消渴方联合二甲双胍对乳腺癌合并2型糖尿病患者血糖控制疗效及凋亡相关因子水平的影响

Effect of Xiaoke Prescription Combined with Metformin on Blood Glucose Control Effect and Apoptosis-related Factor Level in Breast Cancer Patients with Type 2 Diabetes Mellitus

目的:探讨消渴方联合二甲双胍对乳腺癌合并2型糖尿病患者血糖控制疗效及凋亡相关因子水平的影响。方法:选取2018年4月-2019年6月于本院住院治疗的乳腺癌合并2型糖尿病患者138例,将其随机分为中药观察组与西药对照组,每组69例。西药对照组患者接受常规抗肿瘤药物治疗及口服二甲双胍治疗,中药观察组患者在西药对照组基础上服用消渴方。比较两组治疗前后空腹血糖、餐后2 h血糖、糖化血红蛋白、RBP4、癌胚抗原、CA153、Caspase-3、Caspase-9、Bcl-2水平。并比较两组的临床疗效。结果:研究截止时,中药观察组有10例患者脱落(包括死亡患者),59例患者纳入统计中;西药对照组有14例患者脱落(包括死亡患者),55例患者纳入统计中。中药观察组治疗总有效率为89.83%,明显高于西药对照组的70.91%,差异有统计学意义(P<0.05)。治疗前,两组空腹血糖、餐后2 h血糖、糖化血红蛋白、RBP4、癌胚抗原、CA153、Caspase-3、Caspase-9、Bcl-2水平比较,差异均无统计学意义(P>0.05);治疗后,两组的上述指标水平均优于治疗前,且中药观察组均优于西药对照组,差异均有统计学意义(P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论:消渴方联合二甲双胍对乳腺癌合并2型糖尿病患者血糖控制疗效显著,还可升高乳腺组织中促凋亡相关因子的表达以抑制乳腺肿瘤细胞的生长,且无明显副作用,值得临床进一步推广及应用。

Objective:To investigate the effect of Xiaoke Prescription combined with metformin on blood glucose control and apoptosis-related factor levels in breast cancer patients with type 2 diabetes mellitus.Method:A total of 138 patients with type 2 diabetes who were hospitalized in our hospital from April 2018 to June 2019 were selected.They were randomly divided into Chinese medicine observation group and western medicine control group,with 69 cases in each group.Patients in western medicine control group received conventional antitumor drug therapy and oral metformin therapy.The patients in the Chinese medicine observation group were given Xiaoke Prescription on the basis of western medicine control group.Fasting blood glucose,2 h postmeal blood glucose,glycosylated hemoglobin,RBP4,oncoembryonic antigen,CA153,Caspase-3,Caspase-9,and Bcl-2 levels before and after treatment were compared between the two groups.The clinical efficacy of the two groups was compared.Result:By the end of the study,10 patients in the Chinese medicine observation group had fallen off (including those who died),and 59 patients were included in the statistics.In the western medicine control group,14 patients lost their flab (including those who died),and 55 patients were included in the statistics.The total effective rate of the Chinese medicine observation group was 89.83%,significantly higher than 70.91% of the western medicine control group,the difference was statistically significant (P<0.05).Before treatment,fasting blood glucose,2 h postmeal blood glucose,glycosylated hemoglobin,RBP4,oncoembryonic antigen,CA153,Caspase-3,Caspase-9,and Bcl-2 levels of the two groups were compared,the differences were not statistically significant (P>0.05).After treatment,the above indicators in both groups were better than those before treatment,and the Chinese medicine observation group were better than those in the western medicine control group,the differences were statistically significant (P<0.05).There was no significant difference in the rate of adverse reactions between the two groups (P>0.05).Conclusion:Xiaoke Prescription combined with metformin has a significant effect on blood glucose control in patients with breast cancer complicated with type 2 diabetes.It can also increase the expression of pro-apoptotic factors in breast tissue to inhibit the growth of breast tumor cells without obvious side effects,which is worthy of further clinical promotion and application.