【作者】 涂华；

【导师】 欧阳学农；

【作者基本信息】 福建中医学院 ， 中西医结合临床， 2008， 硕士

【摘要】 肺癌是目前常见的、死亡率最高的恶性肿瘤之一,综合治疗是提高疗效的重要举措。肿瘤血管生成是肿瘤生长、侵袭和转移的基础,抗血管生成已成为抗肿瘤治疗的研究热点。人参皂甙Rg3是中药人参提取物之一,实验显示具有抑制肿瘤血管生成和肿瘤组织血管内皮生长因子的作用,文献报道与化疗结合具有提高疗效的作用。目的:1、观察人参皂甙Rg3联合全身化疗对非小细胞肺癌患者血清VEGF影响,探讨其抗肿瘤血管生成的可能机制;2、观察人参皂甙Rg3联合全身化疗对非小细胞肺癌患者的临床疗效。方法:选取南京军区福州总医院确诊为晚期非小细胞肺癌符合观察标准者41例,随机对照分为2组:A组20例采用全身化疗;B组21例采用人参皂甙Rg3胶囊联合全身化疗。观察瘤体指标、行为状态评分,应用酶联免疫吸附法检测外周血清血管内皮生长因子水平变化。结果:1、客观疗效:B组近期有效率为33.3%(7/21),A组为20%(4/20)(P＞0.1),B组疾病控制率为76.2%(16/21),A组为45%(9/20)(P＜0.05);2、生活质量:B组生活质量改善率为66.7%(14/21),A组为35%(7/20)(P＜0.05);3、sVEGF水平:①治疗前:Ⅳ期患者的sVEGF水平为324.04±71.61 pg/ml,Ⅲ期患者的为195.33±48.96pg/ml,健康人群为55.20±9.47 pg/ml(P＜0.05);A组sVEGF水平为277.15±97.69pg/ml,B组为276.76±83.07 pg/ml(P＞0.1);②治疗后A组sVEGF水平为243.65±65.64pg/ml,B组为216.33±56.30pg/ml,具有统计学意义(P＜0.05)。结论:1、人参皂甙Rg3联合全身能进一步下调sVEGF水平,有利于抑制肿瘤新生血管;2、人参皂甙Rg3联合全身化疗具有提高NSCLC患者的近期有效率的趋势,能够提高近期疾病控制率,改善患者生活质量,值得临床进一步观察。更多还原

【Abstract】 Lung carcinoma is one of the most familiar malignant tumours of international community currently.It has already become the main cause of death of malignant tumors,and the mortality will raise gradually.The growth of tumors is vessel-dependent.Therefore,anti-angiogenetic therapy has become one of the heat points in cancer research fled.Ginsenoside Rg3 is a kind of effective chemical component extracted tracely from the Red Ginseng,which can directly inhibit tumor angiogenesis and induce tumor.It was said that chemotherapy combined with Ginsenoside Rg3 was a logical potentially powerful treatment.Objectives:1.To evaluate the influence of serum vascular endothelial growth factor on Ginsenoside Rg3 combined with chemotherapy in patients with non-small cell lung cancer,and approach the mechanisms on neovascularization.2.To obvserve the clinical anticancer of Ginsenoside Rg3 plus chemotherapy in non-small cell lung cancer patients;.Methods:Forty-one patients with non-small lung cancer were selected in Fuzhou general hospital.The patients were randomized into two groups:Group A were treated with systemic chemotherapy,Group B with Ginsenoside Rg3 plus systemic chemotherapy.The gross tumor volume and the score of quality of life was evaluated,and the level of serous vascular endothelial growth factor was detected by using of enzyme linked immunosorbent assay.Results:1.Curative Effect:The recent response rate was 33.3%(7/21)in group B,and 20% (4/20) in group A(P＞0.1).The disease control rate was 76.2%(16/21)in group B,and 45% (9/20) in group A(P＜0.05).2.Quality of Life:The rate of Quality of Life improvement was66.7%in group B,and 35%(7/20) in group A(P＜0.05).3.sVEGF level:①Before treatment:The level of sVEGF was 324.04±71.61 pg/ml in stageⅣpatients,195.33±48.96 pg/ml in stageⅢ,55.20±9.47 pg/ml in healthy population(P＜0.05).The level of sVEGF was 277.15±97.69 pg/ml in group A,and 276.76±83.07 pg/ml in group B(P＞0.1).②After treatment:The level of sVEGF was 243.65±65.64 pg/ml in group A,and 216.33±56.30 pg/ml in group B,with significant difference(P＜0.05).Conclusion:1.Ginsenosides Rg3 combined with chemotherapy could morely descended the level of sVEGF,which was the way to strengthen the effect of neovascularization.2. Preliminary results show improvements in response rate and quality of life in Ginsenosides Rg3 combined with chemotherapy.It is worthy to confirm the results in further clinical trials.更多还原