防己黄芪汤对乳腺癌术后水肿及免疫的影响

目的:观察防己黄芪汤对乳腺癌术后水肿的临床疗效,同时评价其对患者免疫功能的影响。方法:选取2014年1月至2017年1月河南中医药大学第一附属医院收治的乳腺癌术后水肿患者60例纳入研究,随机分为对照组和观察组,每组30例。对照组患者口服呋塞米,20 mg/次,1次/d,地奥司明,0.45 g/片,2片/次,1次/d。观察组在对照组治疗基础上加服防己黄芪汤,200 m L早晚分服温服,1剂/d。2组均连续治疗14 d,比较治疗前后上臂周径、FCAT-B+4量表评分、临床总有效率、生命质量评分(QOL)以及CD4~+、CD8~+、CD4~+/CD8~+、Th17、IL-17的水平变化。结果:1)治疗后观察组上臂周径为(19.28±1.12)cm,与对照组(33.12±2.53)cm比较,差异有统计学意义(t=2.19,P0.05)。2)观察组临床总有效率为86.67%,对照组为66.66%,2组比较,差异有统计学意义(χ2=3.14,P0.05)。3)观察组FCAT-B+4量表评分为(6.12±0.24)分,与对照组(8.02±1.01)分,2组比较差异有统计学意义(t=3.14,P0.05)。4)治疗后观察组QOL各项评分明显高于对照组,差异有统计学意义(P0.05)。5)2组CD4~+及CD4~+/CD8~+比值均高于治疗前(P0.05),CD8~+、Th17与IL-17的含量低于治疗前(P0.05),治疗后观察组与对照组差异均有统计学意义(P0.05)。结论:防己黄芪汤可明显改善乳腺癌术后水肿,提高乳腺癌患者的生命质量,其作用机制可能与提高患者免疫能力有关。

Effects of Fangji Huangqi Decoction on Edema and Immunity of Postoperative Breast Cancer

To observe the clinical effect of Fangji Huangqi decoction on postoperative edema of breast cancer, and to evaluate the effects on the immunity of patients. Methods:A total of 60 patients with postoperative edema of breast cancer included into the research, were randomly divided into the control group (30 cases) and the observation group (30 cases). The patients of the control group had Furosemide, 20 mg/time, 1 time/day, oral furosemide, 20 mg/tablet, 1 time/day. The observation group had Fangji Huangqi decoction on the basis of control group, 200 mL warm-taken separately in the morning and evening, 1 agent/day, with continuous treatment for 14 d. Upper-arm circumference, FCAT-B+4 scale scores, clinical total effective rate, quality of life scores (QOL) and the levels changes of CD4+, CD8+, CD4+/CD8+, Th17, IL-17 of two groups before and after treatment were compared. Results:1) After treatment, the upper-arm circumference of the observation group was (19.28±1.12)cm. Compared with (33.12±2.53) cm of the control group, the differences were statistically significant (P<0.05, t=2.19). 2) The clinical total effective rate of observation group was 86.67%, and that of control group was 66.66 %. The differences were statistically significant (P<0.05, chi-square=3.14). 3) FCAT-B+4 scale of the observation group graded (6.12±0.24) points, and the control group graded (8.02±1.01) points. The differences between the two groups had statistical significance (P<0.05, t=3.14). 4) the QOL scores of the observation group was obviously higher than that of control group after treatment, and the differences were statistically significant (P<0.05). 5) CD4+ and the ratio of CD4+ /CD8+ in the two groups were both higher than before treatment (P<0.05), and the content of CD8+, Th17 and IL-17 levels was lower than that before treatment (P<0.05). The differences between the treatment group and control group were statistically significant (P<0.05). Conclusion:The Fangji Huangqi decoction could obviously improve postoperative edema of breast cancer, improve the quality of life in patients with breast cancer, and the mechanism may be related to the improvement of the patients'' immunity.