| Lung cancer is the leading cause of cancer morbidity and mortality in malignant tumor, its incidence and mortality showed a trend of rising year by year, has become the urban population is the leading cause of cancer death.1.38million people around the world die each year from lung cancer. Non-small cell lung cancer (KSCLC) accounts for80%～85%of all lung cancer cases. Most of patient has developed to the advanced phase when they were diagnosed. The curative efficacy of chemotherapy and radiotherapy has reached the bottleneck, efficient and the median survival period still cannot achieve satisfactory effect. As people learn more about molecular’mechanism of the development of NSCLC, the high specificity of the epidermal growth factor receptor tyrosine kinase inhibitors (epidermal growth factor receptor tyrosinekinase inhibitors, EGFR TKIs) become the popular new theropy for lung cancer. It is mainly used for first-line or second-line treatment for non-small cell lung cancer, because it specifically target to tumor cells, can prolong survival advantage, the median survival period and quality of life. EGFR TKIs, the emergence of a toppled idea and mode of cancer therapy, for its individualization, high curative effect,convenient and low adverse reactions. But the side effects of EGFR-TKI are very different from traditional ways. It mainly includes skin rash, diarrhea and conjunctivitis, stomatitis, and so on. The ongoing treatment has yet to achieve-a satisfactory effect, and what’s more, serious damage of side effect can affect the drug completion. In recent years of the clinical observations, the research shows that the treatment of traditional Chinese medicine combined with targeted drug can somehow reduce the toxicity and enhance the efficacy. Traditional Chinese Medicine can reduce adverse reaction, improve patient quality of life; On the other hand, Traditional Chinese Medicine can effectively inhibit the growth of tumor cells, enhance the body’s immune function. To sum up, Traditional Chinese Medicine and its joint application of targeted drugs therapy is a promising future for treatment of lung cancer..Objective:To study the clinical effect of using method "Nourish Yin to Clear Heat, dissolving blood stasis and detoxication"method (oral administration with external use) to relief the skin rash related to EGFR-TKI treatment,and whether it is worth of further research, popularization and application on patients with Adverse Drug Reaction after EGFR-TKls.Methods:Adopt the method of prospective study, the selection into the standard of50patients,50cases were patients with NSCLC (non-small cell lung cancer). Put25cases into the treatment group (intervened by TCM), as well as the control group (intervened by pimccrolimus). Fill in Clinical Research F orm according to the clinical symptoms, respectively before, and after treatment for7th days,14th days,30th days. There are records of the scale of skin rash, scores of quality of life, scores of syndrome of TCM differentiation. Before treatment and after30days, the tumor markers and T cell subgroup level will be tested. All the Data processings were calculated by SPSS11.0software.Results:1. Rash treatment efficacy. The rash classification of the treatment group all have improved significantly at evry testing point, and is superior to the control group, treatment group. At the30th day Control group rash treatment efficiency (rash classification decline or recovered cases) were72%vs44%(P<0.05).2. The quality of life(OoL) score. At the14th day and30th day,treatment group is superior to the control group, QoL scores calculated by t test, P<0.01, significant differences.3. TCM clinical symptoms. After the30day-treatment, in the treatment group,19cases were markedly effective, effective4cases,2cases failed. In the control group,5cases had marked effect,4cases were effective,16cases were ineffcctive.The effective rates of Treatment group and control group are92%and36%respectively, there were significant differences.4. Tumor markers level. There is no obvious difference of the CEA leavel of the two groups before and after the treatments, calculated by t test (P>0.05)5. T cells subgroup level. There is no obvious difference of the T cells subgroup level of the two groups before and after the treatments, calculated by t test (P>0.05)Based on the above research results, preliminary evidence shows that,"Nourish Yin to Clear Heat, dissolving blood stasis and detoxication"method fo skin rash related to adverse reaction of EGFR-TKIs is effective. Also, it is a applicable therapy to improve patients’ clinical symptoms and improve quality of life.The present curative effect is relatively outstanding. However,whether it can enhance immunity system and increase the curative effect of EGFR-TKIs and prolong the survival period, are still worthy of the further study. |
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