三黄煎剂对乳腺癌患者机体慢性应激状态及血液黏稠状态的改善作用

目的：观察三黄煎剂改善乳腺癌患者内分泌治疗期间血液粘稠与提高生活质量功效。方法：临床入组90例患者,随机分为治疗组与对照组各45例,对照组予以内分泌治疗,治疗组在对照组基础上,予以三黄煎剂口服,3个月一个疗程,共2个疗程。每月记录1次生活质量量表(QLQ-BR23);在治疗前后测定血清学相关指标：（1）血液流变学：全血粘度、血浆粘度;（2）凝血：Ｄ－二聚体（D-D）（3）血脂代谢：甘油三酯脂（ＴＧ）、总胆固醇（ＴＣ）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）;（4）机体氧化应激指标：血清丙二醛( MDA) 、超氧化物歧化酶( SOD) 、一氧化氮（NO）、谷胱甘肽过氧化物酶（GSH-p）;（5）乳腺癌相关肿瘤标记物：癌胚抗原（CEA）、糖类抗原153（CA153）。结果：治疗组患者生活质量明显提高,积分较治疗前下降约三分之一左右,与对照组有显著差异。服用三黄煎剂后,全血粘度与D-二聚体水平显著下降,血脂水平明显改善;治疗组氧化应激指标NO及MDA分别下降了将近1/2及2/3,抗氧化应激SOD与GSH-PX分别上升了2/3与1.5倍,治疗组CEA水平由治疗前的1.85ng/ml降至1.06ng/ml,各指标与对照组比较,均取得了极其显著统计学差异。结论：三黄煎剂改善乳腺癌患者内分泌治疗期间血液粘稠微环境同时,减少机体慢性应激改善血脂代谢;提高患者生活质量,有利于内分泌长期治疗的顺利进行。

Study on the effect of Sanhuang Decoction on chronic stress and blood viscosity of breast cancer patients

[Abstract]Objective: to observe the effect of SHD on ameliorating blood viscosity and improving quality of life in breast cancer patients during endocrine therapy. Methods:Clinical 90 cases were randomly enrolled into treatment and control group with 45 cases of each. The control group received endocrine therapy only, and SHD were orally plus based on the treatments of the control group in the treatment group.The quality of life scale(QLQ-BR23) once a month was recorded. Serology-related indexes were measured before and after treatment which included (1) hemorheology: whole blood viscosity, plasma viscosity; (2) blood coagulation: d-dimer (3) blood lipid metabolism: triglyceride lipid (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c);(4) indicators of oxidative stress: malondialdehyde (MDA), superoxide dismutase (SOD), nitric oxide (NO), glutathione peroxidase (GSH-PX); (5) breast cancer-related tumor markers: CEA and CA153. Results: The QLQ-BR23 scores of the patients in the treatment group was significantly decreased by about one-third compared with that before treatment, reached to significantly different from that in the control group only 1 month after treatment. The whole blood viscosity and d-dimer level decreased significantly as well as the blood lipid level improved significantly. The oxidative stress indexes of NO and MDA in the treatment group decreased by nearly 1/2 and 2/3 respectively company with the antioxidant stress SOD and GSH-PX increased to 2/3 and 1.5 times respectively. The CEA level in the treatment group decreased from 1.85ng/ml to 1.06ng/ml with significantly decreased with the levels in the control group. Conclusions: The blood microenvironment of thickness as well as blood lipid metabolism were improved accompany with ameliorating chronic stress and the improvement the quality of life in patients under endocrine treatment with the treatment of SHD and may give the help of long-term endocrine treatment compliance.