【作者】 黎壮伟；

【导师】 陈锐深；

【作者基本信息】 广州中医药大学 ， 中西医结合临床， 2006， 硕士

【摘要】 目的:观察仙鱼汤及其配合化疗治疗中晚期非小细胞肺癌的临床疗效。 方法:将90例合格的中晚期非小细胞肺癌患者随机分为仙鱼汤组、化疗组和联合组（仙鱼汤+化疗）,仙鱼汤组患者予口服仙鱼汤治疗;化疗组患者接受化疗,联合组接受化疗及口服仙鱼汤治疗。各组均治疗一个疗程,比较各组的瘤体大小、肺癌主要临床症状、生存质量、体重、免疫功能及毒副反应等。 结果:对瘤体改变观察显示,联合组有效率（46.67%）高于化疗组（30.00%）,但无显著性差异（P>0.05）。仙鱼汤组（3.33%）有效率低于化疗组（P<0.01）;瘤体稳定率比较,联合组稳定率最高（86.67%）,与化疗组（60.00%）有显著性差异（P<0.05）,仙鱼汤组稳定率（73.33%）高于化疗组,但无显著性差异（P>0.05）。与化疗组相比,仙鱼汤组在咳嗽、发热、气短、乏力、纳差等方面有较好的有效性（P<0.05或P<0.01）;而在血痰、胸痛等方面,无显著性差异（P>0.05）。联合组在咳嗽、血痰、发热、气短、乏力等方面较化疗组有较好的有效性（P<0.05）;而在胸痛、纳差等方面,无显著性差异（P>0.05）。仙鱼汤组和联合组治疗后患者KPS评分提高,与化疗组比较有显著性差异（P<0.05或P<0.01）。三组治疗后均能不同程度增加患者的体重,通过对比,联合组和仙鱼汤比化疗组能明显增加患者的体重（P<0.05或P<0.01）。仙鱼汤组与联合组治疗后,自然杀伤细胞和淋巴细胞转换率均较治疗前提高,以仙鱼汤组提高较为明显（P<0.01）,与化疗组比较有显著性差异（P<0.01）。仙鱼汤组治疗后CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺均较治疗前有所提高,CD₈⁺较治疗前降低（P<0.01）;化疗组治疗后与治疗前相比,CD₃⁺、CD₄⁺降低,CD₈⁺提高（P<0.01或P<0.05）,CD₄⁺/CD₈⁺较治疗前降低,但差异无显著性（P>0.05）。联合组治疗后,CD₃⁺、CD₄⁺提高（P<0.01或P<0.05）,CD₈⁺、CD₄⁺/CD₈⁺较治疗前升高,但差异无显著性（P>0.05）。仙鱼汤组无明显不良反应,联合组不良反应率较化疗组明显减少,特别是在血液系统、谷丙转氨酶、谷氨酰转肽酶、恶心呕吐、血尿素氮、肌酐、心率、过敏、头发、周围神经、皮肤等方面具有显著性差异（P<0.05）。 结论:综上所述,仙鱼汤毒副作用较少,具有稳定瘤体,改善中晚期非小细胞肺癌患者的临床主要症状,提高患者生活质量,增加体重,提高免疫力等作用;与化疗结合,能提高化疗药物的治疗效果,减轻其毒副反应。更多还原

【Abstract】 Objective: To evaluate the effect and adverse reactions of combined chemotherapy and XianYu Decoction in the treatment of medium or late stage none-small cell lung cancer(NSCLC). Methods:90 patients with stage Ⅲ~Ⅳ NSCLC were divided randomly into groupA, group B and group C. In group A, 30 patients were treated with XianYu Decoction alone. In Group B(as a control group), 30 patients were treated with chemotherapy alone. In Group C, 30 patients were treated with chemotherapy combined with XianYu Decoction. The effect and adverse reactions of the three groups, including the changes of tumors, the main symptoms of NSCLC, quality of life, body weight, immunity and side-effect, were evaluated after one course of treatment.Results:The complete and partial remission rate(CR+PR) of Group C(46. 67%) was higher than Group B(30.00%), but have no significant difference between them(P>0. 05), The complete and partial remission rate of Group A(3. 33%) was lower than Group B and Group C(P<0. 01);The stable rate(CR+PR+SD) of Group C(86. 67%) was the highest and had significant difference comparing with Group B(60. 00%) (P<0. 05), The stable rate of Group A (73. 33%) was higher than the GroupB, but had no significant difference (P>0. 05). The Group A had a better effect in the remission of symptoms such as cough, fever, polypnea, debility and anorexia than Group B (P<0. 05 or P<0. 01) , there was no significant difference between Group A and Group B in the remission of symptoms such as hemoptysis and pectoralgia(P>0.05). The Group C had a better effect in the remission of symptoms such as cough, hemoptysis, fever, polypnea and debility than Group B(P<0. 05), there was no significant difference between Group A and Group B in the remission of symptoms such as pectoralgia and anorexia(P<0.05). TheKarnofsky scores in Group A and Group C increase more than that in Group B after a course of treatment (P<0. 05 or P<0. 01). The three groups could increase the body weight of patients more or less, by comparison , Group A and Group C increase more than Group B(P<0. 05 or P<0. 01). Moreover, XianYu Decoction could increase the percentage of national kill cell(NKC) and LBT in Group A and Group C after treatment, especially Group A increased obviously(P<0. 01). Group A and Group C increase significantly the percentage of NKC and LBT than Group B after treatment(P<0.01).In Group A, XianYu Decoction could increase CD3+, CD4+, CD4VCD8+ and decrease the percentage of CD8+ in T-lymphocyte subcategory statistically after treatment (P<0. 01), while CD3\CD4*, CD//CD/ and CD8+in T-lymphocyte subcategory in Group B were not significant(P>0. 05). In group C, CD3+ and CD4+ increase significantly after treatment (P<0. 05 or P<0. 01), while CD4+/CD8+ and CD8+were not significant (P>0.05). XianYu Decoction had no severe adverse reactions. The rate of adverse reactions in Group C were lower than that in Group B,especially in the field of the system of hematology, alanine ami notransf erase (ALT), aspartate aminotransf erase (AST), vomit, blood urea nitrogen(BUN), creatinine(CREA), heart rate, hypersusceptibility, hair, peripheral nerve and skin, there were significant difference(P<0. 05). Conclusion: The side-effect of XianYu Decoction was less.It could stabilize the tumor , alleviate the symptoms of the medium or late NSCLC patients, improve the quality of life, increase the body weight, improve the immunity. Combined with chemotherapy, XianYu Decoction could enhance the efficacy and reduce the side-effect of chemotherapy.更多还原