2022 年第 6 期 第 17 卷

益气养阴解毒方内服外治对非小细胞肺癌患者靶向治疗相关皮肤毒性反应及皮肤病生活质量指数的影响

The effects of internal and external therapy of supplementing Qi and nourishing Yin and detoxification prescription on skin toxicity related to targeted therapy and dermatology life quality index in patients with non-small cell lung cancer

作者：姚逸临1李和根1陈智伟2姜雪莲3徐蔚杰1周之毅1慕晓艳1刘吟絮1黄弦歌1侯宛昕1肖凌1

英文作者：Yao Yilin1 Li Hegen1 Chen Zhiwei2 Jiang Xuelian3 Xu Weijie1 Zhou Zhiyi1 Mu Xiaoyan1 Liu Yinxu1 Huang Xiange1 Hou Wanxin1 Xiao Ling1

单位：1上海中医药大学附属龙华医院肿瘤科国家中医临床研究中心，上海200032；2上海市胸科医院肿瘤科，上海200030；3上海市长宁区天山中医医院肿瘤科，上海200051

英文单位：1Department of Oncology Longhua Hospital Shanghai University of Traditional Chinese Medicine National Clinical Research Center of Traditional Chinese Medicine Shanghai 200032 China; 2Department of Oncology Shanghai Chest Hospital Shanghai 200030 China; 3Department of Oncology Shanghai Changning Tianshan Traditional Chinese Medicine Hospital Shanghai 200051 China

关键词：非小细胞肺癌；益气养阴解毒方；皮肤毒性反应；皮肤病生活质量指数

英文关键词：Non-smallcelllungcancer;SupplementingQiandnourishingYinanddetoxificationprescription;Skintoxicityreaction;Dermatologylifequalityindex

• 摘要：

• 目的 观察益气养阴解毒方内服外治对非小细胞肺癌（NSCLC）患者表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）相关皮肤毒性反应及皮肤病生活质量指数（DLQI）的影响。方法 选取2020年1月至2021年9月上海中医药大学附属龙华医院及上海市胸科医院收治的接受EGFR-TKI靶向治疗出现皮疹的气阴两虚型NSCLC患者64例。采用随机数字表法分为观察组和对照组，各32例。试验期间，2组各脱落2例，最终完成试验者60例，每组各30例。2组患者均接受靶向治疗，对照组患者加用氢化可的松外涂，观察组加用益气养阴解毒方口服并联合外治法。2组疗程均为28 d。观察2组治疗前后EGFR-TKI相关皮肤毒性反应分级和DLQI评分变化。结果 治疗第14、21、28天，观察组皮疹、皮肤干燥、手足综合征分级均优于对照组，且随治疗时间延长改善效果越好（均P＜0.05）。不同治疗时间，2组瘙痒、皮肤色素沉着分级比较差异均无统计学意义（均P＞0.05）。治疗第14、21、28天，观察组DLQI评分均低于对照组［（4.8±2.9）分比（6.7±3.6）分、（3.8±2.7）分比（6.0±3.4）分、（3.3±2.6）分比（5.7±3.4）分］（均P＜0.05）。结论 益气养阴解毒方内服外治可以明显改善NSCLC患者EGFR-TKI治疗引起的皮疹、皮肤干燥、手足综合征等皮肤毒性反应，显著提高患者的皮肤病生活质量。

• Objective To observe the effects of internal and external therapy of supplementing Qi and nourishing Yin and detoxification prescription on skin toxicity related to epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) and dermatology life quality index (DLQI) in patients with non-small cell lung cancer (NSCLC). Methods From January 2020 to September 2021, 64 patients with NSCLC of Qi Yin deficiency type who underwent EGFR-TKI targeted therapy and had skin rash admitted to Longhua Hospital Shanghai University of Traditional Chinese Medicine and Shanghai Chest Hospital were enrolled. The patients were randomly divided into observation group and control group, with 32 cases in each group. During the experiment, 2 cases fell off in each group, and 60 cases finally completed the experiment, with 30 cases in each group. Both groups received targeted therapy. The control group was treated with hydrocortisone, and the observation group was treated with supplementing Qi and nourishing Yin and detoxification prescription internal and external therapy. The course of treatment of both groups was 28 d. The grade of skin toxicity related to EGFR-TKI and DLQI score were observed before and after treatment. Results   On the 14th, 21th and 28th days of treatment, the grades of rash, dry skin and hand foot syndrome in the observation group were better than those in the control group, and the curative effect was better with the extension of treatment time (all P＜0.05). There were no significant differences in pruritus and skin pigmentation between the two groups at different time (all P＞0.05). On the 14th, 21th and 28th days of treatment, the DLQI scores of the observation group were lower than those of the control group［(4.8±2.9) vs (6.7±3.6), (3.8±2.7) vs (6.0±3.4), (3.3±2.6) vs (5.7±3.4)］(all P＜0.05). Conclusion  Internal and external therapy of supplementing Qi and nourishing Yin and detoxification prescription can significantly improve the skin toxicity reaction such as rash, dry skin and hand foot syndrome caused by EGFR-TKI treatment in patients with NSCLC, and improve the dermatology life quality.