| Objective:The purpose of this project is to observe the clinical efficacy of Jiawei Zhimi Fuling Pills combined with pemetrexed + cisplatin chemotherapy in patients with advanced lung adenocarcinoma of phlegm-damp accumulation lung type,and to provide theoretical guidance and test basis for wide clinical application.Methods: A total of 68 cases who met the inclusion criteria during the treatment at Shijiazhuang City Integrated Traditional Chinese and Western Medicine Tumor Diagnosis and Treatment Center from January 2021 to December 2022 were selected and divided into the control group with 34 cases and the treatment group with 34 cases according to the random number table method.The control group was treated with pemetrexed +cisplatin chemotherapy,and the treatment group was additionally treated with modified Zhimi Fuling Pills on the basis of the chemotherapy regimen of the control group,21 days as a cycle,a total of 2 cycles were observed.The data of solid tumor curative effect,KPS score,tumor markers,TCM clinical symptom score,drug toxicity and side effects and safety data of each group of patients before and after treatment were observed and recorded.The recorded data were statistically analyzed using the software SPSS19.0.Results :(1)RECIST evaluation of solid tumors: After 2 cycles of treatment,in the treatment group,0 cases were complete remission(CR),12 cases were partial remission(PR),14 cases were stable disease(SD),and 5 cases were progressive disease(PD).After 2 cycles of treatment,in the control group,there were 0 cases of complete remission(CR),10 cases of partial remission(PR),15 cases of stable disease(SD),and 6 cases of progressive disease(PD).There was no difference in the curative effect of solid tumors between the two groups after treatment.Statistical significance(P>0.05).(2)KPS score:(1)Intra-group comparison: After 2 cycles of treatment,the KPS score of the treatment group increased,and the difference was statistically significant(P<0.05);after 2 cycles of treatment,the KPS score of the control group increased,but the difference was not statistically significant(P>0.05).(2)Comparison between groups: There was no significant difference in KPS score between the two groups before treatment(P>0.05),which was comparable;after 2 cycles of treatment,there was a statistically significant difference in KPS score between the two groups(P<0.05).(3)Tumor markers:(1)Intra-group comparison: After 2 cycles of treatment,the levels of CEA and CYFRA21-1 in the treatment group and the control group were decreased,and the difference was not statistically significant(P>0.05).(2)Comparison between groups: There was no significant difference in the levels of CEA and CYFRA21-1 between the two groups before and after treatment(P>0.05).(4)TCM clinical symptom score:(1)Comparison within the group:After treatment,the cough,expectoration,chest tightness and mental fatigue in the treatment group were significantly improved,and the difference was statistically significant(P<0.01);shortness of breath and chest pain The difference was statistically significant(P<0.05),and the blood in sputum were relieved,but the difference was not statistically significant(P>0.05).The control group was significantly improved in expectoration and chest tightness after treatment,with a significant difference Statistical significance(P<0.01);mental fatigue were relieved,the difference was statistically significant(P<0.05),and blood in sputum and chest pain were relieved,but the difference was not statistically significant(P>0.05).(2)Comparison between groups: After treatment,the two groups had significant differences in cough,expectoration,mental fatigue(P<0.01);in shortness of breath,the differences were statistically significant(P<0.05);blood in sputum,chest tightness and chest pain,the difference was not statistically significant(P>0.05).(5)The total curative effect of TCM clinical symptoms: After 2cycles of treatment,8 cases in the treatment group were markedly effective,17 cases were effective,and 6 cases were ineffective,with a total effective rate of 80.64%,after 2 cycles of treatment,3 cases in the control group were markedly effective,14 cases were effective,and 14 cases were ineffective,with a total effective rate of 55.83%.the difference was statistically significant between the two groups after treatment(P<0.05).(6)Drug side effects:(1)6 cases of I°myelosuppression and 2 cases of II° myelosuppression in the treatment group,with an adverse reaction rate of 25.80%;8 cases of I°myelosuppression and 6 cases of II°myelosuppression in the control group,There was 1 case of III°myelosuppression,and the rate of adverse reaction was 48.38%.The discrepancy in adverse reactions between the control group and the treatment group was statistically significant(P<0.05).(2)The treatment group had 5 cases of I°gastrointestinal reaction,2 cases of II°gastrointestinal reaction,and the adverse reaction rate was 22.58%;the control group had 12 cases of I° gastrointestinal reaction,5 cases of II°gastrointestinal reaction,There was 1 case of III° gastrointestinal reaction,and the adverse reaction rate was 58.06%,and the difference between the two groups was statistically significant(P<0.01).(7)Safety: During the 2 cycles of treatment,8 cases of mild to moderate myelosuppression in the treatment group and 15 cases of mild to moderate myelosuppression in the control group returned to normal after corresponding whitening treatment;no liver function and renal function damage were found in the two groups;It proclaims that the drug in this study is safe.Conclusion:Jiawei Zhimi Fuling Pills combined with chemotherapy can significantly reduce the symptoms of cough,expectoration,and fatigue in patients with advanced lung adenocarcinoma of phlegm-dampness accumulation type,reduce the bone marrow suppression and gastrointestinal side effects associated with chemotherapy drugs,and improve the quality of life.It has good safety and is worthy of further clinical promotion. |
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