扶正消岩汤联合 NP 方案治疗复发转移性乳腺癌

摘要

目的：观察扶正消岩汤联合 NP 方案治疗复发转移性乳腺癌的临床疗效。方法将复发转移性乳腺癌70例患者随机分为2组，对照组（35例）予 NP 方案化疗为主治疗，治疗组（35例）在 NP 方案基础上加服扶正消积汤。观察2组治疗前后症状积分、化疗后毒副反应、免疫指标、肿瘤标志物、KPS 积分及生活质量变化情况、实体瘤疗效情况等。结果治疗组除失眠健忘、手足麻木及肝肾功损害改善程度与对照组差异无统计学意义外（P >0.05），余症状改善程度及骨髓抑制发生率均明显优于对照组（P <0.05）；尤其恶心呕吐、食欲下降改善具有统计学意义（P <0.01）。治疗组 CD3＋、CD4＋、CD4＋/ CD8＋、Nk 细胞改善率均明显优于对照组，且差异有统计学意义（P <0.05）；2组 B 细胞阳性率前后对比无统计学意义（ P >0.05）。治疗后2组 CEA、CA153、CA125数值较前均降低，但治疗组明显优于对照组，且差异有统计学意义（P <0.05）。治疗后2组 KPS积分分别为（89.118±4.125）（78.371±3.663），说明治疗组在改善 KPS 积分方面明显优于对照组（ P <0.01）；2组生活质量（提高＋稳定）率分别为91.2%、68.6%，治疗组亦明显优于对照组（P <0.01）。实体瘤疗效评价标准情况比较，2组有效率（ RR）分别为41.18%、14.29%，疾病控制率（ DCR）分别为97.06%、91.43%，治疗组在 RR 方面明显优于对照组（P <0.05），而 DCR 方面2组差异无统计学意义（P >0.05）。结论扶正消岩汤联合 NP 方案治疗复发转移性乳腺癌，在增强化疗效果，减轻化疗毒副反应，增强免疫，降低肿瘤标志物，提高患者生活质量等方面疗效显著。%Objective To observe the clinical effect of the treatment of recurrent and metastatic breast cancer by the combination of NP and FZXYT. Methods The 70 patients with recurrent metastatic breast cancer were randomly divided into two groups,the control group(35 cases)were treated with NP regimen chemotherapy,and the treatment group(35 cases)were treated with NP regimen and FZXYT. To observe the symptom score,side effect,immune in-dex,tumor marker,score,KPS score,and the effect of solid tumor before and after treatment. Results There was no significant difference between treatment group and control group except for insomnia,hand and foot numbness,and liv-er and kidney damage(P > 0. 05);and the improvement of other symptoms and bone marrow suppression were signifi-cantly better than those in control group(P < 0. 05). In particular,nausea and vomiting,loss of appetite were particu-larly significant difference(P < 0. 01). In the treatment group,CD3 + ,CD4 + / CD8 + ,CD4 + ,Nk cells were significant-ly better than those in the control group,and the difference was significant( P < 0. 05);there were no significant difference between two groups of B cells positive rate before and after comparison(P > 0. 05). The CA153,CA125 and CEA values in the two groups were significantly lower than those in the control group,but the treatment group was sig-nificantly better than that in the control group,and the difference was significant(P < 0. 05). The KPS score of two groups after treatment were 89. 118 4. 125 and 78. 371 3. 663,which showed that the treatment group was significantly better than the control group(P < 0. 01);the quality of life in the two groups was 91. 2% and 68. 6% ,and the treat-ment group was significantly better than that of the control group(P < 0. 01). The effect of solid tumor was compared with that of the two groups( RR),41. 18% and 14. 29% respectively. The control rate of disease( DCR)was 97. 06% and 91. 43% ,respectively. The treatment groupˊs RR was significantly better than that in control group(P <0. 05),while the difference between the two groupsˊ DCR were not significant(P > 0. 05). Conclusion The treat-ment of recurrent and metastatic breast cancer with the combination of NP and FZXYT,is worthy of further study and clinical application in enhancing the effect of chemotherapy,reducing side effects of chemotherapy,enhancing immuni-ty,reducing tumor markers,improving the quality of life of patients.