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目的观察辨证与辨病治疗Ⅲ、Ⅳ期老年非小细胞肺癌(NSCLC)的近期疗效。方法采用随机、对照的临床研究方法,将91例合格病例按1∶1∶1比例分成中医组、中西医组和西医组。其中中医组31例,中西医组30例,西医组30例。主要观察指标为瘤体大小、卡氏评分、体重、不良反应等。结果中医组、中西医组、西医组瘤体缓解率分别为6.5%、23.3%、16.7%(P<0.05),稳定率为74.2%、83.3%、73.3%(P>0.05),中医组和中西医组行为状态评分(PS评分)的改善率均优于西医组(P<0.05)。中医组与中西医组均能较好的维持体重的稳定,西医组治疗后体重较治疗前有明显下降(P<0.05)。中医组和中西医组在气促、胃纳、乏力、口干等临床症状的改善方面优于西医组(P<0.05)。不良反应观察:中医组、中西医组与西医组比较,较少出现Ⅲ、Ⅳ度血液毒性,西医组Ⅲ、Ⅳ度白细胞、粒细胞、血小板及血红蛋白减少的发生率均显著高于中医组(P<0.01)。结论中医药治疗老年晚期NSCLC在提高身体功能状态、保持体重稳定、改善临床症状方面有一定优势。
Objective To observe the short-term curative effect of syndrome differentiation and differentiation treatment on stage Ⅲ and Ⅳ elderly non-small cell lung cancer (NSCLC). Methods A randomized, controlled clinical study was conducted to divide 91 eligible cases into TCM, Western and Western groups according to the ratio of 1: 1: 1. Among them, 31 were in the TCM group, 30 in the WMD group and 30 in the WM group. The main observation indicators for tumor size, Karnofsky score, weight, adverse reactions. Results The remission rate of tumor in TCM group, TCM group and WM group were 6.5%, 23.3% and 16.7% (P <0.05), and the stability rates were 74.2%, 83.3% and 73.3%, respectively The scores of improvement of behavior state score (PS score) in Chinese and Western medicine groups were better than Western medicine group (P <0.05). The Chinese medicine group and the Western medicine group were able to maintain a stable body weight. The body weight of the Western medicine group was significantly decreased after treatment (P <0.05). The Chinese medicine group and the Western medicine group were superior to the Western medicine group in improving the clinical symptoms such as shortness of breath, appetite, fatigue, dry mouth and so on (P <0.05). Adverse reactions observed: Chinese medicine group, Western medicine group and Western medicine group, less Ⅲ, Ⅳ degrees of hematologic toxicity, Western medicine Ⅲ, Ⅳ leucocyte, granulocyte, thrombocytopenia and hemoglobin reduction rate were significantly higher than the traditional Chinese medicine group ( P <0.01). Conclusion Chinese medicine treatment of elderly patients with advanced NSCLC have some advantages in improving the functional status of the body, keeping the weight stable and improving the clinical symptoms.