中医辨证治疗乳腺癌患者癌因性疲劳的临床观察

Clinical observation of TCM syndrome differentiation on treatment of cancer-related fatigue in patients with breast cancer

目的:观察益气健脾中药汤剂治疗乳腺癌患者癌因性疲劳的临床疗效。方法:应用随机平行对照方法,将75例符合癌因性疲劳诊断的乳腺癌患者,随机分为两组。对照组37例患者使用常规对症支持治疗;治疗组38例患者使用常规对症治疗并服用益气健脾中药汤,每日2次口服,14d为1个疗程,连服2个疗程。两组术后化疗方案均采用乳腺癌NCCN的21d为1个疗程的标准化疗方案。两组均观察2个疗程。观察比较疲劳症状评分、临床疗效、骨髓抑制情况、淋巴细胞免疫功能相关指标。结果:经过两个疗程治疗后,治疗组疲劳评分均数较对照组显著下降,且两组组间比较差异亦有统计学意义(P<0.05);同时治疗组临床有效率为81.6%;对照组有效率为48.6%,差异具有统计学意义(P<0.05)。治疗组白细胞计数较对照组显著升高(P<0.05)。两组患者血小板计数在治疗前及治疗后改变均不明显。治疗组患者的CD+3,CD+4,CD+4/CD+8的水平较化疗前显著提高(P<0.05),且两组组间同期比较亦有显著差异(P<0.05)。结论:说明使用益气健脾汤剂能较好改善乳腺癌患者癌因性疲劳的诸多症状,改善骨髓抑制,增强免疫功能,从而提高患者生活质量。

Objective： To observe the curative effect of Decoction for benefiting qi and strengthening spleen on cancerrelated fatigue in patients with breast cancer. Methods： Seventy-five patients with breast cancer diagnosed by cancer-related fatigue were randomly divided into two groups using a randomized parallel control method. Thirty-seven patients in the control group were treated with conventional symptomatic support, and 38 patients in the treatment group were treated with routine therapy combined with Decoction for benefiting qi and strengthening spleen, 2 times a day orally, 14 d for a treatment course, and the treatments lasted for 2 treatment courses. Postoperative chemotherapy of the two groups uses NCCN for 21 days as a standard chemotherapy regimen. The fatigue symptom score, clinical efficacy, bone marrow suppression, lymphocyte immune function related indicators of the two groups were observed and compared. Results： After two courses of treatment, the fatigue score of the treatment group decreased significantly compared with the control group, the difference was statistically significant（P〈0.05）, while the effective rate of the treatment group was 81.6%, and the control group was 48.6%, the difference was statistically significant（P〈0.05）. The white blood cell count of the treatment group was significantly higher than that of the control group, the difference was statistically significant（P〈0.05）. The platelet count in both groups was not changed before and after treatment. The level of CD＋3, CD＋4, CD＋4/CD＋8 in the control group was significantly lower than that in the control group, while the levels of CD＋3, CD＋4, CD＋4/CD＋8 of treatment group were higher than those before chemotherapy, which were statistically different（P〈0.05）, and there was also significant difference between the two groups（P〈0.05）. Conclusion： Decoction for benefiting qi and strengthening spleen can better improve many symptoms of breast cancer patients due to fatigue, enhance the immune organ function and increase the number of immune cells, thereby improve the quality of life of patients.