The Device Of Benefiting Vital Energy And Eliminating Phlegm Prescription Combined With Chemotherapy Of The EGFR Wild-type And Spleen Deficiency And Phlegm-dampness Syndrome With Advanced-stage NSCLC

ObjectiveTo evaluate quality of life(QOL),clinical symptoms,objective response rate(ORR)of tumor,changes of weight,the incidence of bone marrow depression,and efficacy and toleratability in patients with advanced-stage(?/?)NSCLC receiving Benefiting Vital Energy and Eliminating Phlegm Prescription combined with chemotherapy;and to explore the potential clinical value of mir-21 as a biochemical marker for monitoring the efficacy and prognosis of advanced NSCLC by detacting the expression level of serum miR-21 in patients with NSCLC,and to provide a new way for individualized treatment and efficacy monitoring of advanced NSCLC with integrated traditional Chinese and western medicine.MethodsBetween May 2018 and Jan 2019,40 Patients with a histologically confirmed diagnose of stage ?/? NSCLC were enrolled,they were divided into treatment group(20 cases)and control group(20 cases).A prospective,randomized and controlled study was conducted.The treatment group was given Benefiting Vital Energy and Eliminating Phlegm Prescription combined with NP/TP/GP/DP/PC,the period of treatment was 2 courses,21 days per course;while the control group received NP/TP/GP/DP/PC only,and were repeated every 21days,2 cycles.In this study,the main observation indicators are the quality of life score,and the secondary observation indicators including clinical symptom score,objective remission rate(ORR),weight change and incidence of bone marrow suppression;exploring the expression level of serum microRNA-21 in the control group before chemotherapy.The clinical data and experimental data were sorted out for statistical analysis.Results1.Quality of life:After treatment,the scores of quality of life of each plate in the treatment group were significantly higher than those in the control group(P<0.05),with significant differences in social/family status,emotional status,functional status and additional attention(P=0.000).2.Clinical symptoms:After treatment,the symptoms of anorexia and fatigue in the treatment group were significantly improved compared with those in the control group(P=0.000);the remission rate of clinical symptoms in the treatment group was better than that in the control group(P=0.000).3.Tumor remission:After treatment,there was no significant difference in objective remission rate(ORR)between the two groups(P>0.05).4.Body weight changes:After treatment,the weight of the treatment group increased slightly(P<0.05),while that of the control group decreased(P<0.01);the treatment group had certain advantages in weight gain.5.Bone marrow depression:There were different degrees of bone marrow depression in both groups during 2 cycles of treatment,and the incidence of WBC and NEU bone marrow suppression in treatment group was lower than that in control group(P<0.05).6.Relative expression level of serum miR-21 in the control group:There was no significant correlation between the high and low expression of serum microRNA-21 before chemotherapy and the efficacy of chemotherapy(P>0.05),and there was no significant difference in the relative expression level of serum miR-21 between the beneficiary group and the advanced group(P>0.05).ConclusionCompared with chemotherapy alone,Benefiting Vital Energy and Eliminating Phlegm Prescription combined with chemotherapy can effectively improve the clinical symptoms,enhance the quality of life,increase body weight,and antagonize the toxic and side effects of chemotherapy in patients with advanced NSCLC of wild type of EGFR with spleen deficiency and phlegm dampness syndrome.In the differential diagnosis and treatment of advanced NSCLC by TCM,Benefiting Vital Energy and Eliminating Phlegm Prescription can be used as the basic prescription to add or subtract.By detecting the relative expression level of serum miR-21 before treatment in patients with lung cancer,it was found that there was no significant correlation between the expression level of miR-21 and the efficacy of chemotherapy.As a biochemical index for predicting the treatment and prognosis of advanced non-small cell lung cancer,a large number of clinical studies are still needed to prove it.