固元养血汤联合TE新辅助疗法对乳腺癌气血两虚证患者免疫功能、生长分化因子3、糖类抗原19-9水平及预后的影响

Effects of Guyuan Yangxue decoction combined with TE Neoadjuvant therapy on immune function,serum growth differentiation factor 3 and sugar antigen 19-9 levels and prognosis in patients with deficiency of both Qi and Blood syndrome of breast cancer

目的观察固元养血汤联合TE新辅助疗法对乳腺癌气血两虚证患者免疫功能及血清生长分化因子3(GDF3)、糖类抗原19-9(CA19-9)水平和预后的影响。方法将72例乳腺癌气血两虚证患者按照随机数字表法分为2组。对照组36例术前及术后予TE新辅助疗法治疗;治疗组36例在对照组治疗基础上术后加固元养血汤治疗。观察比较2组治疗前后中医证候积分、免疫功能及血清GDF3、CA19-9水平变化情况,并比较2组临床疗效及预后效果。结果治疗后2组中医证候积分均显著低于本组治疗前(P<0.05),且治疗组低于对照组(P<0.05)。治疗后2组CD3^(+)、CD4^(+)、自然杀伤(NK)细胞比例及CD4^(+)/CD8^(+)比值均较本组治疗前显著降低(P<0.05),但治疗组高于对照组(P<0.05);2组CD8^(+)均显著高于本组治疗前(P<0.05),但治疗组低于对照组(P<0.05)。治疗后2组血清CDF3、CA19-9水平均显著低于本组治疗前(P<0.05),且治疗组显著低于对照组(P<0.05)。治疗组总有效率(77.78%)显著高于对照组(47.22%,P<0.05);随访1年,治疗组复发率及转移率显著低于对照组(P<0.05),存活率显著高于对照组(P<0.05)。结论固元养血汤联合TE新辅助疗法治疗乳腺癌气血两虚证,可改善患者免疫功能,降低血清GDF-3、CA19-9水平,提高预后效果。

Objective To observe the effects of Guyuan Yangxue decoction combined with TE Neoadjuvant therapy on immune function,serum growth differentiation factor 3(GDF3)and sugar antigen 19-9(CA19-9)levels and prognosis in patients with deficiency of both Qi and Blood syndrome of breast cancer.Methods 72 patients with breast cancer were divided into 2 groups according to the random number table method,36 cases in each group.The control group were given TE Neoadjuvant therapy treatment before and after operation,and the treatment group were given Guyuan Yangxue decoction combined with TE neoadjuvant therapy after operation.The TCM syndrome scores,immune function,serum GDF3 and CA19-9 levels were observed before and after treatment,and clinical efficacy and prognosis were compared in the two groups.Results After treatment,TCM syndrome scores were significantly lower than those before treatment in two groups(P<0.05),and those in treatment group were significantly lower than those in control group(P<0.05).After treatment,CD3+,CD4+,CD8+,natural killer(NK)cells ratio and CD4+/CD8+were significantly lower than those before treatment in two groups(P<0.05),and those in treatment group were significantly higher than those in control group(P<0.05);The CD8+ratio in two groups was significantly higher than before treatment(P<0.05),but it was lower in treatment group than in control group(P<0.05).After treatment,serum CDF3 and CA19-9 levels were significantly lower than that before treatment in two groups(P<0.05),and those in treatment group were significantly lower than those in control group(P<0.05).The total effective rate in treatment group(77.78%)was superior to control group(47.22%,P<0.05).After a follow-up of 1 year,the tumor recurrence rate and metastasis rate of the study group were significantly lower than those of the control group(P<0.05),and the survival rate was significantly higher than that of the control group(P<0.05).Conclusion Guyuan Yangxue decoction combined with TE neoadjuvant therapy in treatment of patients with deficiency of both Qi and Blood syndrome of breast cancer,it can improve immune function and decrease serum GDF-3 and CA19-9 levels,and improve prognosis.