新辅助化疗中联合应用复方苦参对局部晚期乳腺癌患者免疫功能、临床疗效及不良反应的观察

Observation of Immune Function,Clinical Effect and Side Effects of Compound Kushen Injection(复方苦参注射液)in Neoadjuvant Chemotherapy of Local Advanced Breast Cancer

目的研究TEC方案新辅助化疗联合复方苦参对局部晚期乳腺癌免疫功能、临床治疗效果及不良反应的观察。方法收集2017年1月—2019年12月在医院确诊为局部晚期浸润性乳腺癌共67例患者资料,全部患者根据病情均给予TEC方案新辅助化疗,对照组患者仅接受TEC方案化疗,观察组接受TEC化疗方案与复方苦参联合治疗,化疗第2周期结束后3周评价近期免疫功能、临床疗效及不良反应。结果观察组血清CEA和CA125、CA153水平治疗后显著低于对照组(P<0.05)。观察组患者肝、肾功能与对照组比较,差异均无统计学意义(P>0.05),观察组KPS评分及生活质量优于对照组(P<0.05),观察组治疗后疾病控制率和总有效率略高于对照组,但差异无统计学意义(P>0.05)。观察组化疗后CD3^(+) 、CD4^(+)T淋巴细胞数值以及CD4^(+)/CD8^(+)T淋巴细胞比值较化疗前有明显升高(P<0.05),CD8^(+)T淋巴细胞数值较化疗前降低(P<0.05),对照组CD3^(+)、CD4^(+)T淋巴数值以及CD4^(+)/CD8^(+)T细胞比值较化疗前均降低(P<0.05),而CD8^(+)T淋巴细胞数值则有升高(P<0.05)。结论复方苦参辅助TEC方案化疗能够有效提高局部晚期乳腺癌患者免疫功能,改善患者生活质量。

Objective To investigate the immune function,clinical therapeutic effect and adverse reactions of TEC neoadjuvant chemotherapy combined with Compound Kushen Injection(复方苦参注射液)in locally advanced breast cancer.Methods From January 2017 to December 2019,67 locally advanced breast cancer patients were selected in our hospital,the study group was treated with TEC chemotherapy combined with Compound Kushen Injection adjuvant therapy,and the control group was treated with TEC chemotherapy alone.After chemotherapy,the immune function,clinical therapeutic effect and adverse reactions in the two groups were compared.Results The serum levels of CEA,CA125 and CA153 in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in liver and kidney function between the experimental group and the control group(P>0.05).KPS score and quality of life in the experimental group were better than those in the control group(P<0.05).The disease control rate and total effective rate in the experimental group were slightly higher than those in the control group,but the difference was not statistically significant(P>0.05).The values of CD3^(+),CD4^(+)T-lymphocyte and CD4^(+)/CD8^(+)T-lymphocyte ratio in the experimental group were significantly higher than those before chemotherapy(P<0.05).CD8^(+)T-lymphocyte values were lower than those before chemotherapy(P<0.05).The values of CD3^(+),CD4^(+)T-lymphocyte and CD4^(+)/CD8^(+)T-lymphocyte ratio in the control group were lower than those before chemotherapy(P<0.05),while the values of CD8^(+)T-lymphocyte were higher(P<0.05).Conclusion The regimen of Compound Kushen Injection combined with TEC chemotherapy can effectively reduce the load of locally advanced breast cancer,enhance the humoral immunity and cellular immune response.