Objective To explore the therapeutic effect of lung cancer Ⅳ recipe combined with chemotherapy on treating middle and advanced stages of non-small cell lung cancer (NSCLC) in the elderly.Methods A total of 77 NSCLC patients in middle and advanced stages aged 70 years and over who had heat-toxin syndrome in traditional Chinese medicine (TCM) were selected from Apr.2013 to Oct.2014 in our hospital.Patients were randomly divided into chemotherapy group (n=39) and chemotherapy + herbs group (n=38).Karnofsky assessment scale (KPS),effective rate,symptom and sign in traditional Chinese medicine,changes in the levels of high-sensitivity c-reactive protein (hs-CRP),carcino embryonic antigen (CEA),neuron specific enolase (NSE),tumor special growth factor (TSGF) were observed before and 1 and 56 days after treatment.Results There was no significant difference in effective rate between the two groups (P＞0.05).The KPS and symptom and sign in TCM were improved significantly in chemotherapy + herbs group as compared with chemotherapy group (36.7 ％ vs.26.5 ％,80.0 ％ vs.58.8 ％,respectively (x2 =2.721,6.731,both P＜0.05).There were no significant differences in hs-CRP,NSE,CEA,TSGF levels between two groups before and after treatment (P＞0.05),but hs-CRP level in both groups was decreased after treatment as compared to pre-treatment and the decvease was more obvious in chemotherapy + herbs group (51.47％ vs.23.77％,x2 =19.713,P＜0.05).Conclusions Lung cancer Ⅳ recipe can improve the main clinical symptoms,quality of life and tolerance to chemotherapy in NSCLC patients with heat-toxin manifestation in TCM.There is a correlation between heat-toxin syndrome and hsCRP level in NSCLC patients,which shows that hs-CRP probably is the material basis of the heattoxin syndrome in TCM.%目的 观察肺癌Ⅳ号方配合化疗对兼具“热毒”表现的中晚期老年非小细胞肺癌(NSCLC)患者的临床疗效观察.方法 选取我科2013年4月至2014年10月收治的70岁以上中晚期NSCLC并兼具“热毒”表现的患者77例,随机分为化疗组39例,化疗+中药组38例,脱落13例(对照组5例,中药组8例),两组患者均给予化疗的基础上,观察患者加用中药后卡氏评分、有效率、中医主症,及治疗前、后第1、56天超敏C反应蛋白(hs-CRP)及肿瘤标志物中癌胚抗原(CEA)、烯醇化酶(NSE)、肿瘤相关物质检测(TSGF)的变化.结果 两组患者治疗后治疗有效率分别为20.0％、23.5％,两组比较差异无统计学意义(P＞0.05).但加用中药组卡氏评分、中医主症明显改善,分别为36.7％比26.5％和80.0％比58.8％,组间比较差异皆有统计学意义(x2=2.721、6.731,P＜0.05).hs-CRP、CEA、NSE、TSGF水平在用药前后两组组间比较差异无统计学意义(P＞0.05),但hs CRP水平两组自身比较皆较治疗前降低,中药组降低更加明显分别为51.47％、23.77％,且差异有统计学意义(x2=19.713,P＜0.05).结论 肺癌Ⅳ号方可改善兼具“热毒”症候的老年肺癌患者的主要临床症状,提高其生活质量,且老年肺癌患者的化疗耐受性可.并发现中医“热毒”症候与患者hs-CRP水平具有相关性,推测其可能为该症候的物质基础.
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