益气活血中药防治化疗心脏毒性的临床研究

Clinical study on the prevention and treatment of chemotherapy cardiotoxicity with Yiqi Huoxue Traditional Chinese Medicine

目的探讨益气活血中药对恶性肿瘤患者心功能及化疗心脏毒性的影响。方法选取2019年1月至2023年1月泰安市肿瘤防治院收治的60例恶性肿瘤患者作为研究对象,按照随机数字表法分为治疗组与对照组,每组30例。对照组行氟尿嘧啶类+铂类化疗方案治疗,治疗组在对照组基础上给予益气活血中药治疗,比较两组治疗前后心肌酶谱[α-羟丁酸脱氢酶(α-HBDH)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、谷草转氨酶(AST)]、B型脑钠肽(BNP)、心肌肌钙蛋白(cTnI)水平及治疗后心电图异常改变、心血管不良事件发生情况和左心室射血分数(LVEF)。结果治疗后,两组AST、α-HBDH水平均高于治疗前,对照组CK、LDH、BNP水平均高于治疗前,治疗组BNP水平低于治疗前和对照组,差异有统计学意义(P<0.05),两组其他指标组间及组内治疗前后比较差异无统计学意义。治疗组治疗后心电图异常改变、心血管不良事件发生率均低于对照组,差异有统计学意义(P<0.05);治疗后,对照组LVEF水平低于治疗前,但治疗组LVEF高于对照组,差异有统计学意义(P<0.05);治疗组治疗前后LVEF比较差异无统计学意义。结论益气活血中药具有一定程度预防化疗心脏毒性的作用,可改善患者心功能,尤其在改善BNP、预防LVEF降低方面优势明显,心肌酶谱、BNP、LVEF可能作为化疗心脏毒性的早期预测指标。

Objective To investigate the effect of Yiqi Huoxue Traditional Chinese Medicine on cardiac function and chemotherapy cardiotoxicity in patients with malignant tumors.Methods A total of 60 patients with malignant tumors admitted to Tai'an Cancer Prevention and Treatment Hospital from January 2019 to January 2023 were selected as the study subjects,and they were divided into the treatment group and the control group according to random number table method,with 30 cases in each group.The control group was treated with fluorouracil+platinum-based chemotherapy,and the treatment group was treated with Yiqi Huoxue Traditional Chinese Medicine on the basis of the control group,and the myocardial enzyme spectrum(α-hydroxybutyrate dehydrogenase[α-HBDH]),lactate dehydrogenase[LDH],creatine kinase[CK],creatine kinase isoenzyme[CKMB],aspartate aminotransferase[AST],B-type natriuretic peptide(BNP),cardiac troponin I(cTnI)levels before and after treatment,abnormal electrocardiogram changes,adverse cardiovascular events,left ventricular ejection fraction(LVEF)were compared between the two groups.Results After treatment,the levels of AST,α-HBDH of the two groups were higher than those before treatment,the levels of CK,LDH and BNP in the control group were higher than those before treatment,and the BNP level in the treatment group were lower than those before treatment and the control group,and the differences were statistically significant(P<0.05);there were no significant differences in other indicators between the two groups and within the group before and after treatment.The incidence of abnormal electrocardiogram changes and adverse cardiovascular events in the treatment group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the level of LVEF in the control group was lower than that before treatment,but LVEF level in the treatment group was higher than control group,the differences were statistically significant(P<0.05);there was no significant difference in LVEF in the treatment group before and after treatment.Conclusion Yiqi Huoxue Traditional Chinese Medicine can prevent chemotherapy cardiotoxicity to a certain extent,and can improve the cardiac function of patients,especially in improving BNP and preventing the reduction of LVEF,and cardiac enzyme spectrum,BNP and LVEF may be used as early predictors of cardiotoxicity in chemotherapy.