氩氦刀联合中药治疗非小细胞肺癌71例临床研究

【作者】 王红；

【导师】 胡凯文；

【作者基本信息】 北京中医药大学 ， 中西医结合临床， 2006， 硕士

【摘要】 目的:氩氦刀是一种新的治疗实体肿瘤的微创手术,对于中晚期非小细胞肺癌,尤其对无法耐受手术、放、化疗的患者是一种好的选择。氩氦刀术后联合中药不仅可以促进术后恢复,还可以抑制残余肿瘤的复发、转移,弥补了氩氦刀术的局限性。这种微创手术配合中药的治疗方案增加了中晚期非小细胞肺癌的临床治疗手段,也可以提高中晚期肺癌的临床疗效,在维护、提高患者生活质量的同时延长生存期。本研究主要观察氩氦刀联合中药对非小细胞肺癌生存期的影响,为肺癌尤其是中晚期非小细胞肺癌的综合治疗,探索出一种更有效、更安全的治疗方案。方法:自2003年9月13日开展氩氦刀联合中药治疗非小细胞肺癌以来,截至2006年1月6日调查结束时,按病例纳入标准,对在东方医院肿瘤科实施氩氦刀联合中药治疗的71例非小细胞肺癌住院病人,采用前瞻性与回顾性相结合的方法进行临床研究。主要研究内容:中药应用情况,生存期及生存率,生存期及生存率与文献比较。结果:1.口服中药情况[1]口服中成药:口服抗癌中成药以平消片、利佳片为主;口服扶正中成药以贞芪扶正胶囊为主。[2]口服汤剂情况:71例中服汤剂者49例(69.01%,49/71),使用率超过51%的前10位单味药物为半夏、甘草、丹参、茯苓、陈皮、沙参、黄芪、麦冬、猪苓、鱼腥草,其中半夏、甘草使用率超过71%。2.静脉用药情况[1]常用静脉中药:71例中69例(97.18%,69/71)输静脉中药,常用静脉药物依次为生脉注射液、康莱特注射液、丹参注射液、华蟾素和鱼腥草注射液。69例中使用2种静脉药物者有18例(26.09%,18/69),使用3种静脉药物者有19例(27.54%,19/69)。[2]静脉中药配伍及药物:静脉中药配伍以抗癌+扶正为主,代表药物康莱特+生脉注射液。3.生存期及生存率到最后一次追访之日(2003.9.13-2006.1.6)止,71例病人中可追访到57例病人,对可追访的57例病人进行生存期及生存率的观察。[1]术后生存期及生存率57例病人中位术后生存期为9月。术后12月以上生存率为46.67%(21/45),术后18月以上生存率为34.62%(9/26),术后24月以上生存率为36.36%(4/11)。[2]生存期及生存率57例病人总中位生存期为13月。总生存期12月以上生存率66.67%(32/48),18月以上生存率41.86%(18/43),24月以上生存率为33.33%(10/30)。4.生存期及生存率与文献比较[1]总中位生存期与文献比较:57例病人总中位生存期13月比文献支持治疗患者的自然中位生存期5个月提高,比单纯化疗患者的7.4-11.4个月提高,比单纯中药治疗患者的9.73更多还原

【Abstract】 Objective: The Argon-helium cryoablation is a new mini-wound therapy to cancer and is a good method to patients who have no therapy,such as surgery,chemical therapy and actinotheraphy among the stage III/IV. The Argon-helium cryoablation joint the traditional Chinese medicine( TCM) after operation can accelerate to recover one’s health after operation, cause the inhibition of the tumor’s relapse and metastasis, and make up the limitation in current therapy method. The new therapy method make up disadvantages in the old therapy method,which reinfore the limitation in current therapy method to the stage III/IV NSCLC,and enhancing the curative effect,prolong survival time.The study tries to observe the NSCLC survival time effect to The Argon-helium cryoablation joint TCM, and find out some valuable rules,which can offer some guide in the clinical applications of the new therapy and seek a kind of more mature modle to treatment lung cancer,particularly to the stage III/IV NSCLC.Methods:Using retrospective research method, the study had a deep and particular research into clinical observation on 71 cases of non smiall cell lung cancer(NSCLC )who had been treated by a new therapy method,which was Argon-helium cryoablation joint the traditional Chinese medicine( TCM), in Dong-Fang hospital from 2006-9 to 2006-1 .The main research are the used methods of the traditional Chinese medicine, survival time after opation, the overall survival time and comparation with literature.Results:Ⅰ. The results of TCM used:The main tablets among the TCM are Pingxiao tablets and Norcanthardin tablets to anticancer,Zhenqi capsule to strengthen the body resistance.Ⅱ.The results of taked medicinal broth used:49 cases (69.01%) taked medicinal broth in all cases. The first 10 TCMs of used-rate more than 51% ware the pinelliae tuber,the Glycyrrhiza uralensis,the salvia miltiorrhiza,the hoelen,the aurantii nobilis pericarpium,the root of straight ladybell, the milkwetch root,the ophiopogonis tuber,the chuling,the heartleaf houttuynia herb.The used-rate of pinelliae tuber and Glycyrrhiza uralensis is more than 71%.Ⅲ. The results of the Injection TCM used:69 cases taked injection TCM in 71 cases. The main injection among the TCM are Shengmai,Kanglait(eKLT),Danshen,Bufalin and houttuynia cordata, and main used 2-3 kinds medicines(18 cases,19cases). The main injection TCM means is one kind of supporting TCM and one kind of anticancer TCM, such as the KLT and the Shengmai.更多还原