乳岩汤联合TX方案化疗治疗晚期三阴乳腺癌患者的疗效观察

Analysis of Therapeutic Effect of Ruyan Decoction Combined with TX Regimen Chemotherapy on Patients with Advanced Triple Negative Breast Cancer

目的分析乳岩汤联合TX方案(多西紫杉醇,卡培他滨)化疗对晚期三阴乳腺癌患者的治疗效果。方法选取2018年10月—2020年10月期间唐山市人民医院乳腺科收治的晚期三阴乳腺癌患者80例,采用随机数字表法分为对照组和观察组,每组患者各40例。对照组采用TX方案化疗进行治疗;观察组在对照组的基础上采用乳岩汤进行治疗,21 d为1个疗程,两组患者均治疗3个疗程。观察比较两组患者治疗后的临床疗效,比较两组患者治疗前后血管内皮功能[血清血管内皮生长因子-A(Vascular endothelial growth factor-A,VEGF-A)、血管内皮生长因子-B(Vascular endothelial growth factor-B,VEGF-B)、血管内皮生长因子-C(Vascular endothelial growth factor-C,VEGF-C)]、免疫功能[外周血CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]、激素水平[血清雌二醇(Estradiol,E_(2))、促卵泡生成素(Follicle stimulating hormone,FSH)]及生活质量。结果治疗3个疗程后,对照组外周血CD4^(+)、CD8^(+)水平较治疗前升高,外周血CD4^(+)/CD8^(+)水平较治疗前降低,差异有统计学意义(P<0.05);观察组外周血CD4^(+)、CD4^(+)/CD8^(+)水平较治疗前升高,外周血CD8^(+)水平较治疗前降低,差异有统计学意义(P<0.05);且观察组外周血CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,差异有统计学意义(P<0.05);外周血CD8^(+)水平低于对照组,差异有统计学意义(P<0.05)。治疗3个疗程后两组患者血清VEGF-A、VEGF-B、VEGF-C水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组低于对照组,差异有统计学意义(P<0.05)。治疗3个疗程后两组患者血清FSH、E_(2)水平较治疗前降低,生活质量评分较治疗前升高,差异有统计学意义(P<0.05);且观察组患者血清FSH、E_(2)水平低于对照组,差异有统计学意义(P<0.05),生活质量评分高于对照组,差异有统计学意义(P<0.05)。治疗3个疗程后,观察组临床总有效率72.50%(29/40)明显高于对照组50.00%(20/40),差异有统计学意义(P<0.05)。结论乳岩汤联合TX方案化疗对晚期三阴乳腺癌患者进行治疗,可有效改善患者血管内皮功能和免疫功能,同时调节激素水平,提高患者生活质量,具有良好的治疗效果。

Objective To analyze the therapeutic effect of Ruyan decoction combined with TX regimen chemo-therapy(docetaxel and capecitabine)on patients with advanced triple negative breast cancer.Methods From October 2018 to October 2020,80 patients with advanced triple negative breast cancer in the galactophore department of Tangshan People′s Hospital were taken as research objects,and they were divided into the control group(40 cases)and the observa-tion group(40 cases)by random number table method.The control group was treated with TX regimen chemotherapy,while the observation group was treated with Ruyan decoction on the basis of the control group,with 21d as a course of treatment,and both groups were treated for three courses of treatment.The curative effect of the two groups was observed after three courses of treatment,and the vascular endothelial function(vascular endothelial growth factors-A(VEGF-A),B(VEGF-B),and C(VEGF-C)),immune function(CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)in peripheral blood),hormone levels[es-tradiol(E_(2))and follicle-stimulating hormone(FSH)],and quality of life were compared before and after three courses of treatment.Results After three courses of treatment,CD4^(+)and CD8^(+)in the peripheral blood of the control group were higher than those before treatment,while CD4^(+)/CD8^(+)in peripheral blood was decreased,with a statistically significant difference(P<0.05).CD4^(+)and CD4^(+)/CD8^(+)in the peripheral blood of the observation group were higher than those be-fore treatment,while CD8^(+)in peripheral blood was decreased,with a statistically significant difference(P<0.05).In addi-tion,the levels of CD4^(+)and CD4^(+)/CD8^(+)in peripheral blood of the observation group were significantly higher than those of the control group(P<0.05);the level of CD8^(+)in peripheral blood of the observation group was significantly lower than that of the control group(P<0.05).After three courses of treatment,VEGF-A,VEGF-B,and VEGF-C in the serum of the two groups were reduced,with a statistically significant difference(P<0.05).In addition,the three factors in the observation group were lower than those in the control group,with a statistically significant difference(P<0.05).In addition,FSH and E_(2) in the serum of the two groups were reduced,and the quality of life score was higher than that before treatment,with a statistically significant difference(P<0.05).FSH and E_(2) in the serum of the observation group were lower than those of the control group,with a statistically significant difference(P<0.05).The quality of life score of the ob-servation group was higher than that of the control group,with a statistically significant difference(P<0.05).After three courses of treatment,the total clinical effective rate of the observation group 72.50%(29/40)was significantly higher than that of the control group 50.00%(20/40)(P<0.05).Conclusion Ruyan decoction combined with TX regimen chemo-therapy could effectively improve the vascular endothelial function and immune function of patients with advanced triple negative breast cancer,regulate hormone levels,and enhance the quality of life of patients,with excellent therapeutic effects.