扶正解毒增效方联合EGFR-TKI 靶向治疗非小细胞肺癌临床研究
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R734.2

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河南省科学重点研发计划项目(2018JY81257-3009);河南省医学科技攻关计划项目(LHGJ20191586)


Clinical Study on Fuzheng Jiedu Zengxiao Prescription Combined with EGFR- TKI in Targeted Treatment of Non-Small Cell Lung Cancer
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    摘要:

    目的:观察扶正解毒增效方联合表皮生长因子受体(EGFR) -酪氨酸激酶抑制剂(TKI) 靶向治疗非小细胞肺癌的临床疗效及对EGFR、自噬效应蛋白(Beclin-1) 表达的影响。方法:采用随机数字表法将96 例非小细胞肺癌患者分为研究组与对照组各48 例。2 组均采取EGFR-TKI 靶向药物治疗,研究组在此基础上联合扶正解毒增效方治疗,2 组均连续治疗2 个月。比较2 组临床疗效和无进展生存期(PFS);比较2 组治疗前后中医证候积分、血清肿瘤标志物含量;比较2 组EGFR 和Beclin-1 阳性表达率及不良反应发生情况。结果:研究组疾病控制率(DCR)、客观有效率(ORR) 均高于对照组(P<0.05),临床疗效优于对照组(P<0.05)。治疗后, 2 组咳嗽无力、食欲不振、气短难续、神疲乏力中医证候积分及血清癌胚抗原(CEA)、细胞角蛋白19 片段(Cyfra21-1) 含量均较治疗前降低(P<0.05),且研究组治疗后上述指标低于对照组(P<0.05)。研究组EGFR 和Beclin-1 阳性表达率均低于对照组(P<0.05),PFS 长于对照组(P<0.05)。研究组皮疹、腹泻发生率低于对照组(P<0.05),2 组肝肾功能异常、口腔黏膜炎发生率比较,差异无统计学意义(P>0.05)。结论:扶正解毒增效方联合EGFR-TKI 靶向治疗非小细胞肺癌疗效确切,能够延长患者PFS,降低肿瘤标志物含量,抑制EGFR 和Beclin-1 表达,减少药物不良反应事件发生。

    Abstract:

    Abstract:Objective:To observe the clinical effect of Fuzheng Jiedu Zengxiao prescription combined with epidermal growth factor receptor(EGFR) - tyrosine kinase inhibitor(TKI) in targeted treatment of nonsmall cell lung cancer and its effects on the expression of EGFR and autophagy effector protein(Beclin- 1). Methods:A total of 96 cases of patients with non-small cell lung cancer were divided into the control group and the study group according to the random number table method, with 48 cases in each group. Both groups were treated with EGFR-TKI targeted medicines,and the study group was additionally treated with Fuzheng Jiedu Zengxiao prescription. Both groups were treated for two months. The clinical effects and progression free survival(PFS) were compared between the two groups. The Chinese medicine syndrome scores and the content of serum tumor markers were compared between the two groups before and after treatment. The positive expression rates of EGFR and Beclin- 1 and the occurrence of adverse reactions were compared between the two groups. Results: The disease control rate(DCR) and objective effective rate(ORR) in the study group were higher than those in the control group(P<0.05),and the clinical effect was better than that in the control group(P<0.05). After treatment,Chinese medicine syndrome scores of cough and weakness,poor appetite,shortness of breath and lassitude of spirit and lack of strength,and the contents of serum carcinoembryonic antigen(CEA) and cytokeratin 19 fragment(Cyfra21- 1) in the two groups were decreased when compared with those before treatment(P<0.05),and the above indexes in the study group were lower than those in the control group(P<0.05). The positive expression rates of EGFR and Beclin-1 in the study group were lower than those in the control group(P<0.05),and PFS was longer than that in the control group(P<0.05). The incidence of rash and diarrhea in the study group was lower than that in the control group(P<0.05). There was no significant difference being found in the comparison of the incidence of liver and kidney dysfunction and oral mucositis between the two groups(P>0.05). Conclusion: Fuzheng Jiedu Zengxiao prescription combined with EGFR -TKI has a defined curative effect in the targeted treatment of on-small cell lung cancer,and can prolong the disease-free survival,decrease the content of tumor markers,inhibit the expression of EGFR and Beclin-1,and reduce the occurrence of adverse drug reactions.

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杨薇琳,梁瑞,王茜.扶正解毒增效方联合EGFR-TKI 靶向治疗非小细胞肺癌临床研究[J].新中医,2022,54(19):177-181

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  • 在线发布日期: 2022-10-08
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