中药维持治疗晚期非小细胞肺癌的回顾性研究—分析治疗前后中性粒细胞与淋巴细胞比率水平变化对其生存及疗效的影响

发布时间：2018-06-04 02:46

  本文选题：非小细胞肺癌 + 中药　； 参考：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:观察分析中药维持治疗前后中性粒细胞与淋巴细胞比率(NLR)水平变化对晚期非小细胞肺癌(NSCLC)患者的生存及疗效的影响。材料与方法:所选患者病例均为2010年1月—2015年10月期间于辽宁中医药大学附属第二医院肿瘤科接受中药维持治疗4周的64例晚期NSCLC患者的住院病例,所有患者予以口服中药汤剂扶正抗癌治疗,且在治疗前后均接受过血常规检查,收集患者的临床资料,包括性别、年龄、吸烟史、病理类型、卡式评分、维持治疗前后的中性粒细胞计数与淋巴细胞计数等。应用SPSS 20.0软件对维持治疗前后NLR变化与晚期NSCLC患者的维持治疗疗效及生存的关系。检验水准定为P0.05。结果:1.据受试者工作特征曲线(ROC),维持治疗前NLR截断值为3.06,低于及高于该值的患者中位生存期分别为14、30月(P=0.000),维持治疗前NLR水平与性别相关(P=0.000),维持治疗前NLR按3.06为界分组与瘤体疗效无相关性(P=0.110),与中医症候疗效有相关性(P=0.021)。经中药治疗后中医主要症候疗效前后差异有统计学意义,P0.05。2.维持治疗后NLR较维持治疗前NLR在部分缓解(PR)组、稳定(SD)组均有所下降,在进展(PD)组有所上升,但是在PR组(P=0.326)、SD组(P=0.051)和PD组(P=0.099)维持治疗前后差异无统计学意义。中医症候疗效在维持治疗后NLR较维持治疗前NLR在各组均有所下降,在有效组维持治疗前后差异有显著性意义(P=0.014)。3.多因素结果显示NLR≥3.06(HR=0.249,P0.05)是预后不良因素。结论:中药维持治疗前NLR升高是晚期NSCLC患者的预后不良因素,虽然维持治疗前NLR对瘤体疗效无预测作用,但其NLR对中医症候疗效密切相关,并且维持治疗前后NLR变化也与疗效密切相关。
[Abstract]:Objective: to observe the influence of the ratio of neutrophil to lymphocyte (NLRR) on the survival and curative effect of NSCLC patients with advanced NSCLC before and after the treatment of traditional Chinese medicine (TCM). Materials and methods: the selected patients were 64 patients with advanced NSCLC who received traditional Chinese medicine (TCM) maintenance therapy for 4 weeks from January 2010 to October 2015 in the Oncology Department of the second affiliated Hospital of Liaoning University of traditional Chinese Medicine. All patients were treated with oral Chinese medicine decoction Fuzheng anticancer therapy, and were examined by blood routine before and after treatment. The clinical data, including sex, age, smoking history, pathological type, card-type score, were collected. Neutrophil count and lymphocyte count were maintained before and after treatment. The relationship between the changes of NLR before and after maintenance therapy with SPSS 20.0 software and the curative effect and survival of patients with advanced NSCLC. The inspection level is set at P0.05. The result is 1: 1. According to the operating characteristic curve of subjects, the truncation value of NLR before maintenance treatment was 3.06, the median survival time of patients below and above this value was 14,30 months, respectively, the NLR level before maintenance was 0.000g / g, and the NLR before maintenance therapy was divided into three groups according to 3.06. There was no correlation between the curative effect of tumor and the curative effect of traditional Chinese medicine (TCM), and there was a correlation between P0. 01 and P0. 021. After the treatment of traditional Chinese medicine, the difference between the main symptoms of traditional Chinese medicine before and after treatment was statistically significant (P 0.05.2). After maintenance, NLR decreased in partial remission group and stable NLR group, and increased in progressive group, but there was no significant difference between PR group and PD group (P 0.051) and PD group (P 0.099) before and after maintenance treatment. The curative effect of TCM syndrome on NLR after maintenance treatment was lower than that before maintenance treatment in all groups, and there was significant difference before and after maintenance treatment in effective group. The multivariate results showed that NLR 鈮，

本文编号：1975507