健脾益腎湯對(duì)脾腎兩虛型晚期非小細(xì)胞肺癌CTC的影響
發(fā)布時(shí)間：2018-08-15 18:44
【摘要】：目的:本課題主要研究健脾益腎湯對(duì)脾腎兩虛型晚期非小細(xì)胞肺癌患者CTC的影響及患者癥候的改善情況,客觀評(píng)價(jià)該方的臨床療效,為個(gè)體化治療提供依據(jù)。方法:所有病例均來(lái)源于2014年3月至2015年2月蘇州大學(xué)附屬第一醫(yī)院腫瘤內(nèi)科經(jīng)細(xì)胞學(xué)或病理學(xué)確診的晚期NSCLC患者(IIIb、IV期)(包括未手術(shù)和術(shù)后復(fù)發(fā)或轉(zhuǎn)移者),并且符合中醫(yī)辨證屬脾腎兩虛證的患者60例,采用隨機(jī)數(shù)字表化,以1:1:1的比例隨機(jī)分為中藥組、西藥組、中西醫(yī)結(jié)合組,分別給予健脾益腎湯口服,NP方案化療,健脾益腎湯口服聯(lián)合NP方案化療,各組均在治療前和治療第21±3后,抽取7.5ml外周血采用Cellsearch系統(tǒng)行CTC檢測(cè),并觀察三組治療后近期療效、中醫(yī)癥候療效、卡氏(KPS)評(píng)分、免疫功能和毒副反應(yīng)的發(fā)生情況。結(jié)果:1、中藥組(口服健脾益腎湯)中有1例患者用藥依從性差,退出治療,作為無(wú)效病例。2、三組患者的病情在有效率及穩(wěn)定率方面中西醫(yī)結(jié)合組優(yōu)于西藥組和中藥組,并有明顯差異(P0.05);西藥組優(yōu)于中藥組,有顯著性差異(P0.05)。3、中藥組、西藥組、中西醫(yī)結(jié)合組三組治療前CTC具有可比性(P0.05)。各組治療前后CTC有顯著性差異(P0.05);中西醫(yī)結(jié)合組治療后較中藥組治療后CTC有顯著性差異(P0.01);中西醫(yī)結(jié)合組治療后較西藥組治療后CTC有顯著性差異(P0.05);西藥組治療后較中藥組治療后CTC有顯著性差異(P0.05)。4、中西醫(yī)結(jié)合組的中醫(yī)癥候療效、KPS評(píng)分、免疫功能高于西藥組,且毒副反應(yīng)較西藥組低(P0.05)。結(jié)論:健脾益腎湯聯(lián)合NP方案明顯減少脾腎兩虛型晚期非小細(xì)胞肺癌患者外周血CTC數(shù)量,且提高了腫瘤緩解率和獲益率,并明顯改善了患者生活質(zhì)量和增強(qiáng)患者的免疫功能、減輕了化療毒副作用。
[Abstract]:Objective: to study the effect of Jianpi Yishen decoction on CTC and the improvement of symptoms in patients with advanced non-small cell lung cancer (NSCLC) with deficiency of spleen and kidney. Methods: all the patients were diagnosed by cytology or pathology in the Department of Oncology of the first affiliated Hospital of Suzhou University from March 2014 to February 2015 (stage IIIb IV) (including those without operation or recurrence or metastasis after operation). According to the TCM syndrome differentiation of spleen and kidney deficiency of 60 patients, The patients were randomly divided into three groups: traditional Chinese medicine group, western medicine group and integrated Chinese and western medicine group. They were treated with Jianpi Yishen decoction and Jianpi Yishen decoction combined with NP regimen respectively. The peripheral blood samples of 7.5ml were collected before treatment and 21 鹵3 after treatment for CTC detection by Cellsearch system. The short-term curative effect, TCM symptom effect, Karschoff (KPS) score, immune function and toxic side effects were observed in the three groups. Results one patient in the Chinese medicine group (oral Jianpi Yishen decoction) had poor compliance and withdrew from the treatment. As an invalid case, the patients in the three groups were better than the western medicine group and the traditional Chinese medicine group in the effective rate and the stability rate in the effective rate and stability. And there was significant difference (P0.05); the western medicine group was better than the traditional Chinese medicine group, there was significant difference (P0.05) .3.The Chinese medicine group, western medicine group, integrated Chinese and western medicine group before treatment CTC was comparable (P0.05). There were significant differences in CTC before and after treatment in each group (P0.05); in the group of integrated traditional Chinese and western medicine, there was a significant difference in CTC after treatment (P0.01); in the group of integrated traditional Chinese and western medicine, there was a significant difference in CTC after treatment (P0.05); in the group of western medicine after treatment, there was a significant difference (P0.05); in the group of western medicine after treatment, the difference was significant (P0.05). There was significant difference in CTC after treatment in the drug group (P0.05). The immune function was higher than that of western medicine group, and the side effect was lower than that of western medicine group (P0.05). Conclusion: the combination of Jianpi Yishen decoction and NP regimen can significantly reduce the number of CTC in peripheral blood of patients with advanced non-small cell lung cancer with deficiency of spleen and kidney, increase the remission rate and benefit rate, improve the quality of life and enhance the immune function of the patients. It alleviates the side effects of chemotherapy.
