Abstract:

Objective　To investigate the clinical efficacy of Jianpi Yishen decoction combined with chemotherapy for patients with advanced non-small cell lung cancer (NSCLC) on and its effect on the level of circulating tumor cells (CTCs). Methods　Sixty patients with advanced NSCLC and Spleen and Kidney difficiency treated in Tumor Hospital, Guangzhou Medical University from January 2019 to January 2021 were selected as the study objects, including 33 males and 27 females; they were 18-75 years old. The patients were divided into a control group and an observation group according to whether they were treated by Jianpi Yishen decoction or not, with 30 cases in each group. The control group was given conventional TP (docetaxel + nedaplatin) chemotherapy; the observation group was given Jianpi Yishen decoction and TP chemotherapy. The levels of CTCs, clinical symptoms, and Karnofsky Performance Status (KPS) of the two groups were observed before and after the treatment. t and χ² tests were applied. Results　After the treatment, the number of CTCs in the observation group was significantly lower than that in the control group [(3.47±1.871) vs. (6.90±2.264)], with a statistical difference (t=-6.403, P<0.001). The symptoms, such as fatigue, anorexia, lumbar debility, nocturia, and dizziness, in the observation group were better than those in the control groups (χ²=4.344, 9.643, 11.915, 4.444, and 5.934; all P<0.05). The KPS score in the observation group was significantly better than that in the control group [(85.83±7.21) vs. (80.36±4.86)], with a statistical difference (t=4.626, P=0.036). Conclusion　Jianpi Yishen decoction combined with chemotherapy for patients with advanced NSCLC can reduce the level of CTCs and improve their clinical symptoms and quality of life.

Key words:

Jianpi Yishen decoction, Advanced non-small cell lung cancer, Circulating tumor cells, KPS score

摘要：

目的　探讨健脾益肾汤联合化疗对晚期非小细胞肺癌（NSCLC）患者循环肿瘤细胞（CTCs）水平及临床疗效。方法　选择广州医科大学附属肿瘤医院2019年1月至2020年1月收治的晚期NSCLC患者60例，中医辨证属脾肾两虚证患者为研究对象，其中男33例、女27例，年龄18～75岁。按照是否联合健脾益肾汤治疗分为对照组和中药组，对照组（30例）行TP化疗方案，中药组（30例）行TP化疗方案联合健脾益肾汤治疗。观察两组患者治疗前后CTCs水平，临床症状及生活质量卡氏功能状态评分标准（KPS）评分变化进行比较。统计学方法采用t检验、χ²检验。结果　在CTCs阳性数量方面，治疗后中药组低于对照组［（3.47±1.87）个比（6.90±2.26）个］，差异有统计学意义［t=-6.403，P<0.001）］；在神疲乏力、纳差、腰膝酸软、夜尿、头晕改善方面，治疗后中药组均明显优于对照组（χ²=4.344、9.643、11.915、4.444、5.934，均P<0.05）；在KPS评分方面，治疗后中药组明显优于对照组［（85.83±7.21）分比（80.36±4.86）分］，差异有统计学意义（t=4.626，P=0.036）。结论　健脾益肾汤联合化疗在晚期NSCLC脾肾两虚证患者中能减少CTCs水平，改善患者各项临床症状，从而提高患者生活质量。

关键词:

健脾益肾汤, 非小细胞肺癌, 循环肿瘤细胞, 晚期, KPS评分