陶智会 仝欣 徐蔚杰 周之毅 靳永杰 许征国 李敏 于小伟

摘要 目的：觀察中药序贯联合化疗治疗非小细胞肺癌的减毒增效临床疗效。方法：选取2016年10月至2019年9月上海市嘉定区中医医院肿瘤科病房收治的非小细胞肺癌患者100例作为研究对象，采用随机数字表法随机分为观察组和对照组，每组50例，对照组给予常规化疗、观察组在常规化疗基础上加予中药序贯口服治疗，4周期后观察2组临床疗效及不良反应情况。结果：最终纳入患者91例，治疗后观察组在全身状态（KFS）、临床症状改善情况、临床受益率等方面高于对照组（P<0.05）;且恶心、呕吐（包括急性、延迟性呕吐）、食欲减退等消化道毒性反应，贫血、白细胞减少等骨髓毒性、癌性疲乏的发生率均均低于对照组（P<0.05）;血小板减少、肝肾功能损害、味觉减退、神经毒性、过敏反应等其他毒性反应的发生率差异无统计学意义（P>0.05）。结论：中药序贯治疗联合化疗治疗NSCLC具有减毒增效作用，具有一定的临床推广意义。

关键词 非小细胞肺癌;序贯治疗;化疗;减毒增效;香砂六君子汤;旋覆代赭汤;益气固本抗癌方;临床观察

Clinical Observation of Chinese Medicine Combined with Chemotherapy on Reducing Toxicity and Increasing Efficiency of Sequential Therapy in the Treatment Non-smallcell Lung Cancer

TAO Zhihui 1，TONG Xin 1，XU Weijie2，ZHOU Zhiyi 2，JIN Yongjie1，XU Zhengguo1，LI Min1，YU Xiaowei1

（1 Department of Oncology，Jiading District Hospital of traditional Chinese Medicine，Shanghai 201899，China; 2 Department of Oncology，Longhua Hospital Affiliated to Shanghai University of traditional Chinese Medicine，Shanghai 200032，China）

Abstract Objective：To Chinese Medicine combined with chemotherapy on reducing toxicity and increasing efficiency of sequential therapy in the treatment non-smallcell lung cancer.Methods：A total of 100 patients with non-small cell lung cancer diagnosed by imaging and pathology or cytology were randomly divided into an observation group and a control group，with 50 patients in each group.The control group received chemotherapy.The observation group received sequential oral administration of Chinese medicine on the basis of routine chemotherapy.After 4 cycles，the clinical efficacy and toxicity of the 2 groups were observed.Results：A total 91 patients were finally included.After treatment，the observation group was higher than the control group in general condition （KPS），improvement of clinical symptoms and clinical benefit rate （P<0.05），and the incidence of nausea，vomiting （including acute and delayed vomiting），loss of appetite and other gastrointestinal toxicity，anemia，leukopenia，myelotoxicity，and other cancer fatigue were lower than the control group （P<0.05）.There was no significant difference in the incidence of thrombocytopenia decrease，liver and kidney function damage，Hypoesthesia，neurotoxicity，allergic reaction and other toxic reactions （P>0.05）.Conclusion：The sequential treatment of traditional Chinese medicine combined with standard chemotherapy has the effect of increasing the efficacy and reducing the toxicity of NSCLC.It has certain clinical promotion significance.

Keywords Non-smallcell lung cancer; Sequential treatment; Chemotherapy; Reducing toxicity and increasing efficiency; Xiangsha Liujunzi Decoction; Xuanfu Daizhe Decoction; Yiqi Guben Kang′ai Formula; Clinical reseach

中图分类号：R2-031;R273;R259文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.03.021

肺癌占癌症总发病率的13%左右，是世界范围内发病率和病死率最高的恶性肿瘤。根据最新资料显示：在我国肺癌发病率约为57.26/10万、死亡率为45.87/10万，5年生存率约为16%，非小细胞肺癌作为主要的病理类型约占肺癌80%～85%[1-2]。虽然近年来在精准治疗越来越多的进入癌症领域，以基因检测为指导的靶向治疗、免疫治疗等治疗方案层出不穷，但由于多数肺癌患者确诊时已属晚期，加之高龄、经济能力不足等诸多因素，仍不能显著提高患者的临床疗效及生存率;而化疗作为肿瘤主要治疗手段之一，由于具有一定的药物可及性、经济性及稳定性（有效率30%～40%）[3]，仍在临床中发挥着不可替代的作用，化疗药物在杀伤肿瘤细胞的同时也可杀伤正常细胞，因此化疗药物均有不同程度的不良反应。……