【作者】 陈晓霞；

【导师】 葛信国；

【作者基本信息】 南京中医药大学 ， 中西医结合肿瘤， 2011， 硕士

【摘要】 研究背景：肺癌是常见的恶性肿瘤之一。其中,非小细胞肺癌(non-small-cell lung cancer, NSCLC)约占80%,而80%的患者在初次确诊时已经进入中晚期阶段,总的5年生存率不足10%。近20年来,我国肺癌的发病率和死亡率呈上升趋势,其死亡率在所有恶性肿瘤中升幅最大,已居首位,且有持续上升之趋势。肺癌早期症状不明显,而且肺癌易发生转移,在初次诊断时多数已经到了中晚期,甚至出现转移,治疗上已失去手术机会,只能采用化放疗结合的综合治疗,预后极差。而化放疗常给患者带来一系列的毒副反应,使患者免疫功能紊乱,免疫机能下降。采用中医中药治疗对于减少化疗毒副反应,提高机体免疫力,改善患者生活质量和中医症状方面均有优势。为探讨中医药在该领域内的作用,本研究选择了扶正类中药制剂--复方黄芪口服液。给予晚期肺癌患者复方黄芪口服液联合TP方案化疗对肺癌患者进行临床观察。复方黄芪口服液主要由黄芪,人参,黄精,陈皮四药的水煎液中提取而成,为常州中医院经多年临床使用,验之有效的制剂。研究目的：探讨复方黄芪口服液配合TP方案治疗晚期气阴两虚型肺癌减毒的临床疗效。研究方法：共选择61例晚期肺癌患者,随机分为治疗组(复方黄芪口服液加TP化疗组)31例和对照组(单纯TP化疗方案)30例。对照组使用单纯TP方案化疗。治疗组：在TP方案的基础上,加用复方黄芪口服液10ml,3次/日,化疗前一周至化疗周期全部结束。两组病人其他处理相同。使用WHO抗癌药物毒副反应分度标准,T淋巴细胞亚群、生活质量指标、KPS评分及中医证候等来观察两组经过二个疗程后的化学治疗所引起的毒副作用的表现及症状的改善。采用SPSS17.0处理.研究结果：治疗组外周血白细胞、血红蛋白下降程度明显好于对照组(p<0.05),恶心呕吐发生率降低(p<0.05),其它肝功能、肾功能损伤等与对照组相比无统计学意义。两组T淋巴细胞亚群治疗后组间比较,有统计学差异(p<0.05),治疗组免疫功能恢复好于对照组。两组化疗前后生命质量无区别(p<0.05),但治疗组化疗结束后第七天,三个月生命质量好于对照组,并有统计学差异(p<0.05)。治疗组的KPS评分明显高于对照组(p<0.05)。中医证候积分治疗组改善较对照组明显,但p>0.05,无统计学差异。口咽干燥,盗汗、神疲乏力等气阴两虚症状改善情况治疗组较为明显。结论：复方黄芪口服液能减轻TP方案治疗晚期气阴两虚型肺癌时的血液学毒性和消化道毒性,促进机体免疫功能的增强,改善生活质量,改善症状,达到减毒的目的。更多还原

【Abstract】 Background:Primary bronchial lung cancer is one of most common malignant tumors, among which, non-small-cell lung cancer accounts for 80%.80% of Patients are in the advanced stage (stagelllB or stagelV).It’s 5-year survival rate less than 10%. The incidence of lung cancer and mortality rates are rising in the past 20 years.The mortality rate of it has been ranked first and shows the largest increase among all malignant tumors, and a continuous upward trend. It’s not obvious of early symptoms, and prone to metastasis. Most patients has been in the advanced stage at the first time of diagnosis, or even the tumor has been transferred. No surgery can be obtained. The only way is the combination of chemotherapy and radiotherapy, but the effect is far from our expectation. The chemo-radiotherapy for patients often brings a series of toxicity, which lead to immune disorders and declination in immune in functions of patients.There are advantages in use of traditional Chinese medicine for reducing side effects of chemotherapy and improvement in life quality and symptoms of patients, the research is about the effect of Compound Astraguls Liquid combined with chemotherapy on advanced lung cancer treatment. Compound Astraguls Liquid is made of four kinds of herbs’extraction of water-Astragalus, Ginseng,Huang Jing,Citrus reticulate Bianco.It’s a effective recipe which is examined by clinical use.Objective:To explore the therapeutic effects with toxicity reducing on treating the advanced lung cancer of deficiency of QI and YIN with Compound Astraguls Liquid combined with chemotherapy.Methods:61 cases confirmed primary advanced lung cancer patients were randomly divided into two groups.31 patients of the treated group were treated with Compound Astraguls Liquid and chemotherapy.30 patients in control group were treated with chemotherapy. The treated group:compound astraguls liquid was used about 10ml, three times of day. It applied from a week before chemotherapy to the end of treatment. All of other treatments were the same. The effects of treatment were be observed after two courses of chemotherapy through some stardards. Statistic was analyzed by spss 17.0.Result:The level of peripheral blood leukocytes and hemoglobin in treatment group dropped letter than control group (p<0.05). The incidence of nausea and vomiting was reduced (p<0.05).Other toxicity was statistically significant. The change of T lymphocytes among two groups has significant difference.The immunity function in treatment group is better than the control one.The quality of life in treatment group is better than the other group. The KPS in former group is higher than the latter one (p<0.05).There was no significant difference in relieving TCM symptoms between two groups.However, the differdence of the symptoms on deficiency of QI and YIN is of significance in statistics science (p<0.05).Conclusion:Compound Astraguls Liquid can dissolve the hmatologic toxicity and gastrointestinal toxicity, enhance the recovery of immune function, improve quality of life and relieve symptoms, which is to achieve the purpose of attenuated.更多还原