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目的探讨益肺消积颗粒联合表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKIs)治疗晚期非鳞状非小细胞肺癌(NSCLC)的临床疗效。方法 47例NSCLC患者随机分为益肺消积颗粒+吉非替尼或埃克替尼联合治疗组(A组,24例)和吉非替尼或埃克替尼单药治疗组(B组,23例)。记录两组中医症候和功能状态改善程度、客观反应率、疾病控制率以及生存情况,采用ELISA法检测患者血浆过氧化物酶体增殖物激活受体γ(PPAR-γ)、葡萄糖转运蛋白1和胰岛素样生长因子1水平,并分析外周血循环肿瘤细胞(CTC)的数量变化。结果与B组相比,A组治疗后中医症候改善,美国东部肿瘤协作组评分降低,客观反应率、生存率以及PPAR-γ水平增加(P<0.05或P<0.01)。两组治疗后外周血CTC数量均较治疗前减少(P<0.01或P<0.05),但组间比较差异无统计学意义(P>0.05)。结论益肺消积颗粒能提高晚期NSCLC患者对EGFR-TKIs治疗的敏感性,改善患者的生活质量,并延长生存期。PPAR-γ水平和CTC数量可作为临床判断益肺消积颗粒增敏EGFR-TKIs疗效的参考指标。
Objective To investigate the clinical efficacy of Yifei Xiaoji granules combined with epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKIs) in the treatment of advanced non-squamous non-small cell lung cancer (NSCLC). Methods Forty-seven patients with NSCLC were randomly divided into Yifei Xiaoji granule + gefitinib group or icotinib group (24 cases in group A) and gefitinib or icotinib group (group B , 23 cases). The improvement of TCM symptom and functional status, objective response rate, disease control rate and survival were recorded in both groups. The levels of plasma peroxisome proliferator-activated receptor γ (PPAR-γ), glucose transporter 1 Insulin-like growth factor 1 levels and analysis of changes in the number of peripheral blood tumor cells (CTC). Results Compared with group B, the symptoms of TCM in group A were improved after treatment. The score of east American cancer cooperation group was decreased, and the objective response rate, survival rate and PPAR-γ level were increased (P <0.05 or P <0.01). The number of CTC in peripheral blood in both groups decreased after treatment (P <0.01 or P <0.05), but there was no significant difference between the two groups (P> 0.05). Conclusion Yifei Xiaoji granules can improve the sensitivity of EGFR-TKIs treatment in advanced NSCLC patients, improve the quality of life of patients and prolong the survival period. The level of PPAR-γ and the number of CTC can be used as a reference index for judging the curative effect of Yifei Xiaoji granule-sensitized EGFR-TKIs.