本文選題：益氣養(yǎng)陰解毒方　切入點：EGFR-TKI　出處：《安徽醫(yī)科大學》2017年碩士論文

【摘要】：目的 通過觀察我科益氣養(yǎng)陰解毒方聯(lián)合表皮生長因子受體酪氨酸激酶抑制劑(EGFR-TKI)治療晚期非小細胞肺癌患者的近期療效、臨床癥狀改善情況、無進展生存期和不良反應,探討益氣養(yǎng)陰解毒方聯(lián)合EGFR-TKI治療晚期非小細胞肺癌的有效性及安全性。方法 收集2014年1月至2015年12月入住安徽醫(yī)科大學附屬省立醫(yī)院中醫(yī)腫瘤科和腫瘤化療科IIIB/IV期的非小細胞肺癌患者,符合納入標準條件的50例患者隨機分為2組,治療組27例,接受益氣養(yǎng)陰解毒方和EGFR-TKI(吉非替尼或厄洛替尼)治療,對照組23例,只接受單藥EGFR-TKI(吉非替尼或厄洛替尼)治療,持續(xù)用藥直到腫瘤進展或因毒副作用不能耐受而終止治療,觀察兩組患者的近期療效、臨床癥狀改善情況、無進展生存期(PFS)和不良反應。臨床觀察結(jié)束后,統(tǒng)計各類數(shù)據(jù)并記錄,應用SPSS 17.0統(tǒng)計軟件進行數(shù)據(jù)處理。結(jié)果 近期療效比較,治療組客觀緩解率為70.37%,高于對照組的56.52%,但差異無統(tǒng)計學意義(P㧐0.05);兩組在KPS評分及無進展生存期等方面,治療組均優(yōu)于對照組,P㩳0.05,兩組之間的差異具有統(tǒng)計學意義;在臨床癥狀改善情況上,治療組患者咳嗽、咳痰較對照組明顯改善,差異有統(tǒng)計學意義,在咯血、胸痛癥狀緩解情況上,治療組患者優(yōu)于對照組,但兩組比較差異無統(tǒng)計學意義;在不良反應方面,治療組皮疹、腹瀉的發(fā)生率分別為62.96%、33.33%,低于對照組的86.95%和60.87%,兩組相比差異無顯著性意義(P㧐0.05),但中藥聯(lián)合EGFR-TKI組患者的皮疹、腹瀉嚴重程度明顯低于對照組。結(jié)論 益氣養(yǎng)陰解毒方聯(lián)合EGFR-TKI治療晚期非小細胞肺癌可以很好的緩解晚期患者的臨床癥狀,減輕皮疹、腹瀉的嚴重程度,穩(wěn)定患者的生活質(zhì)量,進而延長無進展生存期,安全性良好,可以作為治療晚期非小細胞肺癌的有效方法。
[Abstract]:Objective To observe the effect of Yiqi Yangyin Jiedu decoction combined with of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy curative effect in patients with advanced non small cell lung cancer, clinical symptoms, progression free survival and adverse reactions of Yiqi Yangyin Jiedu decoction combined with EGFR-TKI is effective and safety in the treatment of advanced non-small cell lung cancer. The method of non small cell lung cancer were collected from January 2014 to December 2015 in the affiliated Provincial Hospital of Medical University Of Anhui of TCM oncology and chemotherapy of stage IIIB/IV patients, 50 patients were randomly divided in accordance with the inclusion criteria conditions into 2 groups, 27 cases in the treatment group were received Yiqi Yangyin Jiedu Decoction and EGFR-TKI (gefitinib or erlotinib) treatment. The control group of 23 cases, only accept single drug EGFR-TKI (gefitinib or erlotinib) treatment, medication or until the cancer continues to progress because of the adverse effect of intolerance Termination of treatment, to observe the curative effects of two groups of patients, the clinical symptoms, progression free survival (PFS) and adverse reaction. After clinical observation, statistics and record all kinds of data, using SPSS 17 statistical software for data processing. The results of the recent curative effect comparison, treatment group objective remission rate was 70.37% higher than that of the control. The 56.52% group, but the difference was not statistically significant (P? 0.05); the two groups in KPS score and progression free survival, the treatment group was better than the control group, P? 0.05, the difference was statistically significant between the two groups; in the improvement of clinical symptoms, the patients in the treatment group than in the control of cough, expectoration group improved significantly, with statistical significance, the difference in hemoptysis, chest pain symptoms, the patients in the treatment group than the control group, but the difference between the two groups was not statistically significant; in terms of adverse reactions, the treatment group the incidence of rash, diarrhea were 62.96%, 3 3.33%, 86.95% and 60.87% lower than the control group, no significant difference between the two groups (P? 0.05), but the combination of traditional Chinese medicine in EGFR-TKI group were rash, diarrhea severity was significantly lower than the control group. Conclusion Yiqi Yangyin Jiedu decoction combined with EGFR-TKI can better relieve clinical symptoms, reduce skin rash in patients with advanced treatment of advanced non small cell lung cancer, the severity of diarrhea, stable quality of life of patients, prolong progression free survival, good safety, can be used as a treatment for advanced non-small cell lung cancer and effective method.

【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R734.2

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