人参皂苷Rh2联合顺铂+培...曲塞化疗治疗晚期肺癌的疗效_赵明燕.pdf

癌症进展2022 年 12 月第 20 卷第 24 期ONCOLOGY PROGRESS,Dec 2022 V ol.20,No.24*论著*人参皂苷人参皂苷RhRh2 2联合顺铂联合顺铂+培美曲塞化疗治疗晚期肺癌的疗效培美曲塞化疗治疗晚期肺癌的疗效赵明燕#，胡述博，楚旭，秋玉珍驻马店市中心医院肿瘤内科，河南 驻马店 4630000摘要摘要：目的目的探讨人参皂苷Rh2联合顺铂+培美曲塞化疗治疗晚期肺癌的疗效及对患者肿瘤标志物及免疫功能的影响。方法方法根据治疗方式的不同将106例肺癌患者分为对照组和观察组，每组53例，对照组患者给予顺铂+培美曲塞化疗，观察组患者给予顺铂+培美曲塞化疗联合人参皂苷Rh2治疗。比较两组患者的临床疗效、血清肿瘤标志物癌胚抗原（CEA）、糖类抗原125（CA125）、细胞角质蛋白19片段抗原21-1（CYFRA21-1）水平、免疫功能指标（CD3+、CD4+、CD8+，计算CD4+/CD8+）及不良反应发生情况。结果结果观察组患者的治疗总有效率明显高于对照组患者，差异有统计学意义（P0.01）。治疗后，两组患者血清CEA、CA125、CYFRA21-1水平均低于本组治疗前，且观察组患者血清CEA、CA125、CYFRA21-1水平均低于对照组，差异均有统计学意义（P0.05）。治疗后，两组患者CD3+、CD4+水平和CD4+/CD8+均低于本组治疗前，CD8+水平均高于本组治疗前，且观察组患者CD3+、CD4+水平和CD4+/CD8+均高于对照组，CD8+水平低于对照组，差异均有统计学意义（P0.05）。观察组患者血小板减少、白细胞减少发生率均明显低于对照组，差异均有统计学意义（P0.01）。结论结论人参皂苷Rh2联合化疗可明显提高肺癌的疗效，减少化疗对机体免疫功能的损伤，降低肿瘤标志物水平和不良反应发生率。关键词关键词：肺癌；人参皂苷Rh2；化疗；临床疗效中图分类号中图分类号：R R734734.2 2文献标志码文献标志码：AdoiAdoi：10.11877/j.issn.1672-1535.2022.20.24.19Efficacy of ginsenoside RhEfficacy of ginsenoside Rh2 2 combined with cisplatin and pemetrexed in thecombined with cisplatin and pemetrexed in thetreatment of advanced lung cancertreatment of advanced lung cancerZHAO Mingyan#,HU Shubo,CHU Xu,QIU YuzhenDepartment of Oncology,Zhumadian Central Hospital,Zhumadian 463000,He nan,ChinaAbstract:ObjectiveAbstract:ObjectiveTo investigate the effect of ginsenoside Rh2 combined with cisplatin+pemetrexed in the treat-ment of advanced lung cancer and its influence on tumor markers and immune function of patients.MethodMethodA total of106 lung cancer patients were divided into control group and observation group according to different treatment methods,with 53 cases in each group.The control group were given cisplatin+pemetrexed chemotherapy,and the observationgroup were given cisplatin+pemetrexed chemotherapy combined with ginsenoside Rh2.The clinical efficacy,serum tu-mor markers carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),cyto-keratin 19 fragment antigen 21-1(CYFRA21-1)levels,immune function indicators(CD3+,CD4+,CD8+,calculate CD4+/CD8+)and occurrence of adverseevents were compared between the two groups.ResultResultThe total effective rate of treatment in the observation group wassignificantly higher than that in the control group,and the difference was statistically significant(P0.01).After the treat-ment,the levels of serum CEA,CA125,and CYFRA21-1 in the two groups were lower than those before the treatment,and the serum levels of CEA,CA125,and CYFRA21-1 in the observation group were lower than those in the