补肾益气方对乳腺癌化疗后骨髓抑制及免疫功能影响的临床研究

Clinical study on the effect of Bushen Yiqi recipe on bone marrow suppression and immune function after breast cancer chemotherapy

目的探究补肾益气方对乳腺癌化疗后骨髓抑制及免疫功能的影响。方法选取解放军总医院第六医学中心2023年1月至2024年1月收治的110例经表柔比星+环磷酰胺序贯多西紫杉醇(EC-T)方案化疗的乳腺癌患者作为研究对象,采用随机方法分为对照组和观察组,各55例。其中对照组给予EC-T方案治疗,观察组在对照组基础上口服补肾益气方治疗。观察2组患者治疗前后血常规指标、细胞免疫功能、中医症状积分、生存质量评分(QLQ-C30)变化。结果治疗后,2组白细胞计数、中性粒细胞绝对值、血红蛋白、血小板计数水平均低于治疗前,但观察组均高于对照组(均P<0.05)。治疗后,2组CD_(3)^(+)、CD_(4)^(+)水平及CD_(4)^(+)/CD_(8)^(+)比值均低于治疗前,但观察组均高于对照组,CD_(8)^(+)水平均高于治疗前,但观察组低于对照组(均P<0.05)。治疗后,2组气短乏力、心悸失眠、头晕眼花、面色少华、畏寒肢冷、腰膝酸软积分均高于治疗前,但观察组均低于对照组(均P<0.05)。治疗7、20 d后,2组QLQ-C30评分均低于治疗前,但观察组均高于对照组[(75.2±2.1)分比(74.1±1.9)分、(78.9±2.2)分比(75.9±2.1)分](均P<0.05)。结论补肾益气方能够有效预防乳腺癌化疗后骨髓抑制情况,纠正化疗后免疫功能紊乱情况,同时亦能改善患者化疗后继发的临床症状,明显提高生存质量,可以作为乳腺癌化疗患者的辅助补充治疗。

Objective To explore the effect of Bushen Yiqi recipe on bone marrow suppression and immune function after breast cancer chemotherapy.Methods A total of 110 breast cancer patients treated with epirubicin and cyclophosphamide sequential Docetaxel(EC-T)scheme in the Sixth Medical Center of Chinese PLA General Hospital from January 2023 to January 2024 were selected as the research objects.They were randomly divided into the control group and the observation group,with 55 cases in each group.The control group was treated with the EC-T scheme.The observation group was treated with Bushen Yiqi recipe on the basis of the control group.The changes of blood routine indexes,cellular immune function,traditional Chinese medicine symptom score and quality of life score(QLQ-C30)in patients were observed before and after treatment.Results After treatment,the white blood cell count,absolute neutrophil count,hemoglobin and platelet count levels of the two groups were lower than those before treatment,but those in the observation group were higher than those in the control group(all P<0.05).After the treatment,levels of CD_(3)^(+),CD_(4)^(+) and CD_(4)^(+)/CD_(8)^(+) ratio of the two groups were lower than those before the treatment,but those in the observation group were higher than those in the control group;the CD_(8)^(+) level was higher than that before the treatment,but that in the observation group was lower than that in the control group(all P<0.05).After treatment,the scores of shortness of breath,fatigue,palpitation,insomnia,dizziness,complexion,cold limbs,waist and knee soreness in the two groups were higher than those before treatment,but those in the observation group were lower than those in the control group(all P<0.05).After 7 and 20 d of treatment,the QLQ-C30 scores of the two groups were lower than those before treatment,but the scores in the observation group were higher than those in the control group[(75.2±2.1)vs(74.1±1.9),(78.9±2.2)vs(75.9±2.1)](all P<0.05).Conclusions Bushen Yiqi recipe can effectively prevent bone marrow suppression after breast cancer chemotherapy,correct the immune dysfunction after chemotherapy,improve the secondary clinical symptoms of patients after chemotherapy,and significantly improve the quality of life.It can be used as an adjuvant and supplementary treatment for breast cancer patients undergoing chemotherapy.