乳腺癌经西药治疗所致脂肪肝临床特征及中医证候分析

Clinical Study on the Fatty Liver Caused by Western Medicine in Treating Breast Cancer of Endocrino Therapy

目的:观察乳腺癌西药治疗所致脂肪肝的临床特征,并分析其中医证候特点。方法:将81例乳腺癌患者随机分为内分泌组与化疗组,化疗组16例予以TP方案化疗,内分泌组65例予以三苯氧胺或芳香化酶抑制剂口服,观察治疗后两组患者脂肪肝发生情况及中医相关证候。结果:内分泌组65例患者中有43例发生不同程度的脂肪肝,口服三苯氧胺与口服芳香化酶抑制剂的患者脂肪肝发生率分别为46.3%、33.3%,两者比较,差异无统计学意义(P>0.05)。化疗组16例患者脂肪肝发生率为25.0%,与内分泌组比较,差异有统计学意义(P<0.01)。乳腺癌治疗后合并脂肪肝的中医辨证以正气亏虚证为主,发生率为46.3%。结论:乳腺癌药物治疗可引起不同程度的脂肪肝,且患者多为正气亏虚证。

Objective： To observe the clinical characteristics and syndrome of TCM of the fatty liver caused by western medicine in treating breast cancer of endocrinotherapy. Methods： 81 cases were randomly divided into internal secretion group（ 65cases） and chemotherapy group（ 16 cases）. The chemotherapy group was given TP,while the internal secretion group was given tamoxifen and aromatase inhibitor,observing the condition of fatty liver and related syndromes of TCM. Results： In the internal secretion group,43 cases had different degrees of fatty liver,oral tamoxifen and aromatase inhibitors of the patients with fatty liver were 46. 3%,33. 3%,it was no statistically significant difference（ P〉0. 05）. In the chemotherapy group,the incidence of fatty liver was 25. 0%,compared with the internal secretion group,the difference was statistically significant（ P〈0. 01）. The fatty liver caused by in treating breast cancerof endocrinotherapy,which the main is deficiencyof vital Qi,the rate of 46. 3%. Conclusion： The drugs of in treating breast cancer can cause different degree of fatty liver disease,and the patients are vital Qi deficiency syndrome and clinical medication should be given priority to with help the vital Qi,reinforcing the vital essence and strengthening the primordial Qi.