健脾补肾法改善绝经前乳腺癌患者三苯氧胺不良反应的临床研究

Clinical Study on Spleen-invigorating and Kidney-tonifying Therapy in Improving Adverse Reactions of Tamoxifen in Premenopausal Breast Cancer Patients

目的三苯氧胺(TAM)在乳腺癌治疗中发挥重要作用,然而其不良反应严重影响患者的生活质量,甚至有患者因此停止治疗。观察健脾补肾中药联合三苯氧胺缓解内分泌不良反应的作用。方法将符合标准的乳腺癌病人60例分为两组,观察组以TAM配合健脾补肾中药治疗,对照组单纯服用TAM治疗。比较治疗2组患者治疗前后的Kupperman症状积分、KPS评分及中医脾虚证、肾虚证证型积分。结果观察组患者在降低总的Kupperman症状积分方面均优于单纯TAM对照组,经检验差异有统计学意义(P <0.05)。观察组患者烘热汗出、焦躁易怒、刺痛感、焦躁易怒、心悸症状治疗后明显缓解(P <0.05)。对照组Kupperman症状积分在治疗后与治疗前无明显差异(P> 0.05)。结论健脾补肾法配合TAM治疗乳腺癌,能有效缓解TAM引起的围绝经期综合征症状,且无明显毒副作用。

Objective Triphenoxylamine(TAM)plays an important role in the treatment of breast cancer.However,its adverse reactions seriously affect the quality of life of patients.In this study,we observed the effect of spleeninvigorating and kidney-tonifying Chinese medicine combined with triphenoxylamine on relieving endocrine adverse reactions.Methods Sixty cases of premenopausal breast cancer were divided into two groups.The observation group was treated with TAM and spleen-invigorating and kidney-tonifying Chinese medicine,and the control group was treated with TAM alone.Before and after treatment,Kupperman symptom scores,KPS scores and the scores of spleen deficiency syndrome and kidney deficiency syndrome in the two groups were compared.Results The observation group had more stronger effect on decreasing the Kupperman symptom scores than the control group,the difference being significant(P<0.05).The symptoms of hot flush,sweating,irritability,palpitation,and tingling in the observation group were significantly relieved after treatment(P<0.05 compared with those before treatment).However,the Kupperman symptom scores in the control group had no significant difference before and after treatment(P>0.05).Conclusion Spleen-invigorating and kidney-tonifying therapy is effective on relieving the symptoms of perimenopausal syndrome caused by TAM without obvious toxic or side effects.