益髓升白方治疗乳腺癌化疗后骨髓抑制的临床效果

Clinical effect of Yisui Shengbai Prescription in treatment of myelosuppression after chemotherapy in breast cancer

目的 评价中药汤剂(益髓升白方)对乳腺癌化疗后患者出现骨髓抑制的治疗效果,分析其作用机制。方法 入组研究对象50例,为2022年4—9月山西省中医院乳腺科收治住院的乳腺癌化疗患者,辨证为肝肾阴虚、气血不足。根据随机数表法并结合患者是否能坚持长期口服中药汤剂的意愿分为两组,研究组与对照组各25例。研究组自化疗后第1天开始口服益髓升白方(每日一剂,早晚分服,14 d为1个疗程)。对照组同样自化疗后第1天开始口服中药制剂养正合剂(3次/d,20 ml/次,14 d为1个疗程)。若两组患者出现Ⅲ度以上骨髓抑制时,应予升白针对症处理,此外不得使用其他升白药物。通过记录两组患者化疗后第1、7、14天的外周血白细胞(WBC)、中性粒细胞(NE)数值及治疗前后的中医证候积分,综合评价两种药物的治疗效果。结果 外周血象变化:两组患者治疗前外周血中WBC及NE数值比较,差异无统计学意义(P>0.05)。化疗后第7天,研究组的WBC平均数值略高于对照组,但差异无统计学意义(P>0.05);研究组NE数值明显高于对照组,差异有统计学意义(P<0.05)。化疗后第14天,研究组的WBC及NE数值均明显高于对照组,差异有统计学意义(P<0.05)。中医临床证候方面:治疗后两组患者中医临床证候均有改善,其中研究组的有效率明显高于对照组,差异有统计学意义(P<0.05)。结论 乳腺癌化疗后的骨髓抑制患者口服益髓升白方在提升WBC和NE数值方面及改善中医临床证候方面的疗效较好,具有临床可行性。

Objective To evaluate the therapeutic effect of traditional Chinese medicine decoction(Yisui Shengbai Prescription)on myelosuppression in patients with breast cancer after chemotherapy,and analyze its mechanism.Methods A total of 50 patients with breast cancer were enrolled in the study.They were hospitalized in the Galactophore Department of Shanxi Traditional Chinese Medical Hospital from April to September 2022.The syndrome differentiation was yin deficiency of the liver and kidney and deficiency of qi and blood.According to the random number table method and whether the patients can adhere to the long-term oral consumption of traditional Chinese medicine decoction,they were divided into two groups,with 25 cases in the study group and 25 cases in the control group.The study group started taking the Yisui Shengbai Prescription orally on the first day after chemotherapy(one dose per day,divided in the morning and evening,14 days as a course of treatment).The control group also started taking the traditional Chinese medicine of Yangzheng mixture orally from the first day after chemotherapy(3 times a day,20 ml once,14 days as a course of treatment).If two groups of patients experience gradeⅢor above myelosuppression,symptomatic treatment with injection of increasing leukocytes shall be given,and other drugs of increasing leukocytes shall not be used.By recording the values of peripheral blood leukocytes(WBC)and neutrophils(NE)on the 1st,7th,and 14th days after chemotherapy in two groups of patients,and the TCM symptom scores before and after treatment,the therapeutic effects of the two drugs were comprehensively evaluated.Results Changes in peripheral hemogram.There were no statistically significant differences in WBC and NE values between the two groups of patients before treatment(P>0.05).After 7 days of treatment,the average WBC value of the study group was slightly higher than that of the control group,without the statistically significant difference(P>0.05);The NE value of the study group was significantly higher than that of the control group,with a statistically significant difference(P<0.05).After 14 days of treatment,the WBC and NE values in the study group were significantly higher than those in the control group,with statistically significant differences(P<0.05).In terms of traditional Chinese medicine clinical symptoms.After treatment,both groups of patients showed improvement in traditional Chinese medicine clinical symptoms,and the effective rate of the study group was significantly higher than that of the control group,with a statistically significant difference(P<0.05).Conclusion In patients with myelosuppression after chemotherapy for breast cancer,the oral Yisui Formula for increasing leukocyte has a better effect in improving WBC and NE values and improving clinical symptoms of traditional Chinese medicine and has clinical feasibility.