化毒三阴方干预术后三阴乳腺癌

Huadu Sanyin Prescription in the Intervention of Post-Operative Triple-Negative Breast Cancer

目的:观察化毒三阴方防治三阴乳腺癌患者术后复发转移的临床疗效及安全性,探讨患者一般状况、肿瘤特点、不同体质状态与复发转移的相关性。方法:本研究采取单臂研究方法,纳入完成术后辅助治疗的三阴乳腺癌患者作为观察对象。所有患者给予化毒三阴方为基础方辨证加减治疗3年,观察其3年无病生存率及生活质量改变情况,并分析其一般情况、肿瘤特点、不同体质与肿瘤复发转移的相关性。结果:共纳入141例患者,完成3年随访134例,失访7例(4.96%),复发转移有18例,3年无病生存率为86.57%;与治疗前比较,治疗后患者中医症状、匹兹堡睡眠质量指数量表(pittsburgh sleep quality index, PSQI)、Piper疲乏量表中文版(revised Piper fatigue scale, RPFS)、医院焦虑抑郁量表(hospital anxiety and depression scale, HADS)评分有所下降,乳腺癌患者生命质量测定量表(the functional assessment of cancer therapy breast cancer-specific, FACT-B)总分有所上升,差异有统计学意义(P<0.05);与治疗前比较,FACT-B中生理状况、社会家庭状况、情感状况、功能状况、附加关注各项评分均升高,差异有统计学意义(P<0.05)。生存分析显示,气虚质患者生存曲线比非气虚患者生存曲线低,下降陡峭;肿瘤大小、淋巴结转移状态与三阴乳腺癌复发转移相关;多因素分析显示,肿瘤大小是三阴乳腺癌患者独立预后影响因素。结论:化毒三阴方可以提高三阴乳腺癌患者3年无病生存率,并且可以明显改善三阴乳腺癌患者疲乏、体力、焦虑抑郁等症状,缓解患者睡眠问题,安全性较好;淋巴结转移、肿瘤大小、体质状态可影响三阴乳腺癌的复发转移,其中肿瘤大小是其复发转移独立预后影响因素。

Objective: To observe the clinical efficacy and safety of Huadu Sanyin Prescription in preventing recurrence and metastasis of post-operative triple-negative breast cancer patients, and to explore the correlation between general condition, tumor characteristics, different physical status and recurrence and metastasis.Methods: This study adopted a single-arm research method and included patients with triple-negative breast cancer who had completed postoperative adjuvant treatment as the observation object.All patients were treated with modified Huadu Sanyin Prescription based on syndrome differentiation for 3 years.The changes of disease-free survival rate and quality of life in 3 years were observed, and the correlation between general situation, tumor characteristics, different physique and tumor recurrence and metastasis was analyzed.Results: A total of 141 patients were included.134 cases were followed up for 3 years, 7 cases were lost(4.96%),18 cases had recurrence and metastasis, and the 3-year disease-free survival rate was 86.57%.Compared with before treatment, the patients′ TCM symptoms, Pittsburgh sleep quality index(PSQI) and revised Piper fatigue scale(RPFS),the hospital anxiety and depression scale(HADS) score decreased, the total score of the functional assessment of cancer therapy breast cancer-specific(FACT-B) increased, and the difference was statistically significant(P<0.05).Compared with before treatment, the scores of physiological status, social and family status, emotional status, functional status and additional attention in FACT-B increased.The difference was statistically significant(P<0.05).Survival analysis showed that the survival curve of patients with qi deficiency syndrome was lower than that of non-qi asthenia patients, and the decline was steep.The size of tumor and lymph node metastasis were correlated with the recurrence and metastasis of triple-negative breast cancer.Multivariate analysis showed that tumor size was the independent prognostic factor of triple-negative breast cancer patients.Conclusion: Huadu Sanyin Prescription can improve the 3 year disease-free survival rate of triple-negative breast cancer patients, and can obviously improve the symptoms of fatigue, physical strength, anxiety and depression of triple-negative breast cancer patients, alleviate the sleep problems of patients, and has better safety.Lymph node metastasis, tumor size and physical status can affect the recurrence and metastasis of triple-negative breast cancer, and the size of tumor is the independent prognostic factor of recurrence and metastasis.