晚期非小細胞肺癌圍化療期中藥參與治療回顧性臨床研究.pdf

1、北京中醫(yī)藥大學博士學位論文晚期非小細胞肺癌圍化療期中藥參與治療回顧性臨床研究姓名：侯麗申請學位級別：博士專業(yè)：中西醫(yī)結(jié)合臨床指導教師：陳信義200405012晚期非小細胞肺癌固化療期中藥參與治療回顧性臨床研究ABSTRACTPrimarybronchiallungcancea“isoneofthemostcornnlonmalignanttBnlors／ts5yealSurvivalrateislessthan15％Amongwhich

2、80％arenon，srm／1celllungcancerfNSCLC)75％ofpatientsareintheadvancedstage(stageIIIBorstageIV)whendiagnosedmissingt11eoppommityofaradicaloperation11把multimodalitytherapyiSrecommendedatpresent；itsaimistoimprovethequalityoflif

3、eandextendsurvivaltimeLiteratureshowsthattheinterventionofChinesemedicineinthepefichemotherapeutiestageofadvancedNSCLCcanminimizethetoxicandsideeffectsofchemotherapyincreasechemotherapycompleteratesandremissionratesrelie

4、vesymptomsandimprovequalityoflifeHoweverduetOthelackofpolycentricbigsamplingandstandardizedclinicaldatatherealestillnoenoughevidencetoprovetheadvantageofTCMintervenfionandinstmctstandardizedtreatmentThisstudyinitiallyatt

5、emptedtoconductaclinicalretrospectivecomparativestudyofthe211advancedNSCLCcasesadmittedin7firstgradefirstclassBeijinghospitalsfromJanuary1998toDecember2003，106casesofwhichbelongtothewesternmedicine(W啪groupand105casesbclo

6、t瑪totheim孵atedTCMandwesternmedicine(integratedTCMandWM)groupRemitsshow：O)compalisonofprelrealmentbasalinformationshowthatthepatientsDftheintegratedTCMandWlVlgrouparerelativelyolderamongwhich6898％areseniorpatients；thescor

7、esofKPSaresignificantlylowerthanthatoftheWlVIgroup；alsomorepatientshavecomplicationssuchaspainandanemi扎②Evaluationofimmediateeffectsshowthatbothgroupsdonothavecompleteresponse(㈣cases；船fbrthepartialresponse口R)Cases，therea

8、re39fortheWMgroup(3714％)and23矗)rtheintegratedTCMandWMgr(xtp(2l，9㈣；forstablediseasecasesthereare42fortheWMgroupand66fortheintegratedTCMandWMgroup40／oand6286％respectively：forprogressivediseaseca鼢，thereare24fbr也eWMgroupand1

9、6for齜integratedTCMandWMgroup2286％and1524％respectively111eCRPRofbothgroupsshowsignificantstatisticaldifference(PO05)，whereintheW／VlgroupprovestobebetterthantheintegratedTCMandW／Vlgroup；theCRPRSDofbothgroupsshow110signific

10、antstatisticaldifference(em05)；whenevaluatingthePDcasesofbothgroups，thepercentageoftheWMgroupishigherthanthatoftheintegratedTCMandWMgroup‰qualityoflife(QOL)evaluationprovesthatthepost拄eatmentintegratedTCMandWMgrouphasasi

11、gnificantincreaseinthescoresofKPS，thepercentagesofincreaseintheStoresOfKPSaret604％and6000／o，WIVigroupandintegratedTCMandW／vlgrouprespectively；thepercentagesofconstancyale5415％and37，1乃矗WMgroupandintegratedTCMandWMgroup，re

12、spectively；thepercentagesofdecreaseare1981％and28覦WMgroupandintegratedTCMandWMgrouprespectivelyThescoresofKPSofbothgroupsshowverysignificantstatisticaldifference㈣0001)provingthatTCMinterventionintreatmentcanimprovethequal