茵陈蒿汤加减治疗乳腺癌化疗肝损伤的临床研究

目的 观察茵陈蒿汤加减对乳腺癌化疗所致肝损伤（肝胆湿热证）患者中医证候评分、肝功能、炎症因子及氧化应激反应指标的影响。方法 选择乳腺癌化疗所致肝胆湿热型肝损伤患者86例进行研究。采用随机法将患者分为两组，每组各43例。对照组参照《药物性肝损伤诊治指南》给予常规治疗，观察组在此基础上加以茵陈蒿汤加减治疗。比较两组患者临床疗效、中医证候评分、肝功能指标、炎症因子、氧化应激反应及不良反应发生情况。结果 观察组总有效率为93.02%，高于对照组的76.74%(P <0.05)。治疗后两组患者中医证候主证积分与次证积分均明显下降，但观察组下降幅度更大（P <0.05）。治疗后两组患者AST、ALT及TBIL水平均明显下降，但观察组下降幅度更大（P <0.05）。治疗后两组患者超敏C反应蛋白、白细胞介素-6及肿瘤坏死因子-α水平均明显下降，但观察组下降幅度更大（P <0.05）。对照组共出现4例（9.30%）不良反应，与观察组的5例（11.63%）差异无统计学意义（P> 0.05）。治疗后两组患者超氧化物歧化酶、谷胱甘肽过氧化物酶水平均明显升高，但观察组升高幅度更大（...

Observation of the Curative Effect of Yinchenhao Decoction on Patients with Liver Injury,Caused by Chemotherapy of Breast Cancer

Objective:To explore the effect of Yinchenhao Decoction on TCM syndrome scores,liver function,inflammatory factors and oxidative stress indicators in patients with liver injury and liver and gallbladder damp-heat syndrome caused by breast cancer chemotherapy.Methods:A total of 86 patients with liver and gallbladder damp-heat liver injury caused by breast cancer chemotherapy were selected for research.The patients were divided into 2 groups by randomization,43 cases in each group.The control group was given conventional treatment according to the"Guidelines for the Diagnosis and Treatment of Drug-induced Liver Injury"in 2017,and the observation group was treated with Yinchenhao Decoction on this basis.The clinical efficacy,TCM syndrome score,liver function indicators,inflammatory factors,oxidative stress and adverse reactions were compared between the two groups of patients.Results:The total effective rate of the observation group was 93.02%,which was higher than76.74%of the control group(P<0.05).After treatment,the scores of the main syndromes and the scores of the secondary syndromes of the two groups of patients were significantly decreased,but the decline in the observation group was greater(P<0.05).After treatment,the AST,ALT and TBIL levels of the two groups of patients decreased significantly,but the decrease in the observation group was greater(P<0.05).After treatment,the levels of hs-CRP,IL-6 and TNF-αdecreased significantly in the two groups,but the decrease in the observation group was greater(P<0.05).A total of 4 cases(9.30%)in the control group had adverse reactions,which was not significantly different from 5 cases(11.63%)in the observation group(P>0.05).After treatment,the levels of superoxide dismutase and glutathione peroxidase in the two groups were significantly increased,but the increase in the observation group was even greater(P<0.05).Conclusion:Yinchenhao Decoction on the basis of conventional western medicine treatment can effectively improve the clinical efficacy of breast cancer patients with liver injury caused by chemotherapy,liver and gallbladder dampness heat syndrome,and improve the score of TCM syndrome.Its mechanism may be related to improving liver function,alleviating inflammatory reaction and oxidative stress reaction.