Clinical Observation Of Self-made Yangyin Zhixie Decoction Combined With Navel Therapy In The Treatment Of EGFR-TKIs-related Diarrhea

Objective:To observe the therapeutic effect of Yangyin Zhixie Decoction combined with Wubeizi umbilical therapy on EGFR-TKIs-related diarrhea and evaluate its safety,so as to provide a basis for the follow-up study.Methods:60 patients who met the inclusion criteria were divided into traditional Chinese medicine group and Western medicine group by prospective control method.The Chinese medicine group took targeted drugs for lung cancer(Gefitinib 250 mg qd or Erlotinib 150 mg qd or Ektinib 125 mg tid or Alfatinib 40 mg qd or Ositinib 80 mg qd)on time every day,and was given Yangyin Zhixie Decoction twice a day,half an hour after meals,warm water flushing to 250 ml;umbilical therapy was applied once a day.Western medicine group was given targeting drugs for lung cancer(Gefitinib 250 mg qd or Erlotinib 150 mg qd or Ektinib 125 mg tid or Alfatinib 40 mg qd or Ositinib 80 mg qd),and montmorillonite powder was given three times a day,one bag each time,half an hour before meals,warm water flushing to50 ml.The observation lasted for 14 days.The diarrhea grade,diarrhea symptom score and KPS score were recorded before treatment,on the third day,on the seventh day and on the fourteenth day.Safety indicators were recorded on the 14th day of treatment.Result:The study finally completed clinical observation in 54 cases,Chinese medicine group in27 cases,western medicine group in 27 cases.There were no significant differences in age,sex,body mass index,diarrhea grade,diarrhea symptom score and KPS score between the two groups.In diarrhea grade,there was no difference between the two groups on the third day of treatment(P=0.362),but on the seventh day(P=0.040),and on the fourteenth day(P=0.043),the curative effect of the Chinese medicine group was better than that of the western medicine group.In diarrhea symptom score,there was a difference between the two groups on the seventh day of treatment(P=0.046),and the traditional Chinese medicine group was better than the western medicine group.The comparison of the two groups before and after treatment showed that the traditional Chinese medicine group had better symptoms of fecal diarrhea,abdominal distension and abdominal pain,bowel ringing,fullness of abdomen,loss of appetite,fatigue,laziness,thirst,belching,yellow urine and cold limbs than before treatment.Statistical significance(P<0.05),including fecal diarrhea,abdominal distension,abdominal pain,bowel ringing,abdominal fullness,fatigue,belching symptoms were significantly different(P<0.01).There was no significant difference in the symptoms of lumbar and knee pain(P>0.05).There were significant statistical differences in the symptoms of fecal diarrhea,abdominal distension and abdominal pain,bowel ringing,abdominal fullness,loss of appetite,fatigue and laziness,and yellow urine after treatment in the western medicine group(P<0.05).There were significant statistical differences in the symptoms of fecal diarrhea,abdominal distension and abdominal pain and bowel rings(P<0.01).There was no significant difference in the symptoms of fatigue,thirst,belching,cold limbs and lumber and knee pain(P>0.05).In terms of KPS,there was no statistical difference between the two groups(P=0.280).The comparison between the two groups showed that the Karl's score of the traditional Chinese medicine group was improved(P=0.03),while that of the western medicine group was not changed(P=0.56).In terms of safety,there was one case of moderate skin adverse reactions in the traditional Chinese medicine group,which could be relieved after withdrawal.No changes of skin,blood,urine,stool routine,liver and kidney function and electrocardiogram were observed.Conclusion:1.Yangyin Zhixie Decoction combined with umbilical cord therapy has gradually demonstrated its advantages in alleviating EGFR-TKIs-related diarrhea over time.2.Yangyin Zhixie Decoction combined with Wubeizi umbilical therapy can effectively alleviate the overall symptoms of EGFR-TKIs-related diarrhea and improve the quality of life of patients.3.Whether Yangyin Zhixie Decoction combined with Wubeizi umbilical therapy can effectively improve patients'KPS score remains to be studied.4.Yangyin Zhixie Decoction combined with Wubeizi umbilical therapy is safe.