加味逍遥散辅助西医治疗肝郁脾虚型乳腺癌患者临床疗效观察及对生存质量的影响

Jiawei Xiaoyao powder combined with western medicine in treatment of breast carcinoma patients with syndromes of stagnation of liver qi and spleen deficiency and its influence on their quality of life

目的观察加味逍遥散辅助西医治疗肝郁脾虚型乳腺癌患者临床疗效观察及对生存质量的影响。方法选取68例肝郁脾虚型乳腺癌患者作为研究对象,研究中心为辽宁中医药大学附属医院,研究时间为2020年1月至10月,按照随机数字表法分为中医综合治疗组和常规西药对照组,每组34例。常规西药对照组患者年龄(47.61±8.33)岁,TNM分期:Ⅲ期20例,Ⅳ期14例;中医综合治疗组患者年龄(48.46±8.81)岁,TNM分期:Ⅲ期18例,Ⅳ期16例。常规西药对照组采用西医常规治疗方案,中医综合治疗组在常规西药对照组的基础上给予加味逍遥散治疗,两组患者均连续用药8周。记录两组患者治疗前后中医证候积分、生命质量测定量表EORTC QLQ-C30、汉密尔顿抑郁量表(HAMD)评分,检测两组患者治疗前后生化指标[癌胚抗原(CEA)、糖抗原125(CA125)、细胞免疫指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))]水平。结果中医综合治疗组总缓解率(85.29%,29/34)明显高于常规西药对照组(61.76%,21/34),差异有统计学意义(P<0.05)。治疗结束后两组患者的中医证候积分,血清CEA、CA125、CD8^(+)水平,QLQ-C30中的症状评分与HAMD评分均较治疗前明显降低(均P<0.01),且中医综合治疗组的下降程度明显优于常规西药对照组(P<0.01);治疗后两组患者的CD4^(+)、CD4^(+)/CD8^(+)水平及QLQ-C30中的功能评分、总健康评分均较治疗前明显升高(均P<0.01),且中医综合治疗组的上升程度明显优于常规西药对照组(P<0.01)。结论加味逍遥散辅助西医治疗肝郁脾虚型乳腺癌患者临床疗效显著,能够有效改善临床症状,降低血清CEA、CA125水平,调控细胞免疫功能水平,同时对于提高生活质量以及改善负面情绪具有积极作用。

Objective To observe the clinical efficacy of Jiawei Xiaoyao powder combined with western medicine in the treatment of breast carcinoma patients with syndromes of stagnation of liver qi and spleen deficiency and its influence on their quality of life.Methods Sixty-eight breast carcinoma patients with syndromes of stagnation of liver qi and spleen deficiency were selected as the research objects.The research center was Affiliated Hospital of Liaoning University of Traditional Chinese Medicine.The research time was from January to October 2020.According to the random number table method,the 68 patients were randomly divided into a comprehensive treatment with Chinese medicine group,who were(48.46±8.81)years old,and a conventional western medicine control group,who were(47.61±8.33)years old,with 34 cases in each group.There were 20 cases of stageⅢand 14 of stageⅣof TNM staging in the conventional western medicine control group.There were 18 cases of stageⅢand 16 of stageⅣof TNM staging in the comprehensive treatment with Chinese medicine group.The conventional western medicine control group was treated with conventional western medicine,and the comprehensive treatment with Chinese medicine group was treated with Jiawei Xiaoyao powder on the basis of the conventional western medicine control group,for eight weeks.The scores of traditional Chinese medicine syndromes,Quality of Life Scale EORTC QLQ-C30,and Hamilton Depression Scale(HAMD)of the two groups were recorded before and after the treatment.The levels of carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),and cellular immune indicators(CD4^(+),CD8^(+),and CD4^(+)/CD8^(+))of the two groups were detected before and after the treatment.Results The total remission rate was 85.29%(29/34)in the comprehensive treatment with Chinese medicine group,and was 61.76%(21/34)in the conventional western medicine control group,with a statistical difference(P<0.05).The scores of traditional Chinese medicine syndromes,the levels of CEA,CA125,and CD8^(+),the syndrome score of QLQ-C30,and the HAMD score were lower after than before the treatment in both groups(all P<0.01),and were better in the comprehensive treatment with Chinese medicine group than in the conventional western medicine control group(all P<0.01).The levels of CD4^(+)and CD4^(+)/CD8^(+)and the functional score and total health score of QLQ-C30 were higher after than before the treatment in both groups(all P<0.01),and were better in the comprehensive treatment with Chinese medicine group than in the conventional western medicine control group(all P<0.01).Conclusion Jiawei Xiaoyao powder combined with western medicine has good clinical effect in the treatment of breast carcinoma patients with syndromes of stagnation of liver qi and spleen deficiency,and can effectively improve their clinical symptoms,serum CEA and CA125 levels,cellular immune function,quality of life,and negative emotions.