中药益气养阴解毒方联合EGFR-TKI治疗晚期非小细胞肺癌的临床观察

发布时间：2018-03-30 06:11

本文选题：益气养阴解毒方　切入点：EGFR-TKI　出处：《安徽医科大学》2017年硕士论文

【摘要】：目的通过观察我科益气养阴解毒方联合表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗晚期非小细胞肺癌患者的近期疗效、临床症状改善情况、无进展生存期和不良反应,探讨益气养阴解毒方联合EGFR-TKI治疗晚期非小细胞肺癌的有效性及安全性。方法收集2014年1月至2015年12月入住安徽医科大学附属省立医院中医肿瘤科和肿瘤化疗科IIIB/IV期的非小细胞肺癌患者,符合纳入标准条件的50例患者随机分为2组,治疗组27例,接受益气养阴解毒方和EGFR-TKI(吉非替尼或厄洛替尼)治疗,对照组23例,只接受单药EGFR-TKI(吉非替尼或厄洛替尼)治疗,持续用药直到肿瘤进展或因毒副作用不能耐受而终止治疗,观察两组患者的近期疗效、临床症状改善情况、无进展生存期(PFS)和不良反应。临床观察结束后,统计各类数据并记录,应用SPSS 17.0统计软件进行数据处理。结果近期疗效比较,治疗组客观缓解率为70.37%,高于对照组的56.52%,但差异无统计学意义(P㧐0.05);两组在KPS评分及无进展生存期等方面,治疗组均优于对照组,P㩳0.05,两组之间的差异具有统计学意义;在临床症状改善情况上,治疗组患者咳嗽、咳痰较对照组明显改善,差异有统计学意义,在咯血、胸痛症状缓解情况上,治疗组患者优于对照组,但两组比较差异无统计学意义;在不良反应方面,治疗组皮疹、腹泻的发生率分别为62.96%、33.33%,低于对照组的86.95%和60.87%,两组相比差异无显著性意义(P㧐0.05),但中药联合EGFR-TKI组患者的皮疹、腹泻严重程度明显低于对照组。结论益气养阴解毒方联合EGFR-TKI治疗晚期非小细胞肺癌可以很好的缓解晚期患者的临床症状,减轻皮疹、腹泻的严重程度,稳定患者的生活质量,进而延长无进展生存期,安全性良好,可以作为治疗晚期非小细胞肺癌的有效方法。
[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.

【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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