化疗前口服减毒汤对乳腺癌术后AC→T方案化疗耐受性影响观察

Impacts on the Tolerance to the AC→T Scheme after Breast Cancer Operation By Oral Administration of Jiandu Decoction Before Chemotherapy

目的探讨化疗前口服自拟减毒汤对于提高乳腺癌手术后AC→T(阿霉素、环磷酰胺每3周1次,连续4周期→紫杉醇每3周1次,共4周期)方案化疗耐受性的可行性。方法共纳入乳腺癌术后女性患者50例,随机分为两组,每组25例。两组均予以AC→T方案化疗,化疗开始15min前两组均予以恩丹司琼静脉推注和地塞米松静脉滴注预防消化道反应。治疗组于手术后每周期化疗前1周即开始服用自拟的减毒汤中药汤剂,每日1剂分早晚服用,连服7 d直至化疗前1 d。对照组未予以口服中药治疗。观察两组患者化疗前后KPS评分情况及不良反应(恶心呕吐、白细胞变化)发生情况。结果两组患者化疗前后KPS评分比较(P>0.05),差异无统计学意义。两组各化疗周期的恶心呕吐反应、白细胞下降情况比较,差异有统计学意义(P<0.05)。结论化疗前口服减毒汤能减轻乳腺癌术后AC→T方案化疗的副反应,提高患者化疗的耐受性。

Objective To discuss the feasibility on the improvement of the tolerance to the AC→T scheme（doxorubicin,cyclophosphamide and paclitaxel）after breast cancer operation by oral administration of jiandu decoction before chemotherapy.Methods Fifty female patients of postoperative breast cancer were randomized into two groups,25 cases in each one.The AC→T scheme was applied in the two groups.In 15min before chemotherapy,the intravenous injection with ondansetron and intravenous drip with dexamethasone were used to prevent from digestive reactions in the two groups.Additionally,the self-prepared jiandu decoction started to be used 1 week before chemotherapy in the treatment group after operation,one dose a day,taking in the morning and evening,continuously for 7 days till 1 day before chemotherapy.In the control group,the Chinese herbal decoction was not used.Before and after chemotherapy,KPS score and adverse reactions（nausea,vomiting and WBC）were observed in the patients of the two groups.Results KPS score was not different significantly before and after chemotherapy in the two groups（P〉0.05）.The differences in nausea,vomiting and reducing of WBC in chemotherapy cycle were significant statistically between the two groups（P〈0.05）.Conclusion Before chemotherapy,the oral administration of jiandu decoction alleviates the side effects induced by AC→T scheme after breast cancer operation and improves the tolerance of the patients to the chemotherapy.