Abstract:Objective:To observe the clinical effect of moxibustion combined with immune checkpoint inhibitors and chemotherapy on advanced non-squamous non-small cell lung cancer (NSCLC) of lungspleen qi deficiency type. Methods: A total of 62 cases of advanced non-squamous NSCLC patients of lung-spleen qi deficiency type were selected and divided into the control group and the trial group (31 cases respectively) according to random number table method. The control group was treated with immune checkpoint inhibitors and chemotherapy until the disease progressed or intolerable toxic reactions occurred. During chemotherapy, routine acid-suppressing stomach protection, antiemesis, liver protection and other symptomatic supportive treatments were given. The trial group was additionally given moxibustion based on the treatment of the control group. The traditional Chinese medicine (TCM) syndrome scores, TCM syndrome effects, solid tumor effect, progression-free survival time (PFS), the percentages of CD3+ , CD4+ and CD8+ T lymphocytes, CD4+/CD8+ , and adverse reactions were compared between the two groups. Results:After treatment,there was no significant difference in TCM syndrome scores in the control group before and after treatment (P>0.05). The TCM syndrome scores in the trial group were reduced when compared with those before treatment,and lower than those in the control group (P<0.05). The improvement rates of TCM syndromes were respectively 77.42% and 41.94% in the trial group and the control group, the difference being significant (P<0.05). The objective response rate (ORR) were respectively 58.06% and 51.61%, and the disease control rate (DCR) were respectively 83.87% and 77.41% in the trial group and the control group, there being no significant difference in ORR and DCR between the two groups (P>0.05). The PFS in the trial group was longer than that in the control group (Log RankP<0.05). Treatment mode was an independent factor affecting the progression of advanced nonsquamous NSCLC. Compared with that in the control group, the risk of progression in the trial group was lower [HR=0.57 (95%CI 0.33~0.99)]. After treatment, the percentages of CD3+ and CD4+ T lymphocytes, and CD4+ /CD8+ in the trial group were enhanced when compared with those before treatment,while the percentages of CD8+ T lymphocytes were reduced when compared with those before treatment,differences being significant (P<0.05). The percentages of CD3+ and CD8+ T lymphocytes in the control group were declined when compared with those before treatment,differences being significant (P< 0.05). There was no significant difference in the percentage of CD4+ T lymphocytes and CD4+/CD8+ before and after treatment (P>0.05). The percentages of CD3+ and CD4+ T lymphocytes,and CD4+/CD8+ in the trial group were higher than those in the control group (P<0.05). There was no significant difference in the total incidence of leukopenia, neutropenia, anemia, thrombocytopenia, abnormal liver function, abnormal kidney function, nausea and vomiting, reactive capillary hyperplasia, fatigue, decreased appetite and immune pneumonia,and the incidence of above adverse reactions of or over Grade three between the two groups (P>0.05). Conclusion: The therapy of moxibustion combined with immune checkpoint inhibitors and chemotherapy can improve the clinical symptoms of advanced non-squamous NSCLC of lung-spleen qi deficiency type,and improve the immune function and PFS.