血府逐瘀胶囊辅助化疗对中晚期小细胞肺癌患者疗效及凝血指标的影响

廖碧常　邹立华　李惠

摘要：目的 觀察血府逐瘀胶囊辅助化疗治疗中晚期小细胞肺癌的疗效及其对患者凝血指标的影响。方法 将100例中晚期小细胞肺癌患者随机分为观察组和对照组各50例。观察组予EP方案化疗配合血府逐瘀胶囊，对照组仅予EP方案化疗，连续治疗4个周期。观察2组患者治疗前后凝血指标变化，评价2组临床疗效和中医证候疗效。结果 2组患者治疗后肿瘤体积和中医证候积分均较治疗前减少（P<0.01），观察组优于对照组（P<0.01）。观察组有效率为100%，高于对照组的88%，差异有统计学意义（P<0.05）。观察组治疗后中医证候积分改善率为98.0%，对照组为84.0%，观察组优于对照组（P<0.05）。观察组治疗后D-二聚体含量、血小板计数及纤维蛋白原含量较治疗前降低（P<0.05，P<0.01），且均低于对照组（P<0.01）。2组化疗毒副反应比较，差异无统计学意义（P>0.05）。结论 血府逐瘀胶囊辅助EP方案化疗可以改善小细胞肺癌患者血液的高凝状态，提高化疗效果，且未增加毒副反应。

关键词：小细胞肺癌；化疗；血府逐瘀胶囊；凝血功能

DOI：10.3969/j.issn.1005-5304.2015.09.008

中图分类号：R273.42 文献标识码：A 文章编号：1005-5304（2015）09-0026-04

Effects of Xuefu Zhuyu Capsules Combined with Chemotherapy on Treatment and Coagulation Indexes in Patients with Mid-advanced Small Cell Lung Cancer LIAO Bi-chang1， ZOU Li-hua2， LI Hui2 （1.Traditional Chinese Medicine Hospital of Zijin， Zijin 517400， China；2.Longgang Peoples Hospital of Shenzhen， Shenzhen 518172， China）

Abstract：Objective To observe the therapeutic effect and effects on coagulation indexes of Xuefu Zhuyu Capsules combined with chemotherapy in treating patients with mid-advanced small cell lung cancer （SCLC）. Methods Totally 100 patients with mid-advanced SCLC were randomly divided into observation group and control group with 50 cases in each group. The observation group was given EP chemotherapy combined with Xuefu Zhuyu Capsules， while the control group was given EP chemotherapy for 4 cycles. The coagulation indexes of two groups before and after treatment were observed， and the clinical efficacy and TCM syndrome efficacy were evaluated. Results After treatment， the tumor volume and TCM syndrome scores of two groups were lower than those before treatment （P<0.01）， and the observation group was lower than the control group （P<0.01）. The effective rate of the observation group was 100%， higher than 88% of the control group， the difference was statistically significant （P<0.05）. The improvement rate of TCM syndrome score was 98% in the observation group， and was 84.0% in the control group. The observation group was superior to the control group （P<0.05）. In observation group， D-dimer， platelet count and fibrinogen after treatment were lower than those before treatment （P<0.05， P<0.01）， and were lower than those in control group （P<0.01）. There was no significant difference of all kinds of adverse reactions between the two groups （P>0.05）. Conclusion EP chemotherapy combined with Xuefu Zhuyu Capsules can improve hypercoagulable state in patients with SCLC， improve the effect of chemotherapy， and do not increase the adverse reactions.

Key words：small cell lung cancer；chemotherapy；Xuefu Zhuyu Capsules；coagulation function

通讯作者：邹立华，E-mail：zjgzzlh@126.com

现有资料显示，小细胞肺癌（small cell lung cancer，SCLC）约占肺癌总数的15%，因其恶性程度高、易侵犯血管等特点，确诊时大多已是中晚期，患者的生存质量下降[1]。SCLC治疗以化疗为主并配合综合治疗，初期化疗效果一般较好，但后期化疗效果越来越差，患者病情进展或复发[2]。已有研究表明，血液的高凝状态是造成肿瘤转移或复发的重要条件之一。中晚期肺癌患者的血液往往呈高凝状态，有学者认为，行气活血化瘀治疗能提高化疗效果，但目前大部分研究集中于对非小细胞肺癌与凝血功能关系的探讨，对SCLC的研究较少[3]。笔者采用血府逐瘀胶囊辅助化疗治疗中晚期SCLC，并观察其对凝血指标的影响，旨在探讨活血化瘀中药配合化疗的效果，现报道如下。……