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目的:观察葶苈甘遂逐水饮联合胸腔内灌注化疗治疗晚期非小细胞肺癌伴恶性胸水临床疗效。方法:应用随机平行对照方法,将90例晚期非小细胞肺癌伴恶性胸水的住院患者,随机分为两组。对照组45例患者应用胸腔灌注化疗,治疗组45例患者在化疗基础上,应用草芳甘遂逐水饮口服。观察比较两组患者治疗后近期疗效、卡式评分、中医症状评分情况、T淋巴细胞亚群(CD~+_3、CD~+_4、CD~+_4/CD~+_8)、毒副作用。结果:两组患者的近期疗效比较,治疗组为73.7%,对照组51.1%,治疗组总有效率优于对照组,但差异无统计学意义(P>0.05);患者生活质量改善情况比较,行3个疗程治疗后,治疗组改善率为60.9%,对照组改善率为39.1%,差异显著(P<0.05);中医症状评分情况,治疗组症状评分下降明显,而对照组则评分增高,两组与治疗前比较,差异均具有统计学意义(P<0.01),且组间比较差异显著(P<0.01);治疗后,治疗组的CD~+_3,CD~+_4及CD~+_4/CD~+_8值均增高,与对照组相比,差异显著(P<0.05);毒副作用方面,治疗后,治疗组胸痛及胃肠道反应发生率明显低于对照组(P<0.05)。结论:葶苈甘遂逐水饮联合胸腔内灌注化疗治疗晚期非小细胞肺癌伴恶性胸水方面疗效可靠,减轻患者化疗副作用,减轻症状,改善患者免疫功能,提高生活质量。
Objective: To observe the curative effect of Qionglai Kansui water-drink combined with intrathoracic perfusion chemotherapy in the treatment of advanced non-small cell lung cancer with malignant pleural effusion. Methods: Ninety patients with advanced non-small cell lung cancer with malignant pleural effusion were randomly divided into two groups. Forty-five patients in the control group were treated with thoracic perfusion chemotherapy. Forty-five patients in the control group were treated with Cao Fang Gan Sui Sui Shuishui by chemotherapy on the basis of chemotherapy. Short-term curative effect, card score, TCM symptom score, T lymphocyte subsets (CD ~ + _3, CD ~ + _4, CD ~ + _4 / CD ~ + _8) and side effects were observed and compared between the two groups. Results: The short-term curative effect of the two groups was 73.7% in the treatment group and 51.1% in the control group. The total effective rate in the treatment group was better than that in the control group, but the difference was not statistically significant (P> 0.05) After three courses of treatment, the improvement rate was 60.9% in the treatment group and 39.1% in the control group, with significant difference (P <0.05). Symptom scores of Chinese medicine group decreased significantly in the symptom score of the treatment group, but increased in the control group, The differences between the two groups were statistically significant (P <0.01), and there was significant difference between the two groups (P <0.01). After treatment, the levels of CD ~ + _3, CD_4 and CD ~ Compared with the control group, the difference was significant (P <0.05). In terms of toxic and side effects, the incidence of chest pain and gastrointestinal reaction in the treatment group was significantly lower than that in the control group (P <0.05) ). Conclusion: Jieshugan Suishui Decoction combined with intrapleural chemotherapy in the treatment of advanced non-small cell lung cancer with malignant pleural effusion reliable, reduce chemotherapy side effects, reduce symptoms, improve patient’s immune function and improve quality of life.