扶正消瘤汤治疗乳腺癌放化疗所致癌因性疲乏临床疗效

Clinical effect of Fuzheng Xiaoliu Decoction on Cancer-Related Fatigue Caused by Radiotherapy and Chemotherapy of Breast Cancer

目的:探讨扶正消瘤汤治疗乳腺癌放化疗所致癌因性疲乏(CRF)临床疗效。方法:选取深圳市第二人民医院2019年9月至2020年9月期间收治的96例乳腺癌放化疗所致CRF患者,按照随机数字表法分为两组,各48例。对照组给予西医对症治疗,包括营养支持、纠正贫血、纠正白细胞降低、抗感染止痛等。观察组在对照组基础上给予中药扶正消瘤汤口服。比较两组治疗前后Piper疲乏量表(PFS)评分、欧洲癌症研究与观察组织癌症生活质量问卷(EORTCQLQ-C30)评分,并比较血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平、自然杀伤细胞(NK)、CD3^+、CD4^+、CD8^+含量、CD4^+/CD8^+值。结果:治疗前两组患者的PFS各项评分比较,差异无统计学意义(P>0.05)。治疗后两组患者PFS各项评分均有不同程度下降,且观察组降幅大于对照组,差异具有统计学意义(P<0.01);治疗前两组患者的EORTC QLQ–C30各项评分比较,差异无统计学意义(P>0.05)。治疗后两组患者EORTC QLQ–C30各项评分均有不同程度增长,且观察组增幅大于对照组,差异具有统计学意义(P<0.01);治疗前两组患者的各项炎症因子水平比较,差异无统计学意义(P>0.05)。治疗后两组患者各项炎症因子均有不同程度降低,且观察组降幅大于对照组,差异具有统计学意义(P<0.01);治疗前两组患者的NK和T淋巴细胞亚群比较,差异无统计学意义(P>0.05)。治疗后两组患者的NK、CD3^+、CD4^+、CD4^+/CD8^+值有不同程度升高,CD8^+不同程度降低,且观察组患者NK、CD3^+、CD4^+、CD4^+/CD8^+值高于对照组,CD8^+低于对照组,差异具有统计学意义(P<0.01)。结论:扶正消瘤汤可缓解机体炎症反应,增强机体免疫功能,改善患者的疲乏状态,提高生活质量,治疗乳腺癌放化疗所致CRF效果显著。

Objective To investigate the clinical effect of Fuzheng Xiaoliu Decoction in the treatment of cancer causing fatigue(CRF)caused by radiotherapy and chemotherapy for breast cancer.Methods From September 2019 to September 2020,96 patients with breast cancer CRF in Shenzhen second people’s hospital were divided into two groups according to the random number table method,with 48 cases in each group.The control group was given western medicine symptomatic treatment,including application support,correction of anemia,correction of leucopenia,anti infection and pain relief.The control group was given Chinese medicine of Fu Zheng Xiao Liu decoction orally based on the data of the treatment group.The scores of piper Fatigue Scale(PFS),European organization for research and treatment of cancer quality of life questionnaire(EORTC QLQ-C30)of the two groups before and after treatment were compared,Serum levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),natural killer(NK)cells,CD3^+,CD4^+,CD8^+ content,and value of CD4^+/CD8^+ were compared before and after treatment.Results Before treatment,the PFS scores of the two groups were not statistically different(P>0.05).After treatment,the PFS scores of the two groups of patients decreased to varying degrees,and the decrease in the observation group was greater than that of the control group,the difference was statistically significant(P<0.01);the comparison of the scores of the EORTC QLQ-C30 scale between the two groups before treatment,The difference was not statistically significant(P>0.05).After treatment,the scores of the two groups of patients on the EORTC QLQ-C30 scale increased to varying degrees,and the increase in the observation group was greater than that of the control group,the difference was statistically significant(P<0.01);the levels of various inflammatory factors in the two groups before treatment In comparison,the difference was not statistically significant(P>0.05).After treatment,the inflammatory factors of the two groups of patients were reduced to varying degrees,and the decrease in the observation group was greater than that of the control group,the difference was statistically significant(P<0.01);the comparison of NK cells and T lymphocyte subsets in the two groups before treatment,The difference was not statistically significant(P>0.05).After treatment,the NK,CD3^+,CD4^+,CD4^+/CD8^+ values of the two groups of patients increased to different degrees,and CD8^+ decreased to different degrees.The NK,CD3^+,CD4^+,CD4^+/CD8^+ values of the observation group were higher than those of the control group,and CD8^+ was lower than the control Group,the difference was statistically significant(P<0.01).Conclusion Fuzheng Xiaoliu Decoction can relieve the inflammatory reaction system,enhance the immune function,improve the fatigue state and quality of life.It has a significant effect on the treatment of CRF caused by radiotherapy and chemotherapy of breast cancer.