發(fā)布時間：2019-06-02 08:48

【摘要】：目的:觀察鴉膽子油聯(lián)合吉西他濱和順鉑治療晚期非小細胞肺癌(NSCLC)的臨床效果及安全性。方法:選取黃岡市中醫(yī)醫(yī)院2014年2月-2016年1月收治的晚期NSCLC患者131例,按照隨機數(shù)字表法分為觀察組(71例)和對照組(60例)。對照組患者給予注射用鹽酸吉西他濱(第1、8天)+順鉑注射液(第2天),每21 d重復(fù)1次,連續(xù)2次為1個療程;觀察組患者在此基礎(chǔ)上給予鴉膽子油口服乳液20 m L,po,2~3次/d,連續(xù)14 d(于每次化療前3 d開始給藥)。兩組患者均治療87 d,并隨訪至2016年6月1日。觀察兩組患者臨床療效、T細胞亞群(CD3+、CD4+、CD8+)水平和生存時間,對生存時間進行單因素和多因素分析,并記錄不良反應(yīng)發(fā)生情況。結(jié)果:觀察組患者的總有效率(32.39%)高于對照組(25.00%),但差異無統(tǒng)計學(xué)意義(P0.05)。治療前,兩組患者CD3+、CD4+和CD8+水平比較,差異均無統(tǒng)計學(xué)意義(P0.05)。治療后,觀察組患者CD3+、CD4+水平較治療前明顯升高,CD8+水平明顯降低,且與同期對照組比較,差異均有統(tǒng)計學(xué)意義(P0.05)。觀察組患者失訪4例,對照組失訪3例。觀察組患者生存時間[(14.02±4.10)個月]較對照組[(13.21±5.22)個月]長,但差異無統(tǒng)計學(xué)意義(P0.05)。單因素分析結(jié)果顯示,70歲患者的生存時間明顯長于≥70歲患者,合并胸腔積液患者的生存時間明顯短于無胸腔積液患者,差異均有統(tǒng)計學(xué)意義(P0.05)。多因素分析結(jié)果顯示,是否合并胸腔積液和年齡是晚期NSCLC患者生存時間的影響因素(比值比分別為1.685、0.647,P分別為0.012、0.043)。觀察組患者的不良反應(yīng)發(fā)生率(50.70%)與對照組(53.33%)比較,差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:鴉膽子油聯(lián)合吉西他濱和順鉑治療晚期NSCLC,雖不能明顯提高療效,但能提高機體免疫功能。是否合并胸腔積液和年齡是晚期NSCLC患者生存時間的影響因素。
[Abstract]:Objective: to observe the clinical efficacy and safety of Brucea javanica oil combined with gemcitabine and DDP in the treatment of advanced non-small cell lung cancer (NSCLC). Methods: from February 2014 to January 2016, 131 patients with advanced NSCLC were randomly divided into observation group (71 cases) and control group (60 cases). The patients in the control group were given gemcitabine hydrochloric acid injection (day 1 and day 8), repeated every 21 days, twice as a course of treatment. On this basis, the patients in the observation group were given Brucea javanica oil oral emulsion 20 mL, 2 times 3 times a day for 14 days (starting 3 days before each chemotherapy). The patients in both groups were treated for 87 days and followed up until June 1, 2016. The clinical efficacy, CD3, CD4, CD8 level and survival time of the two groups were observed, and the survival time was analyzed by univariate and multivariate analysis, and the occurrence of adverse reactions was recorded. Results: the total effective rate of the patients in the observation group (32.39%) was higher than that in the control group (25.00%), but the difference was not statistically significant (P 0.05). Before treatment, there was no significant difference in the levels of CD3, CD4 and CD8 between the two groups (P 0.05). After treatment, the levels of CD3 and CD4 in the observation group were significantly higher than those before treatment, and the levels of CD8 were significantly lower than those in the control group at the same time (P 0.05). There were 4 cases of lost follow-up in the observation group and 3 cases in the control group. The survival time of the patients in the observation group [(14.02 鹵4.10) months] was longer than that in the control group [(13.21 鹵5.22) months], but the difference was not statistically significant (P 0.05). The results of univariate analysis showed that the survival time of patients aged 70 years old was significantly longer than that of patients 鈮，

本文編號：2490970