【摘要】：目的:基于中醫(yī)體質學說探討肺抑瘤膏治療氣虛質非小細胞肺癌的療效及作用機理。方法:1.動物實驗部分。用煙熏法建立氣虛質小鼠模型,造模成功后向氣虛質小鼠接種Lewis肺腺癌細胞建立病癥結合模型。接種7天后,將造模成功小鼠隨機分為模型對照組、肺抑瘤膏組、吉非替尼組、肺抑瘤膏+吉非替尼組,分別進行藥物干預,對比各組小鼠體重變化、力竭游泳時間、免疫指標、瘤重及VEGF表達情況。2.臨床觀察部分。將64名符合條件的氣虛體質中晚期非小細胞肺癌患者隨機分為中藥加化療組(34例)和單純化療組(30例),對比兩組患者的近期療效、無進展生存期、卡氏評分、體重、中醫(yī)臨床癥狀及藥物毒副反應情況。結果:1.動物實驗結果。氣虛體質Lewis肺腺癌小鼠動物模型造模成功,肺抑瘤膏組在小鼠體重變化、力竭游泳時間、免疫指標、瘤重及VEGF表達方面與模型對照組均存在差異,與吉非替尼聯(lián)合使用較單一用藥效果更佳。2.臨床觀察結果。中藥加化療組在近期療效、體重改變、KPS評分、中醫(yī)臨床癥狀積分、藥物毒副反應方面均優(yōu)于單純化療組。結論:1.使用煙熏法建立的氣虛質小鼠模型在一般情況、免疫指標方面均異于對照組,該體質造模方法可行有效。2.肺抑瘤膏可有效改善中晚期非小細胞肺癌患者的近期療效,減少臨床癥狀,提高生活質量。3.肺抑瘤膏可糾正體質偏頗,改善氣虛質患者免疫力低下、易疲乏的特點。4.肺抑瘤膏與靶向藥物或化療藥物聯(lián)合應用可起到減毒增效的作用。5.通過抑制VEDF表達來降低腫瘤血管生成,可能是肺抑瘤膏抑制腫瘤生長的作用機制之一。
[Abstract]:Objective: to explore the therapeutic effect and mechanism of lung-suppressive ointment on Qi-deficiency non-small cell lung cancer (NSCLC) based on physique theory of traditional Chinese medicine (TCM). Methods: 1. Animal experiment part. The model of qi deficiency mice was established by fumigation, and the disease binding model was established by inoculating Lewis lung gland cancer cells into qi deficiency mice. Seven days after inoculation, the successful mice were randomly divided into three groups: the model control group, the lung tumor suppression paste group, the gefitinib group and the lung tumor suppression ointment group. The mice in each group were treated with drugs, and the weight changes and swimming time of each group were compared. Immune index, tumor weight and VEGF expression. 2. Clinical observation part. Sixty-four patients with advanced non-small cell lung cancer in Qi deficiency constitution were randomly divided into two groups: Chinese medicine plus chemotherapy group (34 cases) and simple chemotherapy group (30 cases). The short-term curative effect, progression-free survival time, Karnaud score and body weight were compared between the two groups. Clinical symptoms and side effects of traditional Chinese medicine. Results: 1. The results of animal experiments. The animal model of lung cancer mice with qi deficiency constitution Lewis was successfully established. There were differences in body weight, exhaustive swimming time, immune index, tumor weight and VEGF expression between the lung cancer ointment group and the model control group. Combined with gefitinib is better than a single drug. 2. Clinical observation results. The traditional Chinese medicine plus chemotherapy group was superior to the simple chemotherapy group in short-term curative effect, weight change, KPS score, TCM clinical symptom score and drug toxicity. Conclusion: 1. The model of qi deficiency and quality mice established by fumigation method is different from that of the control group in general and immune indexes, and the physique modeling method is feasible and effective. 2. Lung anti-tumor ointment can effectively improve the short-term efficacy of patients with advanced non-small cell lung cancer, reduce clinical symptoms, and improve the quality of life. 3. Lung anti-tumor ointment can correct physical bias, improve the low immunity of patients with Qi deficiency, easy to fatigue characteristics. 4. Lung tumor suppressant ointment combined with targeted drugs or chemotherapy drugs can reduce toxicity and enhance the efficacy. 5. Down-regulation of tumor angiogenesis by inhibiting the expression of VEDF may be one of the mechanisms by which lung tumor suppressor ointment inhibits tumor growth.
【學位授予單位】：山東中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R273

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