炙甘草汤改善乳腺癌蒽环类化疗致心肌毒性临床分析及机制探究分析

Clinical Analysis and Mechanism Analysis of Zhigancao Decoction in Improving Cardiotoxicity Caused by Anthracycline Chemotherapy in Breast Cancer

目的探讨炙甘草汤改善乳腺癌蒽环类化疗致心肌毒性临床机制。方法方便收集2016年3月-2018年3月该院乳腺癌的100例患者,两组患者化疗方案均为蒽环类,随机分为:50例研究组和50例对照组。对比两组治疗前后心肌损伤指标CK及CK-MB水平;研究组和对照组治疗后心功能指标左室射血分数;研究组和对照组治疗期间心电图异常发生情况。结果研究组和对照组治疗前CK及CK-MB分别为(112.38±26.37)U/L、(6.38±1.05)U/L、(108.37±24.34)U/L、(6.41±1.12)U/L,差异无统计学意义(t=0.263、0.224,P>0.05);研究组和对照组治疗后CK及CK-MB分别为(98.38±21.77)U/L、(6.41±1.23)U/L、(119.34±26.37)U/L、(6.98±1.87)U/L,差异有统计学意义(t=6.958,8.524,P<0.05);研究组和对照组治疗前心功能指标左室射血分数分别为(64.53±4.98)%、(59.87±5.14)%差异无统计学意义(t=0.259,P>0.05);研究组和对照组治疗后心功能指标左室射血分数分别为(68.45±5.68)%、(61.02±5.45)%,差异有统计学意义(t=6.936,P<0.05);研究组治疗期间心电图异常发生(早搏、ST段改变及心动过缓)发生率低于对照组,差异有统计学意义(χ2=6.953、6.492、6.042,P<0.05)。结论该文认为炙甘草汤改善乳腺癌蒽环类化疗致心肌毒性,同时提高心脏射血功能,减少心律异常的情况,显示出较好的治疗价值。

Objective To investigate the clinical observation and mechanism of Zhigancao Decoction in improving myocardial toxicity induced by anthracycline chemotherapy in breast cancer. Methods 100 patients with breast cancer in our hospital from March 2016 to March 2018 were convenient enrolled. The chemotherapy regimens of the two groups were anthracyclines, which were randomly divided into 50 study groups and 50 control groups. The levels of CK and CK-MB in myocardial injury were compared between the two groups. The left ventricular ejection fraction of cardiac function in the study group and the control group;the abnormal electrocardiogram during the treatment group and the control group. Results The CK and CK-MB in the study group and the control group were(112.38±26.37)U/L,(6.38±1.05)U/L,(108.37±24.34)U/L,(6.41±1.12)U/L, respectively, the difference was statistically significant(t=0.263, 0.224, P>0.05);CK and CK-MB were(98.38 ±21.77)U/L,(6.41±1.23)U/L and(119.34±26.37)U/L,(6.98±1.87)U/L after treatment in the study group and the control group, respectively, the difference was statistically significant(t=6.958, 8.524, P<0.05);the left ventricular ejection fraction of the heart function index of the study group and the control group were(64.53±4.98)% and(59.87±5.14)%, respectively. There was no significant difference(t=0.259, P>0.05). The left ventricular ejection fraction of the cardiac function index in the study group and the control group were(68.45±5.68)% and(61.02±5.45)%, respectively. The difference was statistically significant(t=6.936, P<0.05);the incidence of abnormal electrocardiogram(premature beat, ST-segment change and bradycardia) was lower in the study group than in the control group, and the difference was statistically significant(χ~2=6.953, 6.492, 6.042, P<0.05). Conclusion This article believes that Zhigancao Decoction can improve myocardial toxicity caused by anthracycline chemotherapy in breast cancer, improve cardiac ejection function and reduce heart rhythm abnormality, showing good therapeutic value.