1、中西醫(yī)結(jié)合治療對(duì)中晚期非小細(xì)胞肺癌患者生存質(zhì)量及機(jī)體免疫功能的影響         08-06-17 16:29:00     編輯：studa20         作者：白廣德 練組平 侯恩存 黃丁平 陸運(yùn)鑫 林梅英   【摘要】  目的 觀察扶正抑癌方合氬氦刀、化療對(duì)中晚期非小細(xì)胞肺癌患者生存質(zhì)量及機(jī)體免疫功能的影響，探討該方法治療中晚期非小細(xì)胞肺癌的價(jià)值和安全性

2、。方法 中藥治療，扶正抑癌方辨證加減內(nèi)服，每日1劑，30日為1個(gè)療程。 氬氦刀治療，刀尖溫度達(dá)-130-150，持續(xù)1520 min，熱融溫度升至2040，重復(fù)1次。術(shù)后患者定期復(fù)查CT或B超。 化療：諾維本（NVB）25 mg/m2，第1、8日，順鉑2030 mg/m2，第15日，外周靜脈滴注，21日為1個(gè)療程。4個(gè)療程后評(píng)價(jià)療效。觀察近期療效、臨床證候變化、治療前后免疫功能變化及生活質(zhì)量變化。結(jié)果 近期療效總有效率80.0%，穩(wěn)定率93.3%；臨床證候變化總改善率93.3%；生活質(zhì)量變化治療前后生活質(zhì)量評(píng)價(jià)(KPS)評(píng)分比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；免疫功能變化，治療后T淋巴

3、細(xì)胞亞群水平與治療前比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 采用扶正抑癌方合氬氦刀、化療治療中晚期非小細(xì)胞肺癌，可提高機(jī)體免疫功能，提高患者生活質(zhì)量，延長生存期，是一種療效肯定、安全性高、并發(fā)癥少的綜合治療方法。 【關(guān)鍵詞】  癌,非小細(xì)胞肺；氬；氦；冷凍外科手術(shù); 肺腫瘤；康復(fù);生活質(zhì)量;中西醫(yī)結(jié)合療法；免疫學(xué)Quality of life and cellular activity in middle-advanced nonsmall-cell lung cancer treated by combination of TCM with western medicin

4、e    【Abstract】  Objective  To observe quality of life and cellular activity middle-advanced nonsmall-cell lung cancer treated by combination of TCM, Endocare Cryocare TM Surgical System and Chemotherapy. And research the value and safety of the therapy for treating middle-a

5、dvanced non-small-cell lung cancer. Methods  Treatment of TCM: Fuzhengniai prescription for treating lung cancer, a dose a day, a course was 30 days. Endocare Cryocare TMSurgical System: Temperature of knifepoint is from -150 to-1300, duration 1520 min, temperature of thermal Melting raises 203

6、00 repeat. Chemotherapy: dose of NVB was 25 mg/m2, dose of cisplatin is 200 mg/m2, a course was 21 days. The total cycle of treatment was 4 courses.  Effect in the near future, clinical signs and changes of immune function before and after treatment were observed. Results  The total effect

7、ive rate in the near future was 80%, stable rate was 93.3%, the total improvement rate of clinical signs was 93.3%. Quality of life in KPS was enhanced compared with before treatment P<0.05). There was a significant difference in the changes of T lymphocyte subset (CD3，CD4，CD8，CD4/CD8) before and

8、 after treatment. Conclusion  Combination of TCM, Endocare Cryocare TM Surgical System and Chemotherapy can improve quality of life and cellular activity middle-advanced non-small-cell lung cancer, and it is a safety and comprehensive therapy.     【Key words】  Cancer; Non-sm

9、all-cell; Lung tumor; Recovery; Quality of life; Combination of TCM with western medicine; Immunology肺癌是我國最常見的惡性腫瘤之一，近年來其發(fā)病率有明顯上升趨勢(shì)。據(jù)資料統(tǒng)計(jì)，目前肺癌在城市常見惡性腫瘤死亡中已位居首位1，是一種嚴(yán)重危害人民群眾身心健康的重大疾病。臨床上大多數(shù)肺癌確診時(shí)已屬中晚期而失去手術(shù)切除機(jī)會(huì)。探討非手術(shù)治療特別是中西醫(yī)結(jié)合綜合治療是當(dāng)前提高中晚期非小細(xì)胞肺癌療效的一個(gè)重要途徑，尤其是如何提高生存質(zhì)量、延長生存期，是目前綜合治療研究的重點(diǎn)課題之一。2005-032006-02

10、，我們自擬扶正抑癌方合氬氦刀、化療治療失去手術(shù)切除機(jī)會(huì)的中晚期非小細(xì)胞肺癌30例，現(xiàn)報(bào)告如下。1  資料與方法1.1  一般資料  本組30例均為本院腫瘤科住院患者，男22例，女8例；年齡2978歲，平均（52.4±10.2）歲；病理分型2：鱗癌16例，腺癌9例，大細(xì)胞癌3例，腺鱗癌2例；臨床分期3：a期1例，b期2例，a期11例，b期13例，期3例；周圍型21例，中央型9例；合并慢性支氣管炎肺氣腫、呼吸功能不全者8例，伴胸壁疼痛者11例，伴胸腔積液者5例，伴糖尿病者4例，伴高血壓性心臟病者14例；腫瘤直徑2.514 cm，平均（7.2±5.4

11、）cm，其中直徑<5 cm者7例，510 cm者21例，>10 cm者2例；化療前血常規(guī)檢查：白細(xì)胞計(jì)數(shù)（WBC）4.0×109/L，血紅蛋白（Hb）95 g/L，血小板計(jì)數(shù)（PLT）100×109/L；生存質(zhì)量評(píng)價(jià)(KPS)評(píng)分2均60分； 30例患者均為無手術(shù)適應(yīng)證，不能耐受常規(guī)手術(shù)或患者不愿意接受手術(shù)，預(yù)計(jì)生存期在3個(gè)月以上者。1.2  儀器設(shè)備  美國Endocare公司研制的第三代CryocareTM氬氦刀手術(shù)系統(tǒng)（4刀型）4，并配有2、3、5 mm插入式超冷刀。1.3  治療方法1.4  觀察指標(biāo)  觀察病灶大小變化、臨床證候變化、毒