四逆六君调冲方加减联合AC-T术后化疗方案对乳腺浸润性导管癌患者血清肿瘤标志物水平及预后的影响

Effect of Modified Sini Liujun Tiaochong Recipe Combined with Postoperative AC-Tchemotherapy Regimen on Se-rum Tumor Markers and Prognosis for Patients with Invasive Ductal Carcinoma of Breast

目的:观察四逆六君调冲方加减联合行环磷酰胺+表阿霉素序贯多西紫杉醇化疗(AC-T)术后化疗方案对乳腺浸润性导管癌患者血清肿瘤标志物水平及预后的影响。方法:选取2017年1月~2019年1月于我院治疗的84例患者作为分析对象,按照随机数字表法将其分为观察组与对照组各42例。对照组患者AC-T术后化疗方案治疗,观察组患者在对照组基础上联合使用四逆六君调冲方治疗。观察两组患者近期疗效,比较治疗前、治疗3个疗程后患者血清肿瘤标志物[糖类抗原(CA-125、CA15-3、CA27~29)、癌胚抗原(CEA)]及生活质量[癌症患者生命质量测定量表(QLQ-C30)]水平变化情况,统计两组患者不良反应(胃肠反应、口腔炎、白细胞减少、肝肾功能损害)发生率及治疗后3个月、6个月及1年内复发率。结果:治疗期间两组患者均无死亡病例,观察组患者临床总有效率高于对照组,但差异无统计学意义(P<0.05)。治疗3个疗程后,两组患者血清肿瘤标志物CA-125、CA15-3、CA27~29、CEA水平均低于治疗前,且观察组明显低于同期对照组(P<0.05);两组患者QLQ-C30各维度评分均高于治疗前,且观察组明显高于同期对照组(P<0.05)。两组患者均无化疗相关性死亡。治疗3个疗程后,观察组患者不良反应(胃肠反应、口腔炎、白细胞减少、肝肾功能损害)高于对照组(P<0.05),且经过止呕、护肝以及营养支持等对症支持治疗后上述症状均能有效缓解。随访期间两组患者均无死亡病例,观察组患者治疗后6个月、12个月总复发率均低于对照组(P<0.05);治疗后3个月复发率低于对照组,但差异无统计学意义(P>0.05)。结论:四逆六君调冲方加减联合AC-T术后化疗方案治疗乳腺浸润性导管癌患者效果良好,能有效改善患者临床症状,减少不良反应的发生,降低肿瘤标志物水平,提高患者生活质量,且能降低患者1年内复发率。

Objective: To observe the effect of Modified Sini Liujun Tiaochong Recipe combined with postoperative chemotherapy regimen of cyclophosphamide adding epirubicin sequential docetaxel chemotherapy(AC-T) on serum tumor markers and prognosis for patients with invasive ductal carcinoma of the breast. Methods: 84 patients with primary intracranial tumors treated in our hospital from January 2017 to January 2019 were selected as the analysis subjects, and they were divided into observation group and controlled group according to the random number table method, with 42 cases in each group. The patients in the controlled group were treated with postoperative AC-T chemotherapy regimen, and the patients in the observation group were combined with Sini Liujun Tiaochong Recipe on the basis of the controlled group. The short-term efficacy of the two groups was observed, and the serum tumor markers [carbohydrate antigens(CA-125,CA15-3,CA27-29),carcinoembryonic antigen(CEA)] and quality of life [Quality of Life Scale for Cancer Patient(QLQ-C30)] were compared before treatment and after 3 courses of treatment, and the incidence rates of adverse reactions(gastrointestinal reactions, stomatitis, leukopenia, liver and kidney function damage) and recurrence rate within 3 months, 6 months and 1 year after treatment were counted in the two groups. Results: There were no deaths in the two groups during treatment. The total clinical effective rate in the observation group was higher than that in the controlled group(P<0.05). After 3 courses of treatment, the levels of serum tumor markers CA-125,CA15-3,CA27-29 and CEA in the two groups were lower than those before treatment, and the levels in the observation group were significantly lower than those in the controlled group during the same period(P<0.05). The scores of dimensions of QLQ-C30 in the two groups were higher than those before treatment, and the scores in the observation group were significantly higher than those in the controlled group during the same period(P<0.05). There were no chemotherapy-related deaths in both groups. After 3 courses of treatment, the incidence rates of adverse reactions(gastrointestinal reactions, stomatitis, leukopenia, liver and kidney function damage) in the observation group were higher than those in the controlled group(P<0.05),and all the above symptoms could be effectively relieved after symptomatic support treatments such as vomiting prevention, liver protection and nutritional support. During follow-up, there were no deaths in the two groups. The total recurrence rate in the observation group was lower than that in the controlled group at 6 and 12 months after treatment(P<0.05). The recurrence rate at 3 months after treatment was lower than that in the controlled group(P>0.05). Conclusion: Modified Sini Liujun Tiaochong Recipe combined with postoperative AC-Tchemotherapy regimen has a good effectin the treatment of patients with invasive ductal carcinoma of the breast, and it can effectively improve the clinical symptoms, reduce the occurrence of adverse reactions, lower the levels of tumor markers, and improve the quality of life of patients, and can reduce the recurrence rate of patients within 1 year.