目的 观察消岩汤姑息治疗中晚期非小细胞肺癌（non-small cell lung cancer，NSCLC）的临床疗效。方法 采用回顾性临床研究方法，收集III_b～IV期NSCLC患者127例，其中治疗组73例，采用了消岩汤加减联合姑息治疗；对照组54例，采用单纯姑息治疗。比较两组治疗后无进展生存期（progression free survival，PFS）和总生存期（overall survival，OS）及临床疗效，并对两组治疗前后卡氏评分（Karnofsky performance status，KPS）、免疫功能指标进行疗效评价和对比分析。结果 与对照组比较，治疗组显著延长了NSCLC患者的中位PFS（median PFS，mPFS）（3.6月vs 2.3月，P＝0.017），但中位OS（median OS，mOS）未见显著获益（5.73月vs 5.33月，P＝0.176）。治疗后，治疗组KPS评分较治疗前显著提高（P＜0.05）；治疗组较对照组KPS评分显著提高，差异具有统计学意义（P＜0.05）。治疗组临床总有效率为75.34%，中医症状缓解率为78.08%；对照组临床总有效率为37.04%，中医症状缓解率为44.44%，两组比较差异均具有统计学意义（P＜0.05）。治疗后，治疗组CD3⁺、CD3⁺/CD8⁺水平较治疗前显著升高（P＜0.05）；对照组CD3⁺、CD3⁺/CD8⁺水平较治疗前明显降低（P＜0.05）。与对照组相比，治疗组治疗后免疫功能指标CD3⁺、CD3⁺/CD8⁺水平均升高，差异具有统计学意义（P＜0.05）。两组均未发生明显不良反应。结论 消岩汤联合姑息治疗可显著延长中晚期NSCLC患者PFS，改善患者临床症状，提高患者免疫功能，且安全性良好。

Objective To observe the clinical effect of Xiaoyan Decoction (消岩汤) in palliative treatment of non-small cell lung cancer (NSCLC) of middle-later period. Methods The retrospective clinical research method was used to collect 127 cases of NSCLC of stages IIIb—IV, the treatment group (n = 73) was treated with Xiaoyan Decoction plus subtractive prescription combined with palliative treatment, whereas the control group (n = 54) was treated with palliative treatment. Progression-free survival (PFS), overall survival (OS) and clinical efficacy were evaluated between the two groups, and the karnofsky performance status (KPS), immune function indicators were evaluated and compared of the two groups before and after treatment. Results The treatment group experienced significantly prolonged median PFS (mPFS) (3.6 months vs 2.3 months, P = 0.017), but no significant benefit was observed in OS (5.73 months vs 5.33 months, P = 0.176). The KPS score of treatment group was significantly improved (P < 0.05) and higher than the control group with statistical significance (P < 0.05). The total effective rate (75.34% vs 37.04%) and the remission rate of TCM symptoms (78.08% vs 44.44%) between treatment group and control group were compared, and the difference had statistical significance (P < 0.05). After treatment, and the CD3⁺ and CD3⁺/CD8⁺ levels were significantly higher (P < 0.05) in the treatment group than prior treatment, while the CD3⁺ and CD3⁺/CD8⁺ levels were significantly lower (P < 0.05) in the control group than prior treatment. Compared with the control group, the CD3⁺ and CD3⁺/CD8⁺ levels were significantly improved in the treatment group and the difference had statistical significance (P < 0.05). No obvious adverse reactions occurred in both groups. Conclusion The Xiaoyan Decoction combined with palliative treatment can significantly prolong the PFS of NSCLC patients of middle-later period, alleviate the clinical symptoms, improve the immune function of patients, with good safety.

天津市科委慢性病防治科技重大专项（17ZXMFSY00190）；天津市卫生和计划生育委员会中医药重点领域科研课题（2017003）；天津市第二批卫生健康行业高层次人才选拔培养工程（TJSJMYXYC-D2-030）