【學(xué)位授予單位】：陜西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R734.2
[Abstract]:Objective: to study the effect of Jianpi Yishen decoction on CTC and the improvement of symptoms in patients with advanced non-small cell lung cancer (NSCLC) with deficiency of spleen and kidney. Methods: all the patients were diagnosed by cytology or pathology in the Department of Oncology of the first affiliated Hospital of Suzhou University from March 2014 to February 2015 (stage IIIb IV) (including those without operation or recurrence or metastasis after operation). According to the TCM syndrome differentiation of spleen and kidney deficiency of 60 patients, The patients were randomly divided into three groups: traditional Chinese medicine group, western medicine group and integrated Chinese and western medicine group. They were treated with Jianpi Yishen decoction and Jianpi Yishen decoction combined with NP regimen respectively. The peripheral blood samples of 7.5ml were collected before treatment and 21 鹵3 after treatment for CTC detection by Cellsearch system. The short-term curative effect, TCM symptom effect, Karschoff (KPS) score, immune function and toxic side effects were observed in the three groups. Results one patient in the Chinese medicine group (oral Jianpi Yishen decoction) had poor compliance and withdrew from the treatment. As an invalid case, the patients in the three groups were better than the western medicine group and the traditional Chinese medicine group in the effective rate and the stability rate in the effective rate and stability. And there was significant difference (P0.05); the western medicine group was better than the traditional Chinese medicine group, there was significant difference (P0.05) .3.The Chinese medicine group, western medicine group, integrated Chinese and western medicine group before treatment CTC was comparable (P0.05). There were significant differences in CTC before and after treatment in each group (P0.05); in the group of integrated traditional Chinese and western medicine, there was a significant difference in CTC after treatment (P0.01); in the group of integrated traditional Chinese and western medicine, there was a significant difference in CTC after treatment (P0.05); in the group of western medicine after treatment, there was a significant difference (P0.05); in the group of western medicine after treatment, the difference was significant (P0.05). There was significant difference in CTC after treatment in the drug group (P0.05). The immune function was higher than that of western medicine group, and the side effect was lower than that of western medicine group (P0.05). Conclusion: the combination of Jianpi Yishen decoction and NP regimen can significantly reduce the number of CTC in peripheral blood of patients with advanced non-small cell lung cancer with deficiency of spleen and kidney, increase the remission rate and benefit rate, improve the quality of life and enhance the immune function of the patients. It alleviates the side effects of chemotherapy.
【學(xué)位授予單位】：陜西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R734.2
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