中药辅助化疗治疗晚期非鳞非小细胞肺癌的临床疗效及经济学评价的回顾性研究

Retrospective Study on Clinical Efficacy and Economic Evaluation of Adjuvant Chemotherapy with Traditional Chinese Medicine in the Treatment of Advanced Non-Squamous Non-Small Cell Lung Cancer

摘要: 目的：回顾性分析晚期非鳞非小细胞肺癌中药辅助化疗治疗的临床疗效及经济学评价，为非小细胞肺癌患者提供更有效且经济的治疗方案。方法：回顾性收集2019年1月1日至2020年12月31日在青岛大学附属海慈医院诊治的100例气阴两虚型或者气滞血瘀型晚期非鳞非小细胞肺癌患者的临床基本资料。根据是否联合中药辅助化疗治疗分为两组：A组化疗组，B组化疗 + 中药辅助化疗治疗组。所有患者治疗期间，每2个治疗周期进行影像学及血液学检查。本研究主要研究终点临床疗效、医药经济学评价，次要研究终点临床症状改善情况、治疗期间不良反应发生情况、肿瘤标志物水平及阳性情况、免疫指标、生活质量。结果：A组病人50例，B组病人50例。疗效评价：B组患者的客观缓解率较A组明显提高了20.00% (χ² = 4.762, P < 0.05)。B组患者的咳嗽、胸痛、血痰、食少、乏力、气短改善率均高于A组(P < 0.05)。治疗后，B组患者的CA125、CEA水平及阳性率均低于A组(P < 0.05)，两组患者治疗后的CA125、CEA水平及阳性率均低于治疗前(P < 0.05)。治疗后，B组患者的CD₃、CD₄、CD₄/CD₈、CIK均高于A组(P < 0.05)；两组患者治疗后的CD₃、CD₄、CD₄/CD₈、CIK均高于治疗前(P < 0.05)。B组患者的生活质量提高比例高于A组，B组患者治疗期间胃肠道反应发生率高于A组(P < 0.05)，肝功能损伤、肾功能损伤、骨髓抑制发生率均低于A组(P < 0.05)。B组患者的C、E均高于A组(P < 0.05)，C/E低于A组(P < 0.05)，ΔC/ΔE = 104.72。结论：化疗联合中药辅助化疗治疗可明显提高晚期非鳞非小细胞肺癌患者的客观缓解率，可有效缓解患者咳嗽、胸痛、血痰、食少、乏力、气短等临床症状，减少化疗相关药物副反应，提高机体免疫功能，经济学效益显著。

Abstract: Objective: To retrospectively study the clinical efficacy and economic evaluation of traditional Chinese medicine adjuvant therapy for advanced non-scale non-small cell lung cancer, so as to provide effective evidence for clinical treatment of patients with advanced non-squamous non-small cell lung cancer more economically and effectively. Methods: This study retrospectively collected the basic clinical data of 100 patients with advanced non-squamous non-small cell lung cancer with Qi Yin deficiency or Qi stagnation and blood stasis in Haici Hospital affiliated to Qingdao University from January 1, 2019 to December 31, 2020. According to whether it is combined with the addition and subtraction of fixed traditional Chinese medicine decoction, it is divided into two groups: group A chemotherapy group and group B chemotherapy + addition and subtraction of fixed traditional Chinese medicine decoction adjuvant treatment group. During the treatment period, all patients underwent imaging and hematological examination every two treatment cycles. The main end point of this study was the clinical efficacy and medical economic evaluation, and the secondary end point was the improvement of clinical symptoms, the occurrence of adverse reactions during treatment, the level and positive of tumor markers, immune indexes and quality of life. Results: There were 50 patients in group A and 50 patients in group B. Evaluation of curative effect: the objective remission rate of patients in group B was significantly higher than that in group A by 20.00% (χ² = 4.762, P < 0.05). The improvement rates of cough, chest pain, blood phlegm, anorexia, fatigue and shortness of breath in group B were higher than those in group A (P < 0.05). After treatment, the levels and positive rates of CA125 and CEA in group B were lower than those in group A (P < 0.05), and the levels and positive rates of CA125 and CEA in both groups were lower than those before treatment (P < 0.05). After treatment, CD₃, CD₄, CD₄/CD₈ and CIK in group B were higher than those in group A (P < 0.05). After treatment, CD₃, CD₄, CD₄/CD₈ and CIK in both groups were higher than those before treatment (P < 0.05). The improvement rate of quality of life in group B was higher than that in group A, the incidence of gastrointestinal reaction in group B was higher than that in group A (P < 0.05), and the incidence of liver function damage, renal function damage and bone marrow suppression were lower than those in group A (P < 0.05). C and E in group B were higher than those in group A (P < 0.05), C/E was lower than that in group A (P < 0.05), the ΔC/ΔE = 104.72. Conclusion: Chemotherapy combined with the addition and subtraction of fixed traditional Chinese medicine decoction can significantly improve the objective remission rate of patients with advanced non-squamous non-small cell lung cancer, effectively alleviate the clinical symptoms of patients such as cough, chest pain, blood phlegm, lack of food, fatigue and shortness of breath, reduce the side effects of chemotherapy related drugs, improve the immune function of the body, and have significant economic benefits.