Clinical Study Of Xiaoxuanming Decoction Combined With EGFR-TKI In The Treatment Of Advanced Non-small Cell Lung Cancer(Yang Deficiency And Cold Coagulation,Qi And Blood Deficiency Type)

Objective: To compare the improvement of clinical syndromes,improvement of KPS score,improvement of tumor markers,and treatment of patients with advanced non-small cell lung cancer with Xiaoxuanming Decoction combined with first-generation EGFR-TKI andsingle-agent application of first-generation EGFR-TKI.The occurrence of adverse reactions and the occurrence of toxic and side effects,in order to explore the effectiveness and safety of Xiaoxuanming Decoction combined with EGFR-TKI in the short-term efficacy of advanced non-small cell lung cancer.Methods: Patients with EGFR-mutant non-small cell lung cancer with TNM stage IIIB ? IV admitted from October 2017 to December 2019 in the Department of Oncology of the Hospital of Chengdu University of Chinese Medicine were collected.Divided into 2 groups,referred to as the traditional Chinese medicine group and the targeting group,with 30 cases in each of the two groups.)Treatment,the targeted group received only first-generation EGFR-TKIs(gefitinib or erlotinib or ektinib)monotherapy.Patients are required to complete laboratory-related examinations(three routine,biochemical,coagulation complete sets,tumor markers),imaging examinations(thoracic and abdominal enhanced CT,skull CT or MRI),electrocardiogram examinations,etc.before the medication to comprehensively evaluate the tumor A comprehensive review was performed 2 months after treatment and related data were recorded.Observe the improvement of clinical syndromes,short-term efficacy,adverse reactions,and safety evaluation of the two groups of patients.After the clinical observation and statistics were completed,the statistical software SPSS 23.0 was used for data processing and analysis,and finally came to a conclusion.Results: The age,sex,smoking history,clinical stage,pathological type,mutation site,KPS score before treatment,blood routine before treatment,liver and kidney function of the two groups of patients in this trial were not significantly different after baseline analysis.Statistical significance(P>0.05),comparable between the two groups.1.Efficacy observation indicators: mainly including TCM syndrome grade,KPS score,tumor markers,objective response rate,and disease control rate.(1)TCM Syndrome Grade: After treatment,the TCM syndromes of the 8 groups of patients in the Chinese medicine group and the targeted group were all improved compared with those before the treatment.The Chinese medicine group had cough,expectoration,fatigue,cold limbs,and loss of appetite5 Significant improvement in syndromes in the group(P<0.05),shortness of breath,chest pain,and sputum in the three groups were improved compared with the previous ones,and the improvement was not significant(P>0.05).Significant improvement(P<0.05),shortness of breath,chest pain,sputum and blood,fatigue,and cold limbs improved in the five groups of symptoms,the improvement was not significant(P> 0.05),loss of appetite was worse than before,The difference was not significant(P>0.05).(2)KPS score: The comparison between the Chinese medicine group after treatment,the KPS score was significantly higher than before(P<0.05),and the comparison between the treatment groups in the targeting group,the KPS score was slightly higher than before,and the increase was not significant(P>0.05).After comparison,the KPS score of the traditional Chinese medicine group was significantly higher than that of the targeted group(P<0.05).(3)Tumor markers: Compared with the Chinese medicine group after treatment,CEA and CY21-1 were significantly lower than before treatment(P<0.05).Compared with the target group after treatment,CEA and CY21-1 were slightly higher than before treatment.The decrease was not significant(P>0.05).Compared with the two groups after treatment,the Chinese medicine group CEA and CY21-1 decreased more significantly than the targeted group,but the difference was not significant(P>0.05).(4)Objective response rate(ORR)and disease control rate(DCR): The ORR and DCR of the Chinese medicine group were 60.0% and 96.7%,and the ORR and DCR of the targeted group were 53.3% and 90.3%,respectively.Group,but the difference was not significant(P>0.05).2.Toxic side effects: mainly include the two major side effects of EGFR-TKI rash and diarrhea.(1)Rash: The occurrence and severity of rash in the Chinese medicine group was lower than that in the targeted group,but the difference was not significant(P>0.05).(2)Diarrhea: The incidence and severity of diarrhea were lower in the Chinese medicine group than in the targeted group,and the difference was significant(P>0.05).3.Safety evaluation: It mainly includes the occurrence of blood routine,liver function,kidney function,and ECG safety events before and after treatment.After treatment,the blood routine,liver function,kidney function,and electrocardiogram of the two groups of patients were not significantly different from those before treatment(P>0.05).Conclusion:Xiaoxuming Decoction plus the first-generation EGFR-TKI and single-agent EGFR-TKI in the treatment of EGFR mutation advanced non-small cell lung cancer,although it failed to significantly improve the patient's ORR,DCR,but can significantly improve the patient's clinical symptoms and improve the patient's quality of life,Reduce the level of tumor markers,less skin and diarrhea side effects,after safety analysis,Xiao Xuming Tang addition and subtraction has good safety,will not increase adverse drug reactions,this side is for the treatment of advanced EGFR mutations is not small A good method for cell lung cancer(yang deficiency,cold condensation,qi and blood deficiency type).