健脾益肾汤对脾肾两虚型晚期非小细胞肺癌CTC的影响
发布时间：2018-08-15 18:44
【摘要】：目的:本课题主要研究健脾益肾汤对脾肾两虚型晚期非小细胞肺癌患者CTC的影响及患者症候的改善情况,客观评价该方的临床疗效,为个体化治疗提供依据。方法:所有病例均来源于2014年3月至2015年2月苏州大学附属第一医院肿瘤内科经细胞学或病理学确诊的晚期NSCLC患者(IIIb、IV期)(包括未手术和术后复发或转移者),并且符合中医辨证属脾肾两虚证的患者60例,采用随机数字表化,以1:1:1的比例随机分为中药组、西药组、中西医结合组,分别给予健脾益肾汤口服,NP方案化疗,健脾益肾汤口服联合NP方案化疗,各组均在治疗前和治疗第21±3后,抽取7.5ml外周血采用Cellsearch系统行CTC检测,并观察三组治疗后近期疗效、中医症候疗效、卡氏(KPS)评分、免疫功能和毒副反应的发生情况。结果:1、中药组(口服健脾益肾汤)中有1例患者用药依从性差,退出治疗,作为无效病例。2、三组患者的病情在有效率及稳定率方面中西医结合组优于西药组和中药组,并有明显差异(P0.05);西药组优于中药组,有显著性差异(P0.05)。3、中药组、西药组、中西医结合组三组治疗前CTC具有可比性(P0.05)。各组治疗前后CTC有显著性差异(P0.05);中西医结合组治疗后较中药组治疗后CTC有显著性差异(P0.01);中西医结合组治疗后较西药组治疗后CTC有显著性差异(P0.05);西药组治疗后较中药组治疗后CTC有显著性差异(P0.05)。4、中西医结合组的中医症候疗效、KPS评分、免疫功能高于西药组,且毒副反应较西药组低(P0.05)。结论:健脾益肾汤联合NP方案明显减少脾肾两虚型晚期非小细胞肺癌患者外周血CTC数量,且提高了肿瘤缓解率和获益率,并明显改善了患者生活质量和增强患者的免疫功能、减轻了化疗毒副作用。
[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 卤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.
【学位授予单位】：陕西中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：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 卤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.
【学位授予单位】：陕西中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R734.2
【参考文献】
相关期刊论文 前8条
1 蒋艳;姜孝新;;枸杞多糖对肝癌荷瘤小鼠的抗肿瘤作用及其机制[J];肿瘤药学;2011年04期
2 马飞,孙文欣,张叔人,刘蓉枝,付明,梁肖,张雪艳,林晨;次级淋巴组织趋化因子基因转染对小鼠黑色素瘤细胞生物学特性的影响[J];免疫学杂志;2005年05期
3 刘杰;林洪生;侯炜;李道睿;周雪忠;;利用数据挖掘方法对肺癌中医药治疗特点的初步研究[J];世界科学技术(中医药现代化);2009年05期
4 王院春;王希胜;;扶正抗癌汤联合TP方案治疗晚期非小细胞肺癌临床观察[J];陕西中医学院学报;2008年02期
5 李t，
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