controlgroup,and the differences were statistically significant(P0.05).After the treatment,the levels of CD3+,CD4+,and CD4+/CD8+in the two groups were lower than those before the treatment,and the levels of CD8+were higher than before thetreatment,the levels of CD3+,CD4+,and CD4+/CD8+in the observation group were higher than those in the control group,and the level of CD8+in the observation group was lower than that in the control group,and the differences were statisti-cally significant(P0.05).The incidences of thrombocytopenia and leukopenia in the observation group were significant-ly lower than those in the control group,and the differences were statistically significant(P0.01).ConclusionConclusionGinsen-oside Rh2 combined with chemotherapy can significantly improve the efficacy of lung cancer,reduce the damage of che-motherapy to the immune function of the body,and reduce the level of tumor markers and the incidence of adverse reac-tions.Key words:Key words:lung cancer;ginsenoside Rh2;chemotherapy;clinical efficacyOncol Prog,2022,20(24)肺癌是目前严重危害人类生命健康的恶性肿瘤之一，近年来，随着人们生活水平的提高和生活方式的改变，肺癌的发病率呈逐年上升趋势1。目前，肺癌最有效的治疗手段是手术切除联合化疗，#通信作者（corresponding author），邮箱：2553癌症进展2022年12月第20卷第24期但部分患者确诊时已进展至中晚期，只能进行化疗2。化疗可抑制肿瘤细胞的生长、延缓疾病进展，但多数化疗药物存在细胞毒性，易引发严重的胃肠道不良反应，且化疗药物缺乏特异性，在杀死肿瘤细胞的同时会对患者机体免疫功能产生一定影响3。有研究发现，中医药治疗能够显著改善化疗效果4。人参皂苷 Rh2 是常见的低毒高效的抗肿瘤药物，能够与其他化疗药物协同发挥抗肿瘤作用，还能够增强机体免疫力5。本研究探讨人参皂苷Rh2联合化疗治疗肺癌的疗效，现报道如下。1 1资料与方法资料与方法1 1.1 1 一般资料一般资料选取2020年2月至2022年2月驻马店市中心医院收治的肺癌患者。纳入标准：符合 2015年肺癌诊疗指南：共识和争议6中关于肺癌的诊断标准；病理检查确诊为非小细胞肺癌，病理类型为鳞状细胞癌，TNM分期为期；无放化疗史。排除标准：合并肝肾功能异常；合并其他部位恶性肿瘤；合并化疗禁忌证。依据纳入和排除标准，本研究共纳入106例肺癌患者，根据治疗方式的不同分为对照组和观察组，每组53例，对照组患者给予顺铂+培美曲塞化疗，观察组患者给予顺铂+培美曲塞化疗联合人参皂苷Rh2治疗。对照组中，男30例，女23例；年龄3771岁，平均（55.225.36）岁；TNM分期：期37例，期16例；体重指数（bodymass index，BMI）为19.3226.11 kg/m2，平均（23.121.26）kg/m2。观察组中，男31例，女22例；年龄3770岁，平均（55.295.34）岁；TNM分期：期36例，期17例；BMI为19.3626.15 kg/m2，平均（23.191.21）kg/m2。两组患者性别、年龄、BMI、TNM分期比较，差异均无统计学意义（P0.05），具有可比性。本研究经医院伦理委员会批准通过，所有患者均知情同意并签署知情同意书。1 1.2 2 治疗方法治疗方法对照组患者给予顺铂+培美曲塞化疗：第2天，顺铂75 mg/m2静脉滴注；第1天，培美曲塞500 mg/m2静脉滴注；3周为1个疗程，共治疗2个疗程。观察组患者给予顺铂+培美曲塞化疗联合人参皂苷Rh2治疗，化疗方案与对照组相同，人参皂苷Rh2 0.25 g口服，每天2次，连续治疗10天。1 1.3 3 观察指标和评价标准观察指标和评价标准采用实体瘤疗效评价标准7评估两组患者的临床疗效：完全缓解，目标病灶完全消失，至少持续4周；部分缓解，病灶直径总和与基线相比缩小30%，至少持续4周；疾病稳定，病灶直径总和与基线相比缩小30%或增大20%；疾病进展，病灶直径总和与基线相比增大20%或出现新病灶。总有效率=（完全缓解+部分缓解）例数/总例数100%。治疗前后，抽取两组患者空腹静脉血5 ml，采用电化学发光法检测两组患者的血清肿瘤标志物水平，包括癌胚抗原（carcinoembryonic anti-gen，CEA）、糖 类 抗 原 125（carbohydrate antigen125，CA125）、细胞角质蛋白19片段抗原21-1（cy-to-keratin 19 fragment antigen 21-1，CYFRA21-1）。治疗前后，采用流式细胞术检