调脾疏肝益肾方联合化疗治疗三阴性乳腺癌术后复发患者的临床观察

Clinical observation of Tiaopi Shugan Yishen Decoction combined with chemotherapy in the treatment of postoperative recurrence of triple-negative breast cancer

目的观察调脾疏肝益肾方联合化疗治疗三阴性乳腺癌术后复发患者的临床疗效。方法将50例三阴性乳腺癌术后复发患者随机分为治疗组和对照组,每组25例。对照组予XEC化疗方案(环磷酰胺+表柔比星+卡培他滨),治疗组在化疗基础上加服调脾疏肝益肾方。两组总疗程均为6个月,观察实体瘤疗效和化疗后不良反应,比较生活质量评分、外周血T淋巴细胞亚群水平的变化。结果 (1)治疗组、对照组总有效率分别为84.0%、64.0%;组间实体瘤疗效比较,治疗组明显优于对照组(P<0.05)。(2)组间治疗后比较,治疗组各项生活质量评分明显高于对照组(P<0.05)。(3)组间治疗后比较,治疗组CD3+、CD4+、CD4+/CD8+水平明显高于对照组,而治疗组CD8+水平明显低于对照组(P<0.05)。(4)两组骨髓抑制程度比较,治疗组明显轻于对照组(P<0.05);两组消化道毒副作用程度比较,治疗组明显轻于对照组(P<0.05)。结论调脾疏肝益肾方联合化疗治疗三阴性乳腺癌,疗效满意,且可提高患者生活质量,改善免疫功能(外周血淋巴细胞亚群),减少单纯应用化疗所致的骨髓抑制及消化道毒副作用。

Objective To investigate the clinical efficacy of Tiaopi Shugan Yishen Decoction combined with chemotherapy in the treatment of postoperative recurrence of triple- negative breast cancer. Methods 50 patients with postoperative recurrence of triple- negative breast cancer were randomly divided into the treatment group and control group,25 cases in each group. The control group was treated with the XEC chemotherapy program （cyclophosphamide ＋ epirubiciu ＋ capecitabine） ,and the treatment group was treated with Tiaopi Shugan Yishen Decoction based on the treatment for the control group, with a course of 6 months. The clinical efficacy on tumor and adverse reactions after chemotherapy were observed. The changes on life quality scores and levels of peripheral blood T lymphocyte subsets were compared. Results ①The total effective rates were 84.0% in the treatment group and 64.0% in the control group. The efficacy on tumor in the treatment group was obviously better than that in the control group （P〈0.05）. ②After treatment, the life quality scores of all items in the treatment group were obviously higher than those in the control group （ P〈0.05 ）. ③After treatment, the levels of CD3＋ , CD4＋ and CD4＋/CD8＋ in the treatment group were obviously higher than those in the control group, while the CD8＋ level was obviously lower than that in the control group （ P〈0.05 ）. ④The myelosuppression degree in the treatment group was obviously slighter than that in the control group （P〈0.05）, and the gastrointestinal toxic and side effects in the treatment group was also obviously slighter than that in the control group （P〈0.05）. Conclusion Tiaopi Shugan Yishen Decoction combined with chemotherapy shows satisfactory efficacy in the treatment of triple-negative breast cancer, which can improve the life quality of patients, ameliorate the immune function （peripheral blood lymphocyte subsets） and reduce the myelosuppression and gastrointestinal toxic and side effects caused by chemotherapy alone.