摘要
目的:探究中药联合化疗治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的中药处方辨证用药规律及预后影响因素。方法:收集2018年6月至2023年6月期间接受化疗联合中药(综合治疗组)或仅接受化疗治疗(化疗组)的晚期NSCLC患者的病历资料,对综合治疗组的中药处方进行药物使用频次、功效与聚类分析,同时记录所有患者的一般资料及治疗方案,计算中位无进展生存时间,分析预后影响因素。结果:共纳入219例患者,其中综合治疗组112例,化疗组107例;综合治疗组患者的中药处方分析结果显示,常用药物包括陈皮、茯苓等,常用功效为补虚等,聚类分析得到4个药物组合,分别为补气健脾和胃类、理气化痰散结类、滋阴清热潜阳类、泻火燥湿解毒类;中位无进展生存期(progression free survival,PFS)比较方面,总体、一线、二线及三线治疗中,综合治疗组均优于化疗组,四线及以上治疗中,化疗组优于综合治疗组,总体与一线治疗组间比较,差异有统计学意义(P<0.05);在影响预后因素方面,分期与联合治疗为影响患者PFS的独立危险因素(P<0.05)。结论:依据具体辨证拟方施治晚期NSCLC患者,可以延长化疗治疗周期、延缓疾病进展。
Objective:To investigate the syndrome differentiation and medication rules of traditional Chinese medicine(TCM)prescriptions in TCM combined with chemotherapy for the treatment of advanced non-small cell lung cancer(NSCLC),as well as the influencing factors for prognosis.Methods:Medical records were collected from the patients with advanced NSCLC who received chemotherapy combined with TCM treatment(integrated treatment group)or chemotherapy alone(chemotherapy group)from June 2018 to June 2023.The frequency of use of drugs,functions,and the cluster analysis were performed for the drugs in TCM prescriptions in the integrated treatment group,and general information and treatment regimens were recorded.Median progression-free survival(PFS)was calculated,and the influencing factors for prognosis were analyzed.Results:A total of 219 patients were enrolled,with 112 in the integrated treatment group and 107 in the chemotherapy group.The analysis of the TCM prescriptions for the patients in the integrated treatment group showed that commonly used drugs included tangerine peel and Poria cocos,with the most common function of tonifying deficiency.The cluster analysis obtained four drug combinations with the following functions:tonifying Qi and strengthening the spleen and stomach;regulating Qi,resolving phlegm,and resolving static blood;nourishing Yin,clearing heat,and suppressing Yang;purging fire,drying dampness,and detoxicating.Comparison of median PFS showed that the integrated treatment group had a better result than the chemotherapy group in overall treatment and the first-,second-,and third-line treatment,while the chemotherapy group had a better result than the integrated treatment group in the fourth-line treatment or above,and there was a significant difference between the overall treatment and the first-line treatment(P<0.05).Stage and combination treatment were independent influencing factors for PFS(P<0.05).Conclusion:The treatment of patients with advanced NSCLC based on syndrome differentiation can prolong the cycle of chemotherapy and delay disease progression.
作者
吴冠锦
周慧灵
叶轩婷
姚嘉麟
焦丽静
龚亚斌
陈智伟
许玲
WU Guanjin;ZHOU Huiling;YE Xuanting;YAO Jialin;JIAO Lijing;GONG Yabin;CHEN Zhiwei;XU Ling(First Department of Oncology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Cancer Translational Research Institute of Integrated Traditional Chinese and Western Medicine,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Shanghai Chest Hospital,Shanghai Jiao Tong University,Shanghai 200030,China)
出处
《湖南中医杂志》
2025年第7期41-48,共8页
Hunan Journal of Traditional Chinese Medicine
基金
国家重点研发计划中医药现代化专项(2023YFC3503302)
国家自然科学基金项目(82274595)
上海市科委科技创新行动计划医学创新研究专项(22Y31920400)。
关键词
非小细胞肺癌
化疗
中药
预后疗效
用药规律
non-small cell lung cancer
chemotherapy
traditional Chinese medicine
prognosis
medication rule
