去壁灵芝孢子粉改善乳腺癌患者辅助化疗期间癌因性疲乏研究

Effect of Sporoderm-removed Ganoderma Lucidum Spore Powder on Cancer-related Fatigue in Patients with Breast Cancer During Adjuvant Chemotherapy

目的观察去壁灵芝孢子粉对乳腺癌术后辅助化疗患者癌因性疲乏的防治效果,为使用现代工艺加工的传统中药有效改善肿瘤患者生活质量提供依据。方法采用随机数字表法将浙江省肿瘤医院2021年11月—2023年3月收治的74例接受乳腺癌术后辅助化疗的女性患者分为治疗组(37例)和对照组(37例)。2组均给予4周期表柔比星(或多柔比星脂质体)联合环磷酰胺辅助化疗及相应的对症治疗;治疗组化疗同时口服去壁灵芝孢子粉2 g·d^(-1)治疗,对照组口服安慰剂对照。对比分析2组治疗前后癌因性疲乏发生率及疲乏严重程度、T淋巴细胞亚群、血清炎症因子、肠道菌群变化,以及药物对血常规、肝肾功能的影响。结果治疗组化疗后癌因性疲乏发生率及Piper疲乏修正量表评分显著低于对照组(P<0.05);CD3^(+)、CD4^(+)、CD3-CD56^(+)比例较对照组显著升高(P<0.05),而CD8^(+)比值较对照组显著降低(P<0.05);IL-2、IL-10计数高于对照组(P<0.05),而IL-6、IL-8、C反应蛋白计数低于对照组(P<0.05);白细胞、中性粒细胞及血小板计数显著高于对照组(P<0.05);肠道菌群在属水平普拉梭菌丰度高于对照组;2组肝肾功能指标无明显差异。结论去壁灵芝孢子粉能显著降低乳腺癌患者辅助化疗期间癌因性疲乏的发生率及疲乏程度,抑制炎症因子,调节肠道菌群及机体免疫。

OBJECTIVE To observe the preventive and therapeutic effect of Ganoderma lucidum spore powder on cancer-related fatigue in postoperative adjuvant chemotherapy patients with breast cancer,and to provide a basis for using traditional Chinese medicine processed by modern processing to effectively improve the quality of life of cancer patients.METHODS Seventy-four female patients who received postoperative adjuvant chemotherapy for breast cancer in Zhejiang Cancer Hospital from November 2021 to March 2023 were randomly divided into either treatment(n=37)or control group(n=37).Both groups were given 4 cycles of epirubicin(or liposomal doxorubicin)combined with cyclophosphamide adjuvant chemotherapy and corresponding symptomatic treatment:the treatment group was treated with sporoderm-removed Ganoderma lucidum spore powder 2 g·d^(-1),and the control group was treated with placebo.The incidence and severity of cancer-related fatigue,the changes in T lymphocyte subsets,serum inflammatory factors,intestinal flora,and the effects of drugs on blood routine,liver,and kidney function were compared between the two groups after treatment.RESULTS The incidence of cancer-related fatigue and the score of the Piper correction scale in the treatment group were significantly lower than those in the control group(P<0.05),the proportion of CD3^(+),CD4^(+),and CD3-CD56^(+)was significantly higher than that in the control group(P<0.05),while the proportion of CD8^(+)was significantly lower than that in the control group(P<0.05).The counts of IL-2 and IL-10 were higher than those in the control group,while the counts of IL-6,IL-8,and CRP were lower than those in the control group(P<0.05).The counts of leukocytes,neutrophils,and platelets in the control group were significantly higher than those in the control group(P<0.05),and the abundance of intestinal microflora in the control group was higher than that in the control group.There was no significant difference in liver and kidney function between the 2 groups.CONCLUSION Sporoderm-removed Ganoderma lucidum spore powder can significantly reduce the incidence and level of cancer-related fatigue in breast cancer patients during adjuvant chemotherapy,inhibit inflammatory factors,regulate intestinal flora and body immunity.