广州中医药大学学报2026，Vol.43Issue(5)：1165-1175,11.DOI:10.13359/j.cnki.gzxbtcm.2026.05.006
中药联合PD-1/PD-L1抑制剂一线治疗老年非小细胞肺癌的临床疗效及核心处方分析
Clinical Efficacy and Core Prescription Analysis of Chinese Medicine Combined with First-Line PD-1/PD-L1 Inhibitors in Elderly Patients with Non-Small Cell Lung Cancer
摘要
Abstract
Objective To investigate the effect of Chinese medicine combined with first-line programmed death-1(PD-1)/programmed death-ligand 1(PD-L1)inhibitors on progression-free survival(PFS)in elderly patients with non-small cell lung cancer(NSCLC)based on real-world data,and to explore the core Chinese medicine prescription.Methods A retrospective analysis was conducted on the clinical data of 217 elderly NSCLC patients treated at China-Japan Friendship Hospital from January 2019 to December 2023.The Kaplan-Meier method was used to estimate the median PFS of each group and plot survival curves,and the Log-rank test was employed to compare the differences in median PFS between groups.Cox regression model was used to analyze independent factors influencing PFS prognosis in elderly NSCLC patients,and related adverse events were recorded and analyzed.Clinical records of 73 elderly NSCLC patients treated with Chinese medicine combined with first-line PD-1/PD-L1 inhibitors were collected to establish a Chinese medicine prescription database.Association rule analysis and cluster analysis were used to explore the clinical medication characteristics and principles of effective Chinese medicine compound formulas.Results(1)A total of 206 elderly NSCLC patients were finally included,with 133 cases(64.56%)in the western medicine group and 73 cases(35.44%)in the integrated Chinese medicine and western medicine group(shortened to intergrated group).The median PFS was 11.90 months in the western medicine group,with 1-,2-,and 3-year PFS rates of 52.7%,26.9%,and 21.5%,respectively;the median PFS was 18.83 months in the integrated group,with 1-,2-,and 3-year PFS rates of 59.7%,47.8%,and 40.1%,respectively.The difference in PFS between the two groups was statistically significant(P=0.013).(2)Univariate and multivariate Cox regression analyses showed that clinical stage and whether receiving Chinese medicine treatment were significantly correlated with PFS in elderly NSCLC patients(P＜0.05 or P＜0.01).(3)The Chinese medicine compound prescriptions involved a total of 296 herbs,with 19 herbs used more than 100 times.After cluster analysis,the high-frequency herbs were divided into six clusters,among which"Astragali Radix,Codonopsis Radix,Poria,Atractylodis Macrocephalae Rhizoma,Agrimoniae Herba"constituted the core prescription.Conclusion Chinese medicine combined with first-line PD-1/PD-L1 inhibitors significantly prolongs median PFS and reduces immune-related adverse events in elderly NSCLC patients.Clinical stage and whether receiving Chinese medicine treatment are independent prognostic factors for PFS.The core prescription represented by"Astragali Radix,Codonopsis Radix,Poria,Atractylodis Macrocephalae Rhizoma,Agrimoniae Herba"embodies the traditional Chinese medicine therapeutic principle of"strengthening vital qi and reinforcing deficiency".关键词
非小细胞肺癌/老年患者/免疫治疗/数据挖掘/生存分析/预后因素/扶正补虚Key words
non-small cell lung cancer(NSCLC)/elderly patients/immunotherapy/data mining/survival analysis/prognostic factors/strengthening vital qi and reinforcing deficiency分类
医药卫生引用本文复制引用
张铮,曾婷,木亚赛尔,柳芳,娄彦妮,贾立群,晋梓涵,王瑞韬,樊佳佳,黄蓉,王钦,卢佳,张燕颖,李雨龙..中药联合PD-1/PD-L1抑制剂一线治疗老年非小细胞肺癌的临床疗效及核心处方分析[J].广州中医药大学学报,2026,43(5):1165-1175,11.基金项目
国家自然科学基金项目(编号:82474329) （编号:82474329）
2024年国家临床重点专科建设项目:胸外(肺癌)("1+N"学科群模式) （肺癌）
