疏肝健脾方治疗乳腺癌化疗后癌因性疲乏临床研究

Clinical Study on Liver⁃Soothing and Spleen⁃Invigorating Formula for Cancer⁃Induced Fatigue After Chemotherapy in Breast Cancer

目的:观察疏肝健脾方治疗乳腺癌化疗后癌因性疲乏的临床疗效。方法:将100例乳腺癌化疗后癌因性疲乏患者按照随机数字表法分为对照组和试验组,每组各50例。两组患者接受保乳根治术治疗,并于术后给予常规化疗方案,对照组化疗后给予对症治疗,试验组在对照组治疗的基础上给予疏肝健脾方。比较两组患者治疗前后Piper疲乏修正量表(the revised piper fatigue scale,PFS-R)量表评分、中医证候积分、生化指标[血红蛋白、中性粒细胞计数、白细胞介素-2(interleukin-2,IL-2)、C反应蛋白(C reactive protein,CRP)]、T淋巴细胞亚群指标、癌症治疗功能评价系统(functional assemessment of cancer gherapy,FACT)评分变化情况。结果:两组患者治疗后PFS-R评分低于本组治疗前,且治疗后试验组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后倦怠乏力、纳差、抑郁、便溏等中医证候评分低于本组治疗前,差异具有统计学意义(P<0.05)。两组患者治疗后血红蛋白高于本组治疗前,IL-2、CRP、中性粒细胞低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平高于本组治疗前,且治疗后试验组高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后FACT评分高于本组治疗前,且治疗后试验组高于对照组,差异均有统计学意义(P<0.05)。结论:疏肝健脾方可有效缓解乳腺癌化疗后癌因性疲乏患者负性情绪,降低疲乏程度,提高患者生活质量,作用机制可能与促进患者细胞免疫T淋巴细胞亚群升高,改善患者机体免疫功能有关。

Objective:To observe the clinical efficacy of Liver⁃Soothing and Spleen⁃Invigorating Formula on cancer⁃induced fatigue after chemotherapy in breast cancer.Methods:A total of 100 patients with cancer⁃induced fatigue after chemotherapy for breast cancer were randomly divided into the control group and the experiment group,with 50 cases in each group.The two groups first underwent breast⁃conserving radical surgery and received postoperative chemotherapy.Then the control group added symptomatic treatment after chemo⁃therapy,while the experimental group added Liver⁃Soothing and Spleen⁃Invigorating Formula on the basis of the control group.The chan⁃ges in the revised Piper fatigue scale(RPFS)score,TCM syndrome scores,biochemical indexes[including hemoglobin level,neutro⁃phil count,interleukin⁃2(IL⁃2),C⁃reactive protein(CRP)]levels,and T lymphocyte subgroup index level,functional assessment of cancer therapy(FACT)score in the two groups before and after treatment were compared.Results:After treatment,the RPFS scale scores of the two groups were lower than those before treatment,and the experimental group′s was lower than that of the control group,and the difference was statistically significant(P<0.05);The scores of TCM syndromes such as fatigue,poor appetite,depression,and loose stools in the two groups were lower than those before treatment,and the experimental group′s above scores were lower than those of the control group,and all the differences were statistically significant(P<0.05);The hemoglobin levels of the two groups were higher than those before treatment,while IL⁃2,CRP,and neutrophils were lower than those before treatment,and all the differences were statis⁃tically significant(P<0.05);The levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the two groups were higher than those before treatment,and the experimental group′s above levels were higher than those of the control group,and all the differences were statistically signifi⁃cant(P<0.05);The FACT scores of the two groups were higher than those before treatment,and the experimental group′s above scores were higher than those of the control group after treatment,and all the differences were statistically significant(P<0.05).Con⁃clusion:Liver⁃Soothing and Spleen⁃Invigorating Formula can effectively alleviate the negative emotion of cancer⁃induced fatigue patients after chemotherapy for breast cancer,reduce the degree of fatigue,and improve the quality of life.The mechanism of action may be relat⁃ed to promoting the increase of cellular immune T lymphocyte subsets and improving immune function.