The Study Of The Relation Of The Level Of Serum Matrix Metalloproteinase-9 And Its Inhibitor The Efficacy Of Shenyi Capsule Combined With Chemotherapy In The Treatment Of Advanced NSCLC

Objective : This study compared Shenyi capsule combined with first-line chemotherapy and chemotherapy alone on advanced IIIb / IV non small cell lung cancer(NSCLC) and effect on serum MMP-9 and TIMP-1 levels in patients, and observe the adverse reactions after the recent curative effect and treatment differences, so as to understand the mechanism of anti tumor of Ginsenoside Rg3.Methods:Patients were randomly assigned to a Shenyi Capsule plus chemotherapy group and chemotherapy group.Chemotherapy include :Pacilitaxel 175mg/m2,ivdrip d1,cisplatin 75mg/m2,ivdrip divided into 3 or 4 days for a period of 21 days,Pemetrexed 500mg/m2, ivdrip dl,cisplatin 75mg/m2, ivdrip divided into 3or 4 days with a 21-day cycle,Gemcitabine 1000mg/m2, ivdrip d1.8,cisplatin 75mg/m2, ivdrip divided into 3or 4 days with a 2 1-day cycle,NP(Vinorelbine 25mg/m2, ivdrip d1,8,cisplatin 75mg/m2, ivdrip divided into 3 or 4 days with a 21-day cycle).Shenyi capsule each oral 20 mg, bid, at least 6 weeks.To detect the changes in peripheral serum MMP-9 and TIMP-1 level before chemotherapy and after the two course of chemotherapy using ELISA method, to observe the curative effect of two groups, the reaction after treatment.Results:1 45 people attended the Shenyi capsule group, 44 cases in hemotherapy group. The two groups did not appear completely remission, Capsule plus chemotherapy group,PR 20(44.4%),SD 17(37.8%),PD 8(17.8%)with RR20(44.4%)and clinical benefit 82.2%,in chemotherapy group,PR16(36.4%),SD 11(25%),PD17(38.6%)with RR16(36.4%)and clinical benefit61.4%,By ?2 test, the effective rates of two groups had no significant difference between the two groups(P >0.05), disease control has a significant difference of the rate(P <0.05).2 Comparison of CR+PR, SD, PD in all patients before treatment, serum MMP-9,TIMP-1 levels, no significant difference(P >0.05).After treatment,there was a significant difference(P <0.05), an increasing trend with the effect lowering.3 Compared to the two groups before treatment and after treatment two times the level of serum MMP-9, Shenyi capsule and a combined chemotherapy group decreased more significantly, the difference was significant(P <0.05), while no significant difference of serum TIMP-1 level(P >0.05).4 The relationship between patients with other features and MMP-9, TIMP-1 levels: the levels of MMP-9 in patients with stage IV than patients with stage IIIb in peripheral blood were significantly increased, the difference was significant(P <0.05). But the peripheral serum TIMP-1 in IIIb phase and IV phase has not been significant difference. Other factors such as age, gender, ECOG,pathology,significant differences were not found in MMP-9, TIMP-1 levels.5 Common side effects and QOL(Qullity of life, QOL) observation: the observation group(Shenyi capsule combined with chemotherapy group) in the gastrointestinal tract reaction(such as nausea, vomiting, abdominal distension etc.), bone marrow suppression(such as leukopenia, anemia, thrombocytopenia etc.) are lower than control group reduce(P <0.05), the observation group in improving the quality of life was also significantly higher than that of the control group, with statistical difference(P <0.05).Conclusions:1 Shenyi capsule combined with chemotherapy group peripheral serum MMP-9 level decreased more significantly, and there is significant difference, but there is not significant difference between the changes of serum TIMP-1 level.2 the serum MMP-9,TIMP-1levels after treatment with reduced efficacy showed a rising trend, therefore it can be used as a reference index to judge the curative effect.3 two groups levels of peripheral serum TIMP-1 and MMP-9, not affected by gender, age, ECOG score effect.4 the levels of serum MMP-9 was affected by lung cancer TNM staging, the later TNM staging is, the higher serum level of MMP-9.5 The peripheral serum TIMP-1 level and MMP-9 level in NSCLC patients was positively related to before and after chemotherapy.6 Shenyi Capsule on patients with non small cell lung cancer can increase the clinical benefit rate, reduce the poisonous side reaction, quality of life can improve, adverse reactions such as gastrointestinal symptoms and bone marrow function decline could alleviate.