养心消瘤汤辅助Her-2阴性Luminal B型乳腺癌患者术后化疗综合疗效及对血清肿瘤标志物水平的影响

摘要

目的观察养心消瘤汤辅助Her-2阴性Luminal B型乳腺癌术后化疗的综合疗效及对患者血清肿瘤标志物水平的影响.方法将60例Her-2阴性Luminal B型乳腺癌术后患者按照随机数字表法分为2组.对照组30例予表柔比星联合紫杉醇化疗, 治疗组30例在对照组治疗基础上加养心消瘤汤治疗, 2组均3周为1个疗程, 共治疗6个疗程.比较2组治疗前后血清肿瘤标志物癌胚抗原 (CEA) 、糖类抗原125 (CA125) 、CA153及肿瘤坏死因子α (TNF-α) 水平, 中医证候积分、生活质量变化情况;统计比较2组治疗过程中不良反应发生率及治疗后临床疗效.结果治疗组总有效率96.67％, 对照组为76.67％, 治疗组总有效率高于对照组 (P＜0.05).2组治疗后血清CEA、CA125、CA153及TNF-α水平均较本组治疗前降低 (P＜0.05), 且治疗组低于对照组 (P＜0.05).2组治疗后中医证候积分均较本组治疗前降低 (P＜0.05), 且治疗组低于对照组 (P＜0.05).治疗后, 治疗组乳腺癌患者生命质量测定量表 (FACT-B) 各领域评分及总量表得分升高 (P＜0.05), 对照组降低 (P＜0.05), 且治疗组高于对照组 (P＜0.05).治疗组中性粒细胞减少、血小板减少、贫血、脱发及恶心呕吐发生率低于对照组 (P＜0.05).结论养心消瘤汤辅助Her-2阴性Luminal B型乳腺癌术后化疗疗效显著, 可明显改善患者症状, 降低血清肿瘤标志物水平, 减少不良反应, 提高生活质量.%Objective To observe the clinical effects of Yangxin Xiaoliu decoction on postoperative chemotherapy and its effect on tumor markers in Her-2 negative Luminal B breast cancer patients. Methods 60 patients with Her-2 negative Luminal B breast cancer were divided into two groups according to the random number table method. 30 cases in control group were treated by epirubicin plus paclitaxel chemotherapy. 30 cases in treatment group were treated by Yangxin Xiaoliu decoction on the basis of control group. Both groups were treated for 3 weeks as a course of treatment, a total of 6 courses of treatment. The levels of serum carcinoembryonic antigen ( CEA), carbohydrate antigen 125 ( CA125), CA153 and tumor necrosis factor-α ( TNF-α) were compared before and after treatment in the two groups, and the changes of TCM syndrome scores and quality of life were compared. The incidence of adverse reactions during treatment and the clinical efficacy after treatment in the two groups were compared.Results The total effective rate was 96. 67％ in treatment group and 76. 67％ in control group. The clinical curative effect of the treatment group was better than that of the control group ( P ＜ 0. 05). The levels of serum tumor markers CEA, CA125 and CA153 and TNF-α levels in the two groups were lower than those in the group before treatment ( P＜ 0. 05), and the treatment group was lower than the control group ( P ＜ 0. 05). The scores of TCM syndromes in the two groups were lower than those in the group before treatment ( P ＜ 0. 05), and the treatment group was lower than the control group ( P ＜ 0. 05). After treatment, the FACT-B for patients with breast cancer score of the treatment group was increased ( P ＜ 0. 05), and the FACT-B for patients with breast cancer score of the control group was decreased ( P ＜ 0. 05), and the treatment group was higher than the control group ( P ＜ 0. 05). The incidence of neutropenia, thrombocytopenia, anemia, alopecia and nausea and vomiting in the treatment group was lower than that in the control group ( P ＜ 0. 05). Conclusion Yangxin Xiaoliu decoction is effective in the treatment of Her-2 negative Luminal B breast cancer. It can significantly improve the symptoms of patients, reduce the level of serum tumor markers, reduce the incidence of adverse reactions and improve the quality of life.