疏肝健脾方联合化疗治疗晚期三阴性乳腺癌临床疗效观察

目的探讨疏肝健脾方联合化疗对晚期三阴性乳腺癌的近期疗效、中医证候、不良反应和生活质量的影响。方法将63例肝郁脾虚型晚期三阴性乳腺癌患者按照随机数字表法分为对照组和研究组,对照组31例,研究组32例。对照组给予吉西他滨联合顺铂(GP)方案化疗,研究组在化疗基础上加用疏肝健脾方治疗。2个化疗周期后,比较评价两组患者的近期疗效、中医证候、不良反应和生活质量情况。结果研究组客观缓解率和疾病控制率均高于对照组(P<0.05);研究组在脘胁胀痛、食少、抑郁烦躁、太息等方面中医证候评分均低于对照组(P<0.05);研究组骨髓抑制及消化道不良反应发生率较对照组均明显降低(P<0.05);与对照组治疗后比较,研究组治疗后卡氏(KPS)评分明显升高(P<0.05)。结论疏肝健脾方联合GP方案治疗晚期三阴性乳腺癌具有协同增效减毒作用,可有效控制晚期乳腺癌患者病情进展,提高患者生存质量,值得在临床中推广应用。

Clinical Observation of Shugan Jianpi Decoction Combined with Chemotherapy in the Treatment of Advanced Breast Cancer

Objective To investigate the effects of Shugan Jianpi decoction combined with chemotherapy on the short-term efficacy,traditional Chinese medicine(TCM)syndrome,side effects and quality of life of advanced breast cancer.Methods Sixty-three patients with advanced breast cancer were picked out in accordance with the guidelines for clinical research of new Chinese medicines.They were divided into two groups:control group and study group,31 cases giving gemcitabine combined with cisplatin(GP)chemotherapy in the control group,32 cases giving GP chemotherapy and Shugan Jianpi decoction in the study group.After two chemotherapy cycles,the short-term efficacy,TCM syndrome,side effects and quality of life of two groups were compared.Results The objective response rate and disease control rate of the study group were higher than those of the control group.The disease control rate between two groups was statistically significant(P<0.05).The TCM symptom scores of rib and stomach pain,depression and irritability,inappetence and sighing were lower than those of the control group(P<0.05).The incidence of bone marrow suppression and gastrointestinal side effects in the study group were significantly lower than those of the control group(71.90%vs 93.50%,65.63%vs 87.10%,P<0.05);Compared with the control group,the KPS score of the study group was significantly increased after treatment(P<0.05).Conclusions Shugan Jianpi decoction combined with GP chemotherapy has synergistic effect and attenuated effect on advanced breast cancer,which can effectively control the progress of advanced breast cancer and improve the quality of life of patients.It is worthy of clinical application.