香贝养荣汤加减治疗转移性气血两虚乳腺癌的临床分析

目的:探讨香贝养荣汤加减辨治转移性乳腺癌(气血两虚)的近期疗效及对T淋巴细胞亚群和NK细胞的影响。方法:将90例转移性乳腺癌患者,根据入院先后顺序随机按数字表法分成观察组46例和对照组44例。对照组给予内分泌治疗,必要时加用化疗。观察组在对照组治疗的基础上加香贝养荣汤加减治疗。两组疗程直到疾病出现进展。进行气血两虚及兼证评分;进行功能状态Kupperman评分;记录疾病进展时间(TTP);采用乳腺癌患者生命质量测定量表(FACT-B)和KPS评分;检测T淋巴细胞亚群和自然杀伤细胞(NK)水平,记录不良反应。结果:观察组临床总有效率为54.35%,高于对照组的31.82%(P0.05);对照组TTP(5.12±1.04)个月,观察组为(7.91±1.41)个月,观察组TTP长于对照组(P0.05);治疗后观察组症状评分和Kupperman评分低于对照组,KPS评分高于对照组(P0.01);治疗后观察组生理状况、社会家庭情况、情感情况、功能状况和附加关注5个维度评分均低于对照组(P0.01);治疗后观察组CD3~+,CD4~+,CD4~+/CD8~+和NK水平上升,并高于同期对照组(P0.01),CD8~+水平明显降低,并低于对照组(P0.01);对照组化疗导致不良反应程度重于观察组(P0.05)。结论:香贝养荣汤加减方辨治转移性乳腺癌内分泌治疗或(和)化疗的患者,能延长TTP,提高近期实体瘤疗效,能减轻症状、提高患者生活质量和提高免疫功能,并能减轻内分泌和化疗导致的不良反应。

Effect of Modified Xiangbei Yangrong Tang Based on Differentiation in Treating Metastatic Breast Cancer Treated

Objective: To discuss the short-term effect of modified Xiangbei Yangrong Tang based on differentiation and its influence on T-lymphocyte and natural killer cells in treating metastatic breast cancer treated. Method: Ninety patients were divided into control group (44 cases) and observation group (46 cases) by random number table. Patients in control group received endocrine therapy, as well as chemotherapy when necessary. In addition to the therapy of control group, patients in observation group were additionally administered with modified Xiangbei Yangrong Tang based on differentiation. The treatment was end when the disease progressed. Qi-blood deficiency, and accompanied symptoms and Kupperman were scored. Time to progression (TTP) was recorded, quality of life-liver cancer of breast cancer patients (FACT-B) and Keypunch Performance System (KPS) were adopted. Levels of T-lymphocyte and natural killer cells were detected, and adverse reactions were recorded. Result: The effective rate in observation group was 54.35%, which was superior to 31.82%in control group (P<0.05). TTP in control group was (5.12±1.04) mouths, which was lower than (7.91±1.41) in observation group (P<0.05). After treatment, scores of symptoms and Kupperman in observation group were lower than those in control group, but score of KPS was higher than that in control group (P<0.05). After the treatment, scores of physiological status, social and family status, emotional situation, functional status and additional attention in observation group were all lower than those in control group (P<0.01). In observation group, levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺ and NK increased and were higher than those in control group (P<0.01), and level of CD8⁺decreased and was lower than that in control group (P<0.01). Adverse reactions caused by chemotherapy in control group was more serious than in observation group (P<0.05). Conclusion: Modified Xiangbei Yangrong Tang based on differentiation can prolong TTP, promote short-term effects on solid tumor, attenuate symptoms, improve patients'' qualities of live and immune function and relieve adverse reactions caused by endocrine and chemotherapy therapy.