减毒增效汤防治HER-2阳性乳腺癌经分子靶向治疗后糖代谢异常

Eff ect of Jiandu Zengxiao Decoction in the prevention and treatment of abnormal glucose metabolism after the molecular targeted treatment of HER-2 positive breast cancer

目的观察减毒增效汤防治表皮生长因子受体-2(HER-2)阳性乳腺癌经分子靶向治疗后糖代谢异常的疗效。方法将96例HER-2阳性乳腺癌患者随机分为2组,对照组给予曲妥珠单抗联合DC化疗方案,观察组在对照组基础上给予减毒增效汤治疗。记录2组化疗期间糖代谢异常发生率、血糖指标和胰岛素抵抗指标变化。并统计化疗疗效和生活质量改善情况。结果观察组化疗期间糖代谢异常发生率为6.45%(4/62),显著低于对照组的17.74%(11/62)(P<0.05)。与化疗前比较,2组化疗第3周期、第6周期空腹血糖、餐后2 h血糖、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)水平均较高(P<0.05),且化疗第3周期、第6周期观察组以上指标均低于对照组(P<0.05)。与化疗前比较,2组化疗第3周期、第6周期血浆IL-6较高(P<0.05),且化疗第3周期、第6周期观察组以上指标均低于对照组(P<0.05)。观察组化疗临床有效率和控制率均显著高于对照组(P<0.05)。结论减毒增效汤可显著降低HER-2阳性乳腺癌经分子靶向治疗后糖代谢异常发生率,具有显著的减毒增效功效,其机制可能与其抑制胰岛素抵抗、抑制炎症反应有关。

Objective To observe the eff ect of the Jiandu Zengxiao Decoction in the prevention and treatment of abnormal glucose metabolism after the molecular targeted treatment of epidermal growth factor receptor-2(HER-2)positive breast cancer.Methods A total of 96 patients with HER-2 positive breast cancer were randomly divided into two groups.The control group was treated with trastuzumab combined with the DC chemotherapy,while the observation group was treated with Jiandu Zengxiao Decoction on the basis of the control group.The incidence of abnormal glucose metabolism,the changes of blood glucose index and insulin resistance index were recorded during chemotherapy in the two groups,and the improvement of chemotherapy effect and quality of life were also counted.Results The incidence of abnormal glucose metabolism was 6.45%(4/62)in the observation group during chemotherapy,which was significantly lower than that in the control group(17.74%,11/62)(P<0.05).Compared with before chemotherapy,the levels of fasting blood glucose,postprandial blood glucose,fasting insulin(FINS)and insulin resistance indexes(HOMA-IR)were higher in the third and sixth cycles of chemotherapy in the two groups(P<0.05),and the above indicators were lower in the observation group in the third and sixth cycles of chemotherapy than those in the control group(P<0.05).Compared with before chemotherapy,the levels of IL-6 were higher in the third and sixth cycles of chemotherapy in the two groups(P<0.05),and the observation group was lower than the control group(P<0.05).The clinical effective rate and control rate of chemotherapy were significantly higher in the observation group than those in the control group(P<0.05).Conclusion The Jiandu Zengxiao Decoction can significantly reduce the incidence of abnormal glucose metabolism in HER-2-positive breast cancer after a molecular targeted treatment,which has a significant effect in reducing toxicity and increasing efficiency and whose mechanism may be related to its inhibition of insulin resistance and infl ammatory responses.