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目的:观察扶正益气抗癌汤联合化疗治疗晚期非小细胞肺癌患者临床疗效,对于患者血清基质金属蛋白酶9(MMP-9)、血管内皮生长因子(VEGF)、T细胞亚群水平的影响。方法:应用随机平行对照方法,将92例住院患者,随机分为两组。对照组46例患者化疗用法、用量与对照组相同,治疗组46例患者在化疗基础上,应用益气扶正抗癌汤100 m L,日3次口服,治疗21 d为1周期,共行4周期化疗。观察比较两组患者中医症状评分情况、卡式评分、T淋巴细胞亚群(CD+3CD+4CD+8)及血清MMP-9、VEGF水平,近期疗效、远期疗效,不良反应。结果:两组治疗总有效率比较,治疗组(63.1%)优于对照组(54.4%),差异无统计学意义(P>0.05);治疗组中位生存期为16.0个月,2年生存率为45.7%;对照组中位生存期为12.0个月,2年生存率为34.8%,治疗组优于对照组,但两组相比差异无统计学意义(P>0.05);第2~4周期,治疗组症状评分下降明显,而对照组则评分增高,两组与治疗前比较,差异均具有统计学意义(P<0.01),且两组组间比较差异显著(P<0.01);治疗组改善率为60.9%;对照组改善率为39.1%,两组患者生活质量改善率比较有显著性差异(P<0.05);治疗后,治疗组CD+3,CD+4,CD+4/CD+8均升高,与治疗前相比差异明显(P<0.01)。与对照组治疗后结果相比,差异显著(P<0.01);两组治疗后VEGF水平均下降,但治疗前后及组间比较,血清VEGF水平无显著差异(P>0.05);患者两组治疗后血清MMP-9水平与治疗前相比均下降,且治疗组优于对照组(P<0.01);不良反应方面,治疗组骨髓抑制及消化道反应改善情况优于对照组(P<0.01)。结论:扶正益气抗癌汤联合化疗,可以有效减轻患者化疗期间的不良反应,缓解不适症状,显著改善患者生活质量,缓解病情进展。
Objective: To observe the clinical effect of Fuzheng Yiqi Kang Cancer Decoction combined with chemotherapy on patients with advanced non-small cell lung cancer (NSCLC) and its effect on serum MMP-9, VEGF and T cell subsets. Methods: A total of 92 hospitalized patients were randomly divided into two groups using randomized parallel control. Forty-six patients in the control group received the same amount of chemotherapy as the control group. On the basis of chemotherapy, 46 patients in the control group received 100 ml of Yiqi Fuzheng Kang Cancer Decoction daily for 3 days and 21 days for 1 cycle. Cycle chemotherapy. The TCM symptom score, card score, T lymphocyte subsets (CD + 3CD + 4CD + 8), serum MMP-9 and VEGF levels, short-term curative effect, long-term curative effect and adverse reactions were observed and compared between the two groups. Results: The total effective rate in the two groups was significantly higher than that in the control group (63.1% vs 54.4%, P> 0.05). The median survival time was 16.0 months in the treatment group and 2 years in the treatment group The median survival time was 12.0 months in the control group and 34.8% in 2 years. The treatment group was superior to the control group, but there was no significant difference between the two groups (P> 0.05) (P <0.01). There was significant difference between the two groups (P <0.01). The difference between the two groups was statistically significant (P <0.01). The improvement rate of the treatment group was 60.9%; the improvement rate of the control group was 39.1%; the improvement rate of the quality of life between the two groups was significantly different (P <0.05); After treatment, CD + 3, CD + 4, CD + 4 / CD + 8 were significantly higher than those before treatment (P <0.01). Compared with the control group, the difference was significant (P <0.01). The levels of VEGF in both groups decreased after treatment, but there was no significant difference in serum VEGF between the two groups before and after treatment (P> 0.05) Compared with the control group, the serum level of MMP-9 decreased after treatment, and the treatment group was better than the control group (P <0.01). In adverse reactions, the improvement of bone marrow suppression and digestive tract response in the treatment group was better than that in the control group (P <0.01) . Conclusion: Fuzheng Yiqi Kang Cancer Decoction combined with chemotherapy can effectively reduce the adverse reactions during chemotherapy, relieve the symptoms of discomfort, significantly improve the quality of life of patients and alleviate the progression of the disease.