十全大补汤对乳腺癌患者术后早期恢复及切口引流液血管生成因子的影响

Effect of Shiquan Dabu Tang on Early Recovery and Wound Fluid Angiogenesis Factor in Breast Cancer Patients After Surgery

目的:观察十全大补汤对乳腺癌患者术后早期恢复的作用,并探讨对切口引流液血管生成因子的影响以及引流液对乳腺癌细胞MDA-MB-231增殖、迁移和侵袭能力的作用。方法:将61例乳腺癌病例随机分为对照组30例和治疗组31例,两组术后均采用西医常规治疗,治疗组于术后第1天起服用十全大补汤,连续7 d;观察两组患者治疗前后中医证候疗效、切口引流时间及不同时点引流量,CCK-8法检测引流液对MDA-MB-231细胞增殖的影响、Transwell法检测细胞迁移、侵袭能力的变化,蛋白质芯片法筛选两组引流液中血管生成因子的表达。结果:(1)十全大补汤组中医证候疗效总有效率为89.66%,高于对照组的63.33%(P<0.05)。(2)十全大补汤组切口引流时间短于对照组引流时间,分别为(12.48±2.11)d、(14.23±1.94)d(P<0.05)。两组引流量均呈下降趋势,其中第7天十全大补汤组引流量低于对照组(P<0.05)。(3)引流液对MDA-MB-231细胞有促增殖作用,十全大补汤组引流液对MDA-MB-231乳腺癌细胞的促增殖作用低于对照组(P<0.05)。(4)Transwell结果发现引流液能促进MDA-MB-231细胞迁移和侵袭能力,而十全大补汤组的引流液促迁移和侵袭能力较对照组降低(P<0.05)。(5)人血管生成因子抗体芯片筛选发现43种血管生成因子在引流液中均有表达,部分促血管生成因子上调≥2倍,其中十全大补汤组IL-8、Leptin的表达水平低于对照组(P<0.05)。结论:十全大补汤能改善乳腺癌患者术后早期气血两虚症候,有效缩短术区引流时间、减少术区引流量;切口引流液能促进MDA-MB-231的增殖、迁移及侵袭,十全大补汤可能通过降低引流液中IL-8、Le Ptin等促血管生成因子的表达进一步抑制引流液对MDA-MB-231细胞的促增殖、迁移及侵袭能力。

Objective ： To observe the effect of Shiquan Dabu Tang （SDT） on the early postoperative recovery of the breast cancer patients. To study the effect of wound fluids on the proliferation, migration and invasion of MDA - MB - 231. To detect the difference of the angiogenic factors in the wound fluids（WF）. Method： Sixty- one patients, who underwent modified radical mastectomy in our hospital and met the inclusion criteria, were randomly divided into the SDT group （31 cases） and the control group （30 cases）. The SDT group were given SDT on the basis of western medicine treatment. The control group were only treated with the western medicine. Treatment course was 7 days. PS and WF were collected from the two groups on day 7 after the surgery. Add WF to the culture of breast cancer celts. By the end of the intervention, the proliferation, migration and invasion of MDA -MB -231 were observed by CCK -8 and Transwell assay. Use protein chip to screen the difference of the WF angiogenesis factor between the SDT group and the control group. Results：After treatment,the TCM syndrome scores were both reduced in two groups. The SDT group＇s was 89.66% ,decreased more than the control group＇s 63.33% （P 〈0. 05）. The wound drainage time of the SDT group （12.48 ± 2.11 days） was less than the control group＇ s （ 14.23 ± 1.94 days） （P 〈0.05）. Both groups showed a downward trend on the wound drainage volume. The wound drainage volume of the SDT group on the 7 th day was significantly different from that of the control group（P 〈0. 05）. After the WF action on MDA - MB -231 for 24 h,48 h and 72 h, WF promoted proliferation of MDA - MB - 231 more stronger than the same group of PS （ P 〈 0. 05 ） and WF from the SDT group had the weaker ability to promote proliferation of MDA - MB - 231 than that of the control group（ P 〈 0. 05 ）. The ability of MDA - MB - 231 breast cancer cell in PS group to migration and invasion were significantly lower than that of MDA - MB - 231 breast cancer cell in WF group （ P 〈 0. 05 ）. The ability of MDA - MB - 231 breast cancer cell in WF untreated group to migration and invasion were significantly stronger than that of MDA - MB -231 breast cancer cell in WF treated group （P 〈 0. 05）. Forty - three kinds of angiogenic factors were all expressed in WF and there were a lot of angiogenic factors raised ≥ 2 times and the expression levels of IL - 8, Leptin in the SDT group were significantly lower than that of the control group （P 〈 0. 05 ）. Conclusion： SDT can significantly improve the Qi and blood deficiency symptoms at the early period after breast cancer surgery and also can shorten the wound drainage time and reduce drainage volume. WF from breast cancer patients has the ability to promote MDA -MB -231 proliferation, migration and invasion. But SDT can reduce the ability of MDA - MB -231 to proliferation, migration and invasion by reducing the expression levels of IL -8 and Leptin.