中西医结合治疗晚期肺癌疗效观察

摘要

目的 观察中西医结合治疗晚期肺癌疗效.方法 将确诊的65例晚期肺癌患者按随机数字表法分为治疗组33例,对照组32例.对照组非小细胞肺癌采用CAP(环磷酰胺+阿霉素+顺铂)方案,小细胞肺癌采用EP(足叶乙苷+顺铂)方案治疗,4周重复1次,3～4次为1个疗程.治疗组在上述治疗的同时给予中药辨证施治,对痰瘀蕴结型采用六君子汤和涤痰汤加减;气阴两虚型采用人参养荣汤加减;阴阳两虚型采用资生丸加减,以上方药每日1剂水煎服.结果 治疗组临床症状明显改善,生活质量提高,明显优于对照组(P<0.05).治疗组治疗后咳嗽痰血、胸痛、气急、纳差好转,稳定率分别为81.8%(27/33)、75.8%(23/33)、69.7%(23/33)、81.8%(27/33)和69.7(25/33),对照组分别为46.9%(15/32)、31.2%(10/32)、31.2%(10/32)、34.4%(11/32)和37.5%(12/32).治疗组平均生存332 d,较对照组145 d长.治疗组治疗后Kamofsky评分稳定或增加23例(69.7%)对照组10例(31.2%),2组比较差异有统计学意义(P<0.05).结论 中药能减少放化疗产生的不良反应,对提高晚期肺癌患者生活质量和延长生存期具有较好效果.%Objective To observe the curative effect of combined therapy of traditional Chinese medicine and western medicine (TCM WM therapy)for advanced lung cancer. Methods Sixty-five patients of advanced lung cancer were randomly divided into therapy group (33 cases) and control group (32 cases). In control group, CAP schedule was used in patients with non small-cell lung cancer and EP schedule was used in patients with small cell lung cancer. A therapeutic period in two groups was four weeks and one course of treatment needed three to four pe-rieds . The therapy group was given differential treatment with herbal medicines. The phlegrm and petechia type was given Liujunzi decoction and Ditan decoction. The Qi and Yin deficiency type was given Renshenyangrong decoc-tion. The Yin and Yang deficiency type was given Zishengwan decoction. Results Clinical symptom, quality of life and life span in therapy group were significantly better than control group (P < 0.05). After treatment, the improved stability rates of cough, blood in sputum, chest pain, dyspnea, anorexia were 81.8% (27/33), 75.8% (25/33), 69.7% (23/33), 81.8% (27/33) and 69.7% (23/33);the control group were 46.9% (15/32), 31.2% (10/32), 31.2% (10/32), 34.4% (11/32) and 37.5% (12 / 32). Differences between the two groups were statistically significant(P < 0.05). The average survival days of therapy group (322 d)was longer than that of the control group (145 d)(P < 0.01). Conclusion Combined therapy of traditional Chinese medicine and western medicine is effective for treatment of advanced lung cancer.