Clinical Observation Of GuiFu Lizhong Wan Modified Prescription For NSCLC Targeted Therapy Associated Diarrhea

Objective:Under the guidance of "Yang protection",the clinical efficacy of "GuiFu Lizhong Wan Modified Prescriptionl" in the treatment of EGFR-TKI associated diarrhea with spleen and kidney yang deficiency was explored by observing the frequency of defecation,diarrhea grading,TCM syndrome score,physical state score and diarrhea recurrence,so as to accumulate data for TCM treatment of EGFR-TKI associated diarrhea.Methods:In this study,64 patients with EGFR-TKI associated diarrhea of spleen and kidney yang deficiency type were enrolled and randomly divided into two groups,32 cases in the experimental group and 32 cases in the control group.The experimental group was treated with Smecta plus GuiFu Lizhong Wan modified prescription,while the control group was treated with Smecta orally.Both groups were treated for 2 weeks.The changes of stool frequency,diarrhea grade,physical status score and TCM syndrome score before and after treatment were observed,and the recurrence of diarrhea was recorded in the follow-up period one month after the end of treatment.Relevant data were collected for statistical analysis.Results:1.Baseline comparison:During the study,2 cases were shed in the experimental group and 2 cases in the control group.A total of 60 cases were observed in this study,with 30 cases in each group.The two groups had the same baseline and were comparable.2.Therapeutic results:(1)Number of stool: After 1 course of treatment,the number of stool in both groups decreased compared with before treatment,and after treatment,the number of stool in test group was lower than that in control group(P<0.05);After 2 courses of treatment,the number of stool in both groups decreased significantly compared with the first course of treatment,and the number of stool in experimental group was significantly lower than that in control group(P<0.01).(2)Grade efficacy of diarrhea:After 1 course of treatment,the effective rate of diarrhea in the experimental group was 83.3%,which was better than 70.0% in the control group,and there was a difference between the two groups(P<0.05);After 2 courses of treatment,the effective rates of diarrhea in the two groups were 93.3% and 76.6%,respectively,and the experimental group was significantly better than the control group(P<0.01).(3)TCM syndrome:The total score of TCM syndrome in the two groups after treatment was lower than that before treatment,and the difference between the two groups was statistically significant(P<0.01).The scores of each symptom in experimental group were significantly lower after treatment than before treatment(P<0.01).In the control group,the scores of diarrhea in stool,inappetence,abdominal pain,lumbago and knee pain,mental fatigue,languor and fatigue were decreased after treatment(P<0.05),and the symptom scores of chills and chills of limbs did not differ from those before treatment(P>0.05).After treatment,the symptoms of stool diarrhea,tiredness and weakness,mental fatigue and lazy speech,inappetence,chills,and weakness of waist and knee in experimental group were lower than those in control group(P<0.05).There was no significant difference in the score of abdominal pain(P>0.05).The effective rates of TCM syndromes in the two groups were 90.00% in the experimental group and 66.67% in the control group,respectively,and the efficacy of the experimental group was higher than that of the control group(P<0.05).(4)Physical status score:After treatment,the physical status scores of the two groups improved to different degrees,and the improvement of the test group was greater than that of the control group,with a significant difference between the two groups(P<0.05).(5)Diarrhea recurrence:1 month after the end of the treatment,the two groups of patients with effective diarrhea grading were followed up by telephone.The diarrhea recurrence rate of the experimental group was 10.7%,and that of the control group was 39.1%,which was significantly lower than that of the control group(P<0.05).Conclusions:(1)GuiFu Lizhong Wan modified prescriptionl combined with Smecta and Smecta alone can improve the diarrhea of patients with EGFR-TKI associated diarrhea of spleen and kidney yang deficiency type,but the overall efficacy of Guifu Lizhong pill combined with Smecta is better than that of Smecta alone.(2)GuiFu Lizhong Wan modified prescriptionll combined with Smecta can effectively improve the TCM symptoms of patients with EGFR-TKI associated diarrhea of spleen and kidney yang deficiency type,and has obvious advantages in improving the TCM symptoms of stool diarrhea,fatigue,mental fatigue,anorexia,chilly limbs,weak waist and knees.(3)GuiFu Lizhong Wan modified prescriptionll combined with Smecta can effectively improve the physical state score of patients with EGFR-TKI associated diarrhea of spleen and kidney yang deficiency type,improve the physical condition and quality of life of patients,and the curative effect is better than that of Smecta alone.(4)GuiFu Lizhong Wan modified prescriptionll combined with smecta can better control the diarrhea recurrence in patients with spleen-kidney Yang deficiency type EGFR-TKI associated diarrhea,so that patients can obtain a better prognosis.