自拟扶正祛邪解毒方结合常规化疗对乳腺癌术后复发转移、生活质量的影响

目的：探讨自拟扶正祛邪解毒方结合常规化疗对乳腺癌术后患者的复发转移、生活质量的影响。方法将符合入选标准的144例乳腺癌术后患者，依据治疗方法分为中药结合组86例和化疗组58例，化疗组采用常规CTF化疗方案(环磷酰胺＋吡柔比星＋5-氟尿嘧啶)，中药结合组在化疗组的基础上加服自拟扶正祛邪解毒方，疗程为6个月。比较2组5年转移复发率、中医证候积分，采用SF-36量表评价生活质量，采用Logistic回归分析评价转移复发的危险因素。结果中药结合组5年转移复发率为11.63%(10/86)，化疗组为25.86%(15/58)，2组比较差异有统计学意义(χ2＝4.892，P＝0.027)。治疗后，中药结合组 SF-36量表中躯体状况[(72.11±10.41)分比(64.59±9.83)分， t＝3.252]、社会功能[(65.61±12.54)分比(58.94±11.62)分，t＝3.302]、躯体角色功能[(55.84±10.65)分比(47.46±9.18)分， t＝3.487]、躯体疼痛[(66.62±12.53)分比(60.68±11.76)分，t＝2.859]、心理健康[(67.64±11.35)分比(62.65±12.10)分， t＝3.449]、情绪角色功能[(60.44±9.20)分比(55.04±9.44)分， t＝2.624]、精力[(69.77±9.43)分比(62.47±10.12)分，t＝3.557]、一般健康状况[(68.46±10.25)分比(62.45±11.78)分， t＝3.216]8个维度评分均较化疗组明显增加(P＜0.05)。Logistic 回归分析显示影响转移复发的危险因素有TNM分期(OR＝1.984，95%CI 1.510～2.607)、肿瘤大小(OR＝2.015，95%CI 1.426～2.847)、腋窝淋巴结(+)个数(OR＝2.114，95%CI 1.620～2.759)、中医辅助化疗(OR＝0.389，95%CI0.235～0.644)和CD4/CD8(OR＝0.487，95%CI 0.317～0.748)。结论自拟扶正祛邪解毒方结合常规化疗可明显降低乳腺癌术后患者远期转移复发率、提高生活质量和改善临床症状。

Effect of self-designedFuzheng-Quxie-Jiedu decoction combined with chemotherapy on breast cancer

ObjectiveTo study the effect of self-designedFuzheng-Quxie-Jiedu decoction on transferring, relapse and liver quality of breast cancer patients after operation.Methods144 breast cancer patients after operation were divided into a study group and a control group. The control group was treated with CTF chemotherapy, and the study group was additionally treated with Chinese medicine. Both groups were treated for for 6 months. The 5-year recurrent rate and TCM syndrome scoring of the two groups were compared. The QOL was evaluated by SF-36 scale, and the related risk factors were tested by Logistic analysis. ResultsAfter treatment, the 5-year transferring recurrent rate of the study group lower than the control group (11.63%vs. 25.86%,χ2=4.892,P=4.892). The SF-36 scale body condition (72.11 ± 10.41 vs. 64.59 ± 9.83, t=3.252), social function (65.61 ± 12.54 vs. 58.94 ± 11.62,t=3.302), body role function (55.84 ± 10.65 vs. 47.46 ± 9.18,t=3.487), body pain (66.62 ± 12.53 vs. 60.68 ± 11.76,t=2.859), mental health (67.64 ± 11.35 vs. 62.65 ± 12.10,t=3.449), emotional role function (60.44 ± 9.20 vs. 55.04 ± 9.44),t=2.624), (69.77 ± 9.43 vs. 62.47 ± 10.12,t=3.557), and general health status (68.46 ± 10.25 vs. 62.45 ± 11.78,t=3.216) in the study group were all significantly increased comparing with the control group (P < 0.05). Results of logistic regression analysis showed that the transferring risk factors for recurrence were TNM staging (OR=1.984, 95%CI 1.510-2.607) and tumor size (OR=2.015, 95% CI2.015-2.847), the number of axillary lymph nodes (+) (OR=2.114, 95%CI 2.114-2.759), Chinese medicine adjuvant chemotherapy (OR=0.389, 95% CI0.235-0.644) and CD4/CD8 (OR=0.487, 95%CI 0.487-0.748).ConclusionSelf-designedFuzheng-Quxie-Jiedu decoction combined with standard chemotherapy can obviously reduce the recurrent rate of the postoperative patients with breast cancer, improve the quality of life and improve the clinical symptoms.