【摘要】 目的评价复方苦参注射液联合TP方案治疗晚期肺癌恶性胸腔积液的疗效,观察其对癌胚抗原（CEA）、甲胎蛋白（AFP）和神经元特异性烯醇化酶（NSE）水平的影响。方法将2018年6月—2019年3月就诊于河北省邯郸市人民医院和河北省邯郸市第一医院的晚期肺癌恶性胸腔积液患者100例,按照随机对照原则进行分组,对照组50例给予TP方案（紫杉醇+顺铂）治疗,联合组50例给予TP方案+复方苦参注射液治疗,均治疗3个周期。评估2组疗效,观察治疗前后患者胸腔积液、肺功能[用力呼气量占用力肺活量比值（FEV₁/FVC）、每分钟最大通气量（MVV）]、血清肿瘤标志物变化,记录不良反应发生情况。结果联合组治疗总有效率为80%（40/50）,明显高于对照组的62%（31/50）（P<0.05）;治疗3个周期后2组胸腔积液均较治疗前明显减少,MVV、FEV₁/FVC较治疗前明显增加,CEA、AFP、NSE水平较治疗前明显降低,差异均有统计学意义（P均<0.05）;联合组治疗3个周期后胸腔积液少于对照组,MVV及FEV₁/FVC高于对照组,CEA、AFP及NSE水平明显低于对照组,差异均有统计学意义（P均<0.05）。2组胃肠反应、乏力、发热及白细胞和/或血小板计数减少发生率相比差异无统计学意义（P>0.05）。结论复方苦参注射液联合TP方案治疗晚期肺癌恶性胸腔积液的疗效较好,可明显减少胸腔积液,改善肺功能,抑制病情进展,且未增加不良反应发生。更多还原

【Abstract】 Objective It is to evaluate the curative effect of compound Kushen injection combined with TP regimen on malignant pleural effusion of advanced lung cancer and its effects on the levels of carcinoembryonic antigen（CEA）, alpha-fetoprotein（AFP） and neuron-specific enolase（NSE）. Methods 100 patients with advanced lung cancer and malignant pleural effusion treated in Handan People’s Hospital and Handan First Hospital from June 2018 to March 2019 were divided into two groups according to randomized control the principle, the control group（50 cases） was treated with TP regimen（paclitaxel+cisplatin）, the combination group（50 cases） was treated with TP regimen+compound Kushen injection, both groups were treated for 3 cycles of treatment. The efficacy was evaluated and adverse reactions occurred were recorded in the two groups, and the changes in pleural effusion, lung function [forced expiratory volume-occupied vital capacity ratio（FEV₁/FVC）, maximum ventilation per minute（MVV）], and serum tumor markers were observed before and after treatment. Results The total effective rate of treatment in the combination group was 80%（40/50）, which was higher than that 62%（31/50） of the control group（P<0.05）. After 3 cycles of treatment, the pleural effusion of the two groups was significantly reduced, MVV and FEV₁/FVC were significantly increased and the levels of CEA, AFP, and NSE were significantly decreased compared to before treatment,after 3 cycles of treatment, the pleural effusion of the combination group was less, MVV and FEV₁/FVC were higher and the levels of CEA, AFP, and NSE were significantly lower than those of the control group after 3 cycles of treatment, and the difference were statistically significant（P<0.05）. There was no significant difference in the incidence of gastrointestinal reactions, fatigue, fever and white blood cell or/and platelet count reduction between the two groups（P>0.05）. Conclusion Compound Kushen injection combined with TP regimen has good curative effect on advanced lung cancer with malignant pleural effusion without increasing the occurrence of adverse reactions. It can reduce the pleural effusion and improve lung function, and inhibit the progression of the disease. Its mechanism of action may be related to inhibiting the expression of serum CEA, AFP and NSE.更多还原