| Nowadays, tumor has become a kind of frequently-occurring and worldwide disease. The morbidity and mortality of malignant tumors were showed a trend of rising year by year. International agency for research on cancer, according to the world cancer report in2012, The world’s most populous has cancer is lung cancer,the cancer of highest mortality rate is also lung cancer. Since the1970s, lung adenocarcinoma incidence rise rapidly, become the most common type of lung cancer cases. Targeted therapy is a kind of good efficacy and patient tolerance of emerging treatment,for patients with EGFR mutations, researches prove that the epidermal growth factor receptor (EGFR) mutations occur mainly in adenocarcinoma patients, less in glands squamous carcinoma and large cell anaplastic carcinoma, the mutation rate is less than5%in patients with squamous cell carcinomas. Epidermal growth factor receptor inhibitors (EGFRIs) to specific, competitive combination of EGFR kinase function ATP binding site, inhibit its activity which block cancer cell proliferation and metastasis related signal conduction, in order to achieve objective tumor treatment, because it has significant curative effect and good tolerance, in the treatment of non-small cell lung cancer made significant breakthrough, become the current research in the field of anti-cancer drugs is one of the most high-profile drugs. But EGFRIs can appear a variety of adverse reaction when using, such as:the skin reactions, pernicious vomiting, diarrhea, pulmonary fibrosis, bone marrow suppression, etc. Among them, the skin adverse reaction is the most common adverse reactions, it performs variety, high incidence, and illnesses out, no more for a long time, often affect the patient’s normal life, and even affect the treatment. TCM as early as in the "element asked" proposed "acne is the Lung Qi depression inside" thoughts, on EGFRIs related skin reactions. There are many kinds of Chinese medicine treatments of EGFRIs related skin reactions, and there are many clinical traditional Chinese medicine for treating skin adverse reactions associated with EGFRIs research shows that Chinese medicine has a good effect on EGFRIs related skin reactions, traditional Chinese medicine. Cui Huijuan professor EGFRIs related skin reactions in clinical treatment, it found that, with the use of EGFRIs, the traditional Chinese medicine clinical symptoms of patients with malignant tumor presents an obvious and regular changes, but at present Chinese medicine for EGFRIs related adverse skin reaction of classification and the change of syndrome types of TCM is still lack of systematic research. For a small sample of clinical observation, this study statistics using EGFRIs therapy in the treatment of patients with clinical symptoms in the process of change, expect to provide valuable clinical reference for the researchers.Research purposes:by observing clinical cases patients clinical data, finally summarizes EGFRIs related adverse reactions in patients with skin reactions change rule and the change of TCM syndrome types.Selection methods:the patients of china-japan friendship hospital oncology department of outpatient and ward were confirmed by pathology of pulmonary malignant tumor use EGFRIs treatment and cause skin related adverse reaction of patients. Using the method of epidemiology and collected the clinical data of the patients (tongue and pulse condition, symptoms, etc.), on the basis of TCM symptom types and combining EGFRIs acne/acne sample characteristics of rash type. Record every15days the patient’s skin reactions, lingual arteries and veins, and other symptoms, carried out a statistical analysis on the observation after60days.Results:during March2013to March2014, there are20patinets up to snuff. Among all the EGFRIs related clinical observation of rash,about9.1days after taking the drugs,skin rashes appeared gradually aggravate,1-3weeks after about the worst in three to four weeks, after the rash stable gradually, about37.5days after the rash began to appear, finally the skin erythema, dry skin, etc as the main performance. EGFRIs related adverse reactions to skin rash, as the main performance of incipient accompanied by itching, itching symptoms aggravate gradually1-3weeks,9-32days after peak, then gradually improve, about44.7days itch relief. dry skin is another observation,in this study dry skin as little incipient symptoms, appear in21-38, in dry all kinds of performance, dry mouth and skin desquamation are two of the most common symptoms, followed by nails change and bleeding gums. Reached a peak in37days to55days skin is dry, then although the ease, but the majority of patients (19/20) in the group of60days remain dry symptoms, usually cash for skin erythema with skin tight or desquamation. Skin adverse reaction of TCM syndrome types, in the process of drug use, the certificate type of early syndrome (10cases) and wind heat type (10cases), are all positive. In the process of observation, gradually transforms the syndrome rash Yin deficiency type (9/10) and wind heat type (1/10), the wind heat rash most (9/10) into Yin deficiency type, the time needed for the shift is about43.5days. |
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