乳腺癌时辰治疗对患者中性粒细胞的影响

Effects of chronotherapy on neutrophils in breast cancer patients

目的探讨乳腺癌新辅助化疗患者采用时辰治疗（时辰化疗±择时服药）对患者中性粒细胞的影响。方法抽取2011年至2014年我院乳腺科确诊为乳腺癌患者50例，均采用新辅助化疗，按随机数字表法分成时辰治疗组（时辰组）及常规治疗组（常规组）各25例。常规组应用新辅助化疗及常规的用药治疗；时辰组采用新辅助化疗同时结合子午流注理论的时辰治疗，即时辰化疗及择时服药治疗，并应用中医临床护理路径进行护理。2组均进行3个周期化疗，每个周期21d，第1周期及第2周期化疗3周后抽血比较2组患者血常规及肝功能的结果，统计2组因为中性粒细胞缺乏而再次人院的例数及中性粒细胞缺乏发热的例数。结果2组患者均顺利完成了3个周期的化疗，第1周期和第2周期化疗3周后，时辰组中性粒细胞都明显高于常规组，分别为[（4．40±2．20）±10 9／L比（3．18±1．35）×109/L和[（3．95±1．58）±10 9／L比（2．83±1．49）×109/L]，差异均有统计学意义，t=2．375、2．563，P〈O．05。时辰组需在3个周期化疗期间再次入院2例占8％（2／25），远低于常规组的8例占32％（8／25）。结论乳腺癌采用时辰化疗及择时服药治疗，患者中l眭粒细胞下降较少，骨髓抑制不良反应较轻，是一种有效安全可行的方案。

Objective To investigate the effect of chronotherapy （chemotherapy plus timely medication） on neutrophils in breast cancer patients with neoadjuvant chemotherapy. Methods Fifty breast cancer patients with neoadjuvant chemotherapy were selected from 2011 to 2014 and divided into chronotherapy group and conventional treatment group （conventional group） by random number table method with 25 cases each. Conventional group received conventional neoadjuvant chemotherapy and conventional drug treatment. Chronotherapy group received neoadjuvant chemotherapy combined with ehronochemotherapy and timely medication treatment, and applied clinical nursing care pathway. Both groups were conducted three cycles of chemotherapy, three weeks after the first and the second chemotherapy,the results of routine blood and liver function were compared in patients between two groups. The number of readmission and fever because of agranulocytosis were calculated. Results The two groups of patients were successfully completed three cycles of chemotherapy, after the first cycle of chemotherapy, the neutrophil was （4.40 ± 2.20） x109 /L in chronotherapy group, and （3.18 ± 1.35） × 109/L in conventional group; after the second cycle of chemotherapy, the neutrophil was （3.95 ± 1.58） × 109/L, and （2.83 ± 1.49） × 109/L in conventional gioup, the two groups were statistically significant, t=2.375, 2.563, P 〈0.05. Two cases needed readmission in chronotherapy group during chemotherapy,accounting for 8%（2/25）, much lower than conventional group of 8 cases accounting for 32%（8/25）. Conclusions The use of chronotherapy in breast cancer chemotherapy has less neutropenia, mild side effects of bone marrow suppression. It is an effective and safe viable option.