参麦注射液对乳腺癌患者术后化疗导致心肌损害的保护作用

Protection Effect of Shenmai Injection on Myocardial Damage Induced by Chemotherapy in Postoperative Breast Cancer Patients

目的:探讨参麦注射液对乳腺癌患者术后化疗导致心肌损害的疗效以及对氧化应激的影响。方法:98例乳腺癌术后患者参照数字表法随机分为治疗组和对照组,各49例;对照组采用化疗方案[CEF,环磷酰胺(CTX)75 mg·m-2+表柔比星(EPI)60 mg·m-2+氟尿嘧啶500 mg·m-2],21 d为1个周期,1次/周期,共6个周期;治疗组在对照组基础上给予参麦注射液治疗,60 m L/次,用5%葡萄糖注射液500 m L稀释静脉滴注,于化疗前1 d开始给予,7次/周期;化疗结束后继续给予1周治疗。比较两组中医症状积分和心功能状况,检测两组血清肌钙蛋白I(c Tn I)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、总超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)、丙二醛(MDA)水平。结果:化疗结束时和化疗后1周,治疗组中医症状积分均明显低于对照组(P<0.01);化疗结束时和化疗后1周,治疗组舒张早期/舒张晚期最大血流速度(E/A)和左室射血分数(LVEF)均明显高于对照组(P<0.01);化疗结束时和化疗后1周,治疗组c Tn I,CK,CK-MB和MDA水平均明显低于对照组,而SOD和GSH明显高于对照组,差异有统计学意义(P<0.01)。结论:参麦注射液对乳腺癌术后患者化疗治疗导致心肌损害具有明显保护作用,其机制可能与改善氧化应激状态有关。

Objective： To investigate the efficacy of Shenmai injection for myocardial damage caused by chemotherapy in postoperative breast cancer patients,and observe its effect on oxidative stress. Method： The 98 postoperative breast cancer patients were randomly divided into control group（ 49 cases） and treatment group（ 49cases） with reference to digital table method. Patients of control group were treated with CEF chemotherapy[cytoxan（ CTX） 75 mg·m- 2＋ epirubicin（ EPI） 60 mg·m- 2＋ fluorouracil 500 mg·m- 2],with 21 days as one cycle,one time / cycle,for a total of 6 cycles. Patients of treatment group were also treated with Shenmai injection based on the treatment in control group,60 m L / time, by intravenous drip of 500 m L 5% glucose injection,from 1 d before chemotherapy to one week after chemotherapy,7 times / cycle. The traditional Chinese medicine（ TCM） symptom scores and cardiac function pre-post treatment were compared between two groups.Levels of cardiac troponin-I（ c Tn I）, creatine kinase（ CK）, creatine kinase isoenzyme（ CK-MB）, total superoxide dismutase（ SOD）,reduced glutathione（ GSH） and malondialdehyde（ MDA） were detected in two groups. Result： At the ending of chemotherapy and 1 week after chemotherapy,the TCM symptom scores in treatment were significantly lower than those in control group（ P〈 0. 01）; cardiac function indexes of E / A and LVEF were significantly higher than those in control group（ P〈 0. 01）,levels of c Tn I,CK,CK-MB,and MDA in treatment group were significantly lower than those in control group,while levels of SOD and GSH in treatment group were significantly higher than those in control group,with statistically significant difference（ P〈 0. 01）.Conclusion： Shenmai injection has obvious protection effect on myocardial damage caused by chemotherapy in postoperative breast cancer patients,and its mechanism may be associated with improving oxidative stress state.