三黄抗氧化方改善乳腺癌术后蒽环类药物化疗心脏毒性临床观察

Clinical Observation of Sanhuang Kangyanghua Decoction Improving Anthracycline Cardiotoxicity of Breast Cancer Patients

目的:观察三黄抗氧化方改善乳腺癌患者术后使用蒽环类药物化疗心脏毒性的效果。方法:67例患者均来自江苏省中医院2014年1月—2014年11月收治的乳腺科住院患者,经手术病理确诊为乳腺癌。67例乳腺癌患者被随机分为2组,即治疗组与对照组,治疗组34例,对照组33例。治疗组加服三黄抗氧化方。观察化疗前后心电图、心脏彩超(左室射血分数LVEF)、心肌肌钙蛋白(c Tn I)、血清一氧化氮(NO)与超氧化歧化酶(SOD)、临床症状改善等情况。结果:(1)治疗组发生窦性心动过速、室性或房性期前收缩、ST-T段改变以及室性心动过速的比率显著低于对照组(P<0.05)。(2)治疗组患者心脏彩超中LVEF值在化疗后下降不明显,与化疗前相比,差异无统计学意义(P>0.05),而对照组LVEF值较化疗前明显降低(P<0.05)。化疗后两组相比,治疗组LVEF明显优于对照组(P<0.05)。(3)心肌肌钙蛋白(c Tn I)无论是治疗组还是对照组患者,化疗前后的肌钙蛋白I均无显著性差异(P>0.05),且两组差异无统计学意义(P>0.05)。(4)治疗组血清NO明显低于对照组,SOD含量明显高于对照组,差异有统计学意义(P<0.05)。(5)三黄抗氧化方明显改善患者化疗期出现的不适症状包括胸闷、心悸、乏力等症状(P<0.05)。结论:三黄抗氧化方通过抗氧化应激机制,有效清除体内自由基和氧化物,保护心肌细胞,从而缓解乳腺癌术后蒽环类药物化疗所致的心脏毒性。

Objective： To observe the Sanhuang Kangyanghua Decoction improving anthracyeline cardiotoxicity of breast cancer patients. Methods ： 67 patients from the Jiangsu province traditional Chinese medicine hospital from January 2014 to November 2014 were admitted, were pathologically diagnosed with breast cancer. 67 cases of breast cancer patients were randomly divided into two groups, namely, the treatment group and the control group, the treatment group, 34 cases, the other 33 cases in the control group. The treatment group took Sanhuang Kangyanghua Decoction before and after chemotherapy, observed electrocardiogram, cardiac uftrasound, cTrlI, NO, SOD and other symptoms. Results ： （ 1 ） Treatment group was significantly lower at the ratio of heartbeat sinus tachycardia, systolic ventrieular oratrial extrasystole, ST-Tsegment change and beckoning ventrieular tachycardia than the control group （ P〈0.05 ）. （ 2 ） The value of LVEF in the treatment group was not significantly decreased afler chemotherapy （ P〉0.05 ）, control group was the opposite （P〈0.05）.Compared with the two groups after chemotherapy, LVEF in the treatment group was significantly better than that in the control group （ P〈0.05 ）. （ 3 ） The eTnI was unchanged before or after chemotherapy also in the treatment group or the control group （ P〉0.05 ）. （ 4 ） Serum NO of treatment group was significantly lower than that in the control group, but the content of SOD was higher than that in the control group, with statistical significance between the two groups （ P〈0.05 ）. （ 5 ） Sanhuang Kangyanghua Decoction significantly improve symptoms in patients with chemotherapy, including chest tightness, palpitations, and fatigue （ P〈0.05 ）. Conclusion ： Through anti oxidative stress mechanism, Sanhuang Kangyanghua Decoction can remove free radicals and oxides in the body effectively, protect cardiac muscle cells, and relieve the cardiac toxicity induced by chemotherapy in patients with breast cancer after operation.