中药治疗对乳腺癌术后放化疗患者生活质量及毒副反应的影响

Effects of Traditional Chinese Medicine on the Quality of Life and Toxicity of Patients with Chemoradiotherapy after Breast Cancer Surgery

目的评价中药治疗对乳腺癌术后放化疗患者生活质量(QOL)及毒副反应的影响。方法选择乳腺癌术后患者163例,随机分为对照组和研究组,对照组采用术后常规放化疗和对症处理,研究组同步加服中药汤剂治疗6个月。采用乳腺癌生命质量测定量表FACT-B中文版对患者进行问卷调查,检测化疗前和化疗开始后第14 d的外周血白细胞计数(WBC)和血小板(PLT)参数,记录治疗期间消化系不良反应、脱发、放射性皮肤损伤及心肺损伤的严重程度。结果研究组和对照组在生理状况、情感状况、功能状况和附加关注4个生活质量领域的评分差异有统计学意义(P=0.000)。两组每个化疗周期开始第14 d的WBC值和PLT值较治疗前低(P=0.000),且对照组WBC值和PLT值低于研究组(P=0.000)。与对照组相比,研究组消化系统不良反应、脱发和放射性皮肤损伤的严重程度轻微。两组心肺损伤的发生率比较,差异无统计学意义(P>0.05)。结论放化疗期间同步加用中药治疗可改善乳腺癌术后患者QOL和减轻毒副反应。

Objective To evaluate the quality of life（QOL）and toxicity of patients with traditional Chinese medicine and chemoradiotherapy after breast cancer surgery. Methods 163 postoperative patients of breast cancer were divided into control group and group randomly. Patients in control group were applied routine chemoradiotherapy and symptomatic treatment. Patients in study group were added with traditional Chinese medicine for 6 months. A questionnaire survey was conducted on the breast cancer patients with the quality of life scale FACT-B Chinese version. Peripheral blood WBC and PLT were detected before chemotherapy and at the 14 th day of each chemotherapy cycle. The gastrointestinal adverse reactions, hair loss, skin radiation injury and heart and lung injury during treatment were recorded. Results The score differences had statistical significance between study group and control group in physical activity, emotional state, functional status and additional attention in the areas of life quality（P=0.000）. The WBC and PLT at 14 d of each chemotherapy cycle of the two groups all were lower than those before treatment（P=0.000）. In addition, the WBC and PLT of the control group were lower than those of the study group（P=0.000）. Compared to the control group, there were slight gastrointestinal adverse reactions, hair loss and skin radiation injury in the study group. There were no statistical differences in incidence rate of heart and lung injury between the two groups. Conclusion Traditional Chinese medicine has the tendency to improve the QOL of patients with chemoradiotherapy after breast cancer surgery, and to reduce the toxicity.