自拟舒肝益肾方联合内分泌治疗激素依赖型乳腺癌疗效

Effects of Self-made Shugan Yishen Decoction(自拟舒肝益肾方)Combined with Endocrine Therapy on Hormone-Dependent Breast Cancer

目的探讨自拟舒肝益肾方联合内分泌治疗激素依赖型乳腺癌疗效分析。方法选取该院2018年1月—2020年1月70例激素受体阳性乳腺癌内分泌治疗患者,随机分为观察组与对照组,每组各包括35例患者,对照组给予内分泌治疗,观察组应用舒肝益肾方联合内分泌治疗,比较两组治疗3个月后的临床疗效、临床症状改善、肿瘤标志物、Th1/Th2细胞因子水平、内分泌治疗相关不良反应以及随访2年生存情况。结果观察组治疗有效率94.29%高于对照组74.29%(P<0.05);观察组治疗后乳房胀痛、情志抑郁、腰膝酸软、头晕目眩、两胁作痛、食欲不振、二便不调症状评分均低于对照组(P<0.05);观察组治疗后肿瘤标志物糖类抗原153(CA153)、糖类抗原125(CA125)、癌胚抗原(CEA)以及血管内皮生长因子(VEGF)水平均低于对照组(P<0.05);观察组治疗后Th1细胞因子白细胞介素-2(IL-2)、肿瘤坏死因子α(TNF-α)、γ-干扰素(IFN-γ)水平高于对照组,Th2细胞因子白细胞介素-4/-8/-10(IL-4/-8/-10)水平低于对照组,Th1/Th2比值高于对照组(P<0.05);观察组治疗后血脂水平低于对照组,子宫内膜厚度小于对照组,骨密度值大于对照组(P<0.05);随访2年,观察组2年无进展生存率为85.71%(30/35),总生存率为91.43%(32/35);对照组2年无进展生存率为77.14%(27/35),总生存率为85.71%(30/35),两组随访2年生存情况比较(P>0.05)。结论自拟舒肝益肾方联合内分泌治疗可有效改善激素依赖型乳腺癌患者临床症状,抑制肿瘤进展,调节Th1/Th2细胞因子平衡,减轻内分泌治疗导致的血脂升高、骨密度增加、子宫内膜增厚等不良反应。

Objective To explore the effects of Self-made Shugan Yishen Decoction(自拟舒肝益肾方)combined with endocrine therapy on hormone-dependent breast cancer.Methods A total of 70 patients with hormone receptor-positive breast cancer undergoing endocrine therapy in the hospital were enrolled between January 2018 and January 2020.They were randomly divided into observation group and control group,35 cases in each group.The control group was given endocrine therapy,while the observation group was additionally given Shugan Yishen Decoction.The clinical efficacy after 3 months of treatment,the improvement of clinical symptoms,tumor markers,Th1/Th2 cytokines,endocrine therapy-related adverse reactions and survival conditions after 2 years of follow-up between the two groups were compared.Results The response rate of treatment in the observation group was higher than that in the control group(94.29%vs 74.29%)(P<0.05).After treatment,the scores of symptoms(breast distending pain,depression,soreness and weakness of the waist and knees,dizziness,bilateral flanks pain,loss of appetite,disharmony of stool and urine)in the observation group were lower than those in the control group(P<0.05),and the levels of carbohydrate antigen 153(CA153),carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA)and vascular endothelial growth factor(VEGF)were lower than those in the control group(P<0.05).After treatment,the levels of Th1 cytokines[interleukin-2(IL-2),tumor necrosis factorα(TNF-α),γ-interferon(IFN-γ)]in the observation group were higher than those in the control group,the levels of Th2 cytokines[interleukin-4/-8/-10(IL-4/-8/-10)]were lower than those in the control group,and the ratio of Th1/Th2 was greater than that in the control group(P<0.05).After treatment,the blood lipid level in the observation group was lower than that in the control group,the endometrial thickness was thinner than that in the control group,and the bone mineral density was greater than that in the control group(P<0.05).After 2 years of follow-up,2-year progression-free sur vival and overall survival rates in the observation group were 85.71%(30/35)and 91.43%(32/35),while those in control group were 77.14%(27/35)and 85.71%(30/35).The difference in survival conditions between the two groups was not statistically significant(P>0.05).Conclusion Self-made Shugan Yishen Decoction combined with endocrine therapy can effectively improve the clinical symptoms in patients with hormone-dependent breast cancer,inhibit the tumor progression,regulate the balance of Th1/Th2 cytokines and alleviate adverse reactions(increased blood lipid,bone mineral density and endometrial thickness)induced by endocrine therapy.