目的 通过回顾性研究，探讨消岩汤维持治疗晚期非小细胞肺癌（non-small cell lung cance，NSCLC）的疗效。方法 收集2013年1月1日-2017年12月30日期间于天津中医药大学第一附属医院治疗的晚期NSCLC患者。根据当时采用的治疗手段，筛选到消岩汤加减方联合对症治疗组（治疗组）46例与对症治疗组（对照组）50例。对两组患者生存情况进行分析，比较两组患者Karnofsky（KPS）评分，分层分析探讨性别、年龄、吸烟史、饮酒史、组织学分级、化疗方案、病理类型、中医证型、脉管侵袭、软组织侵袭等因素与患者预后的相关性。结果 治疗组晚期NSCLC患者中位无进展生存期（mPFS）与对照组比较，显著延长（P<0.05）；两组患者中位总生存期（mOS）比较，无统计学意义（P>0.05）；与对照组比较，治疗组患者生存质量显著改善（KPS评分显著提高，P<0.05），其中，肺鳞癌、无脉管、无软组织侵袭、痰热阻肺证患者疗效最佳（P<0.05）。结论 消岩汤加减方联合对症治疗维持治疗晚期NSCLC患者具有延长无进展生存期（PFS）、改善患者生存质量的效果，最佳受益人群为肺鳞癌、无脉管及软组织侵袭的痰热阻肺证患者。

Objective To investigate the efficacy of Xiaoyan Decoction in the treatment of non-small cell lung cancer (NSCLC) by retrospective study. Methods Patients with NSCLC treated in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 1, 2013 to December 30, 2017 were collected. The patients were divided into two groups:Xiaoyan Decoction plus subtractive prescription combined with symptomatic treatment group (46) and symptomatic treatment group (50). Analyze the survival of the two groups of patients, compare the Karnofsky scores of the two groups, and analyze the sex, age, smoking history, drinking history, histological grade, chemotherapy regimen, pathological type, TCM syndrome type, vascular invasion, and soft tissue invasion Correlation with patient prognosis. Results There was a significant difference in median progression-free survival (mPFS) between the two groups (P<0.05). Median Overall Survival (mOS) of the two groups was not statistically significant (P>0.05).The quality of life of patients in Xiaoyan Decoction plus subtractive prescription combined with symptomatic treatment group was significantly improved (P<0.05), among which, lung squamous cell carcinoma, no vascular, no soft tissue invasion, and patients with phlegm heat obstruction of lung syndrome had the best efficacy (P<0.05). Conclusion Xiaoyan Decoction combined with symptomatic maintenance therapy can prolong median progression-free survival (mPFS) and improve the quality of life of patients with advanced NSCLC. The best beneficiaries are patients with lung squamous cell carcinoma, phlegm-heat obstructive pulmonary syndrome without vascular or soft tissue invasion.

R286.91

天津市卫生和计划生育委员会：基于LAPTM4B-35-PI3K/AKT信号通路探讨消岩汤在非小细胞肺癌中抗肿瘤作用及其机制研究（2017003）；天津市卫生和计划生育委员会：从“同病异治”探讨消岩汤联合阿帕替尼对NSCLC的临床研究（2017119）；天津市科技计划项目：扶正解毒祛瘀法方药联合甲磺酸阿帕替尼治疗晚期胃癌放化疗失败患者的临床研究（17ZXMFSY00190）