血府逐瘀汤合四君子汤联合尼洛替尼治疗非小细胞肺癌术后患者的效果

doi:10.3760/cma.j.cn441417-20240927-15022

摘要/Abstract

摘要：

目的　分析血府逐瘀汤合四君子汤联合尼洛替尼治疗非小细胞肺癌（NSCLC）术后患者的效果。方法　选取2020年9月至2022年8月安康市中医医院收治的118例NSCLC术后患者作为研究对象。按治疗方法不同，将患者分为对照组（57例）和观察组（61例）。对照组男33例，女24例；年龄19～78（48.56±4.58）岁。观察组男34例，女27例；年龄20～77（46.84±4.86）岁。对照组采用尼洛替尼胶囊治疗，观察组在对照组基础上联合血府逐瘀汤合四君子汤治疗。两组均连续治疗8周。比较两组治疗效果，治疗前后中医证候积分、生存质量［卡氏功能状态评分（KPS）、肺癌患者生存质量评价量表（FACT-L）］、免疫指标（CD3+、CD4+、CD8+），不良反应和远期效果。采用独立样本t检验、配对t检验和χ²检验进行统计学分析。采用Kaplan-Meier法估计生存率，采用Log-rank χ²检验进行生存分析。结果　观察组疾病缓解率、疾病控制率均高于对照组［75.41%（46/61）比43.86%（32/57）、88.52%（54/61）比73.68%（42/57）］（均P<0.05）。治疗后，观察组中医证候积分（主症、次症）均低于对照组（均P<0.05）；观察组KPS评分、FACT-L评分均高于对照组［（79.85±4.58）分比（76.52±3.89）分、（83.24±5.63）分比（78.29±5.24）分］（均P<0.05）；观察组CD3+、CD4+水平均高于对照组［（68.45±4.85）%比（64.15±4.28）%、（42.63±4.15）%比（40.25±3.89）%］，CD8+水平低于对照组［（20.36±2.47）%比（25.03±2.95）%］（均P<0.05）。治疗期间，两组不良反应总发生率比较，差异无统计学意义（P>0.05）。随访2年，因联系方式丢失、家庭住址更换脱落患者14例（对照组5例，观察组9例）。观察组病死率低于对照组［11.54%（6/52）比19.23%（10/52）］，差异无统计学意义（P>0.05）。结论　血府逐瘀汤合四君子汤联合尼洛替尼治疗NSCLC术后患者效果较好，可有效降低中医证候积分，提高生存质量，改善机体免疫状态，降低病死率。

关键词:

非小细胞肺癌, 血府逐瘀汤, 四君子汤, 尼洛替尼

Abstract:

Objective　To analyze the effect of Xuefu Zhuyu decoction and Si Junzi decoction combined with nilotinib in the treatment of postoperative patients with non-small cell lung cancer (NSCLC). Methods　A total of 118 postoperative patients with NSCLC who were admitted to Ankang Hospital of Traditional Chinese Medicine from September 2020 to August 2022 were selected as the research subjects. According to the different treatment methods, the patients were divided into the control group (57 cases) and the observation group (61 cases). There were 33 males and 24 females in the control group, aged 19-78 (48.56±4.58) years. There were 34 males and 27 females in the observation group, aged 20-77 (46.84±4.86) years. The control group was treated with nilotinib capsules, while the observation group was treated with the combination of Xuefu Zhuyu decoction and Si Junzi decoction in addition to the treatment of the control group. Both groups were treated continuously for 8 weeks. The therapeutic effects, adverse reactions and long-term outcomes were compared between the two groups, as well as the traditional Chinese medicine symptom scores, quality of life [Karnofsky Performance Status Score (KPS), Functional Assessment of Cancer Therapy-Lung cancer (FACT-L)], immune indicators (CD3+, CD4+, CD8+) before and after treatment. Independent sample t test, paired t test, and χ² test were used for statistical analysis. The survival rate was estimated using the Kaplan-Meier method, and the survival analysis was conducted using the Log-rank χ² test. Results　The disease remission rate and disease control rate in the observation group were both higher than those in the control group [75.41% (46/61) vs. 43.86% (32/57), 88.52% (54/61) vs. 73.68% (42/57)] (both P<0.05). After treatment, the traditional Chinese medicine symptom scores (main symptoms and secondary symptoms) of the observation group were lower than those of the control group (both P<0.05); the KPS score and FACT-L score of the observation group were higher than those of the control group [(79.85±4.58) points vs. (76.52±3.89) points, (83.24±5.63) points vs. (78.29±5.24) points] (both P<0.05); the levels of CD3+ and CD4+ in the observation group were higher than those in the control group [(68.45±4.85)% vs. (64.15±4.28)%, (42.63±4.15)% vs. (40.25±3.89)%], while the level of CD8+ was lower than that in the control group [(20.36±2.47)% vs. (25.03±2.95)%] (all P<0.05). During the treatment period, there was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). After a 2-year follow-up, 14 patients were lost (5 in the control group and 9 in the observation group) due to lost contact information or changes in their home addresses. The mortality rate in the observation group was lower than that in the control group [11.54% (6/52) vs. 19.23% (10/52)], and the difference was not statistically significant (P>0.05). Conclusion　Xuefu Zhuyu decoction and Si junzi decoction combined with nilotinib has a better therapeutic effect on postoperative NSCLC patients. It can effectively reduce the traditional Chinese medicine syndrome score, improve the quality of life, enhance the immune status of the body, and reduce the mortality rate.

Key words:

Non-small cell lung cancer, Xuefu , Zhuyu , decoction, Si Junzi , decoction, Nilotinib

马小红张晨吴安洪.

血府逐瘀汤合四君子汤联合尼洛替尼治疗非小细胞肺癌术后患者的效果 [J]. 国际医药卫生导报, 2025, 31(15): 2578-2582.

Ma Xiaohong, Zhang Chen, Wu Anhong.

The effect of Xuefu Zhuyu decoction and Si Junzi decoction combined with nilotinib in the treatment of postoperative patients with non-small cell lung cancer [J]. International Medicine and Health Guidance News, 2025, 31(15): 2578-2582.

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