Tang Combined with Kanglaite Injection for Non- Small Cell Lung Adenocarcinoma at Middle-Advanced Stage

Objective:To analyze the clinical effect of Shashen Maidong tang combined with Kanglaite injection for patients undergoing chemotherapy who had non-small cell lung adenocarcinoma at middle-advanced stage by retrospective analysis. Methods:Among a total of 72 cases of enrolled patients with non-small cell lung adenocarcinoma at middleadvanced stage who were admitted and treated from June 2012 to June 2014,retrospective analysis was conducted on their clinical data. All patients were divided into the control group and the study group according to therapeutic schemes,36 cases in each group. The control group was given routine chemotherapy, and the study group was additionally given the oral administration of Shashen Maidong tang and intravenous drip of Kanglaite injection based on the chemotherapy regimen of the control group. After treatment,the clinical effect was counted in the two groups. Before and after treatment,the levels of cytokeratin 19 fragment antigen 21-1(Cyfra21-1) and carcinoembryonic antigen(CEA) in serum, toxic side effects, and indexes of immune function including CD3⁺,CD4⁺,CD8⁺,and CD4⁺/CD8⁺were counted. After treatment,all patients were followed up from one to three years;the survival in the two groups was counted. Results:The total effective rate was75.00% in the study group, higher than that of 50.00% in the control group, the difference being significant(P<0.05).After treatment,the levels of Cyfra21-1 and CEA in serum in the two groups were decreased when compared with those before treatment,and the two levels in the study group were lower than those in the control group,the difference being significant(P<0.05). No toxic side effects of Ⅳ degree occurred in the two groups;in the study group, the diarrhea rate(16.67%),the rate of nausea and vomiting(19.44%),the myelosuppression rate(22.22%),and the leukopenia rate(19.44%)were all lower than those in the control group(P<0.05). After treatment,the indexes of CD3⁺,CD4⁺,and CD4⁺/CD8⁺in the study group were higher than those in the control group,and CD8⁺was lower(P<0.05). In the study group,the median survival time was 23.1 months,and the progression free survival was 20.6 months. In the control group,the median survival time was 18.0 months,and the progression free survival was 15.7 months. The one-year survival rate was 86.11% in the study group,higher than that of 61.11% in the control group,the difference being significant(P<0.05). When compared the two-year and the three-year survival rates respectively,there was no significant difference being found between the two groups(P>0.05). Conclusion:In the treatment of non-small cell lung adenocarcinoma at middle-advanced stage, the combined therapy of Shashen Maidong tang and Kanglaite injection based on chemotherapy can effectively reduce the levels of Cyfra21-1 and CEA in serum and the incidence of toxic side effects, improve immune function of body and curative effect,as well as increase short-term survival rate.