摘要
目的 探讨加减清金化痰汤联合头孢唑肟治疗进展期非小细胞肺癌(non-small-cell lung cancer, NSCLC)化疗后肺部感染的效果及对血清中性粒细胞与淋巴细胞比值(Neutrophils lymphocytes ratio, NLR)、降钙素原(Procalcitonin, PCT)、高迁移率族蛋白B1(High mobility group box 1,HMGB1)水平、免疫状态的影响。方法 选取2018年3月—2021年3月我院进展期NSCLC化疗后肺部感染患者102例,以随机数字表法分为治疗组、对照组,各51例。对照组给予头孢唑肟治疗,治疗组在对照组基础上给予加减清金化痰汤治疗,均治疗2 w。比较两组肺部感染疗效、感染症状改善情况、不良反应以及治疗前、治疗2 w后血清血清中性粒细胞与淋巴细胞比值(Neutrophil to Lymphocyte Ratio, NLR)、降钙素原(Procalcitonin, PCT)、高迁移率族蛋白B1(High mobility group box 1,HMGB1)、免疫功能指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、肺功能指标[用力肺活量(Forced vital capacity, FVC)、每分钟最大通气量占预计值百分比(Maximum ventilation volume per minute as a percentage of expected value, MVV)、第1 s用力呼气容积占预计值百分比(percentage of forced expiratory volume in first second to predicted value, FEV1)]水平。结果 治疗组治疗2 w后总有效率为92.16%,高于对照组的76.47%(P<0.05);经治疗,治疗组退热、咳嗽消失、肺部啰音消失时间较对照组短(P<0.05);治疗组治疗2 w后血清NLR、PCT、HMGB1、CD8^(+)水平均低于对照组,血清CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组(P<0.05);治疗组治疗2 w后FVC、MVV、FEV1水平均高于对照组(P<0.05);两组治疗期间不良反应发生率相比,差异无统计学意义(P>0.05)。结论 应用加减清金化痰汤联合头孢唑肟治疗进展期NSCLC化疗后肺部感染可减轻感染症状,降低血清NLR、PCT、HMGB1表达,提升免疫功能与肺功能,安全有效。
Objective To explore the effect of modified Qingjin Huatan decoction combined with cefazoxime in the treatment of lung infection in advanced non-small cell lung cancer(NSCLC)after chemotherapy,and its impact on serum neutrophil lymphocyte ratio(NLR),procalcitonin(PCT),high mobility group protein B1(HMGB1)levels,and immune status.Methods 102 patients with advanced NSCLC chemotherapy induced pulmonary infection in our hospital from March 2018 to March 2021 were selected and randomly divided into a treatment group and a control group,with 51 cases in each group,using a random number table method.The control group was treated with cefazoxime,while the treatment group was treated with modified Qingjin Huatan decoction on the basis of the control group,both treated for 2 weeks.Compare the therapeutic effects,improvement of infection symptoms,adverse reactions,and serum NLR,PCT,HMGB1,immune function indicators(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),lung function indicators(Forced vital capacity(FVC),maximum ventilation volume per minute as a percentage of expected value(MVV),percentage of forced expiratory volume in first second to predicted value(FEV1)in the first second before and after 2 weeks of treatment between two groups.Results The total effective rate of the treatment group after 2 weeks of treatment was 92.16%,which was higher than 76.47%in the control group(P<0.05);After treatment,the time for fever reduction,cough disappearance,and lung rales disappearance in the treatment group was shorter than that in the control group(P<0.05);After 2 weeks of treatment,the serum levels of NLR,PCT,HMGB1,and CD8^(+)in the treatment group were lower than those in the control group,while the serum levels of CD4^(+)and CD4^(+)/CD8^(+)were higher than those in the control group(P<0.05);After 2 weeks of treatment,the levels of FVC,MVV%,and FEV1%in the treatment group were higher than those in the control group(P<0.05);There was no statistically significant difference in the incidence of adverse reactions between the two treatment groups(P>0.05).Conclusion The application of modified Qingjin Huatan decoction combined with cefazoxime in the treatment of lung infection in advanced NSCLC after chemotherapy can alleviate infection symptoms,reduce serum NLR,PCT,and HMGB1 expression,enhance immune and lung function,and is safe and effective.
作者
陈方园
李天浩
张莉媛
周凤
贾睿
马建刚
CHEN Fangyuan;LI Tianhao;ZHANG Liyuan;ZHOU Feng;JIA Rui;MA Jiangang(Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712000,China)
出处
《现代中医药》
CAS
2024年第2期53-58,共6页
Modern Chinese Medicine
基金
陕西省自然科学基础研究计划项目(2014JM4186)。
关键词
加减清金化痰汤
进展期非小细胞肺癌
肺部感染
免疫状态
临床研究
Modified Qingjin Huatan decoction
Progressive non-small cell lung cancer
Pulmonary infection
Immune status
Clinical research
