| Objective: By observing the clinical effects and safety of Jiawei Shengmai Powder combined with Nimotuzumab and Nimotuzumab alone in patients with Stage III/IV nasopharyngeal carcinoma radiotherapy with EGFR(epidermal growth factor receptor)positive Qi and Yin deficiency,the advantages of Jiawei Shengmai Powder combined with Nimotuzumab in patients with advanced nasopharyngeal carcinoma radiotherapy with EGFR positive Qi and Yin deficiency were clarified.To provide an optimized diagnosis and treatment scheme for patients with advanced nasopharyngeal carcinoma with EGFR positive Qi and Yin deficiency treated by integrated Chinese and western medicine.Methods: A total of 60 nasopharyngeal carcinoma patients with Stage III/IV EGFR positive Qi and Yin deficiency who were admitted to Radiotherapy Center,Oncology Department and otolaryngology Department of the First Affiliated Hospital of Hunan University of Chinese Medicine from January 2021 to January 2023 were selected and divided into 2 groups according to random number table method: Treatment group(Nimotuzumab + Jiawei Shengmai Powder group)and control group(Nimotuzumab group),with 30 patients in each group(there were no significant differences in gender,age,pathological stage and other aspects between the two groups).The curative effect was observed after 8 weeks of continuous medication in both groups.The recent efficacy of solid tumor,Karnofsky Performance Status(KPS)score,tumor marker indexes,clinical symptoms of traditional Chinese medicine and the incidence of adverse reactions of the 2 groups were observed.SPSS24.0 statistical software was used for statistical analysis,and the differences before and after treatment and between groups were compared,so as to evaluate the efficacy and safety of Jiawei Shengmai Powder combined with Nimotuzumab in patients with advanced EGFR positive nasopharyngeal carcinoma radiotherapy.Results: 1.After treatment,Chi-square test showed no significant difference in disease control rate(DCR)and objective response rate(ORR)of the two groups(P>0.05).Both the DCR and ORR levels were high in the two groups,indicating that radiotherapy combined with Nimotuzumab targeted therapy is effective for patients with advanced EGFR positive nasopharyngeal carcinoma.2.The paired sample rank sum test of paired samples showed that KPS scores in both groups were significantly higher after treatment than before treatment(P<0.05).After the two-sample rank sum test,the KPS score of the control group was slightly lower than that of the treatment group,but there was no significant difference between the two groups(P>0.05).3.After the two-sample rank sum test of two samples,the treatment group significantly improved compared with the control group in the epistaxis,nasal obstruction,dry mouth and pharynx,fatigue,emaciation,dysphoria with feverish sensation in chest,night sweat and tolerance(P<0.05),but there were no significant differences in deafness,tinnitus,headache and spontaneous sweating(P>0.05).The paired sample rank sum test of paired samples showed that the scores of all traditional Chinese medicine(TCM)symptoms in the treatment group were lower after treatment than before treatment,and the difference was statistically significant(P<0.05).The paired sample rank sum test of paired samples showed that the scores of the control group in epistaxis,deafness,tinnitus,nasal obstruction,headache,fatigue,emaciation and perspiration decreased after treatment,and the difference was statistically significant(P<0.05),but there were no significant changes in the scores of dry mouth and pharynx,dysphoria with feverish sensation in chest,night sweat and tolerance(P>0.05),and the scores of dry mouth and pharynx and night sweat increased slightly after treatment compared with before treatment.4.The two-sample rank sum test of two samples showed that CEA(carcino-embryonic antigen)and EBV-DNA(Nasopharyngeal cancer viral DNA)values in the treatment group were significantly decreased compared with those in the control group,with statistical significance(P<0.05).The paired sample rank sum test of paired samples showed that CEA and EBV-DNA values of the two groups decreased significantly after treatment compared with those before treatment,and the difference was statistically significant(P<0.05).5.In all the observed side effects of radiotherapy,the incidence of the treatment group was lower than that of the control group.Chi-square test showed that the incidence of decreased hemoglobin and salivary gland injury in the treatment group was significantly lower than that in the control group,and the difference between the two groups was statistically significant(P<0.05),and there was no significant difference in the incidence of other adverse reactions between the two groups(P>0.05).Conclusion: For patients with advanced EGFR positive nasopharyngeal carcinoma with Qi and Yin deficiency,the clinical efficacy of adding Jiawei Shengmai Powder is better than that of only using Nimotuzumab combined with radiotherapy.In the course of treatment,the short-term efficacy,KPS score,TCM syndrome score,serum tumor markers and most adverse reactions of the two groups were significantly improved compared with before treatment,indicating that Nimotuzumab combined with radiotherapy is one of the important means for the treatment of advanced nasopharyngeal carcinoma.When Nimotuzumab is combined with radiotherapy,Jiawei Shengmai Powder is added to reduce the toxicity and increase the effect,which is worthy of clinical promotion and application. |
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