自拟参麦养心汤联合磷酸肌酸对接受CAF化疗方案的乳腺癌患者氧自由基及心脏功能的影响

摘要

目的 观察自拟参麦养心汤联合磷酸肌酸对接受CAF化疗方案的乳腺癌患者氧自由基及心脏功能的影响.方法 将144例乳腺癌患者随机分为观察组72例和对照组72例,2组均给予常规CAF化疗方案,对照组在此基础上给予磷酸肌酸治疗,观察组在对照组治疗基础上给予自拟参麦养心汤治疗,21d为1个疗程,2组均治疗6个疗程;观察2组治疗前及治疗3个疗程、6个疗程血清超氧化物歧化酶(SOD)、总氧化能力(TAC)及丙二醛(MDA)水平和心肌损伤标记物、心脏超声相关指标变化情况;记录2组治疗期间心电图异常率及心脏不良反应发生情况.结果 2组治疗3个疗程、6个疗程血清SOD、TAC均较治疗前明显降低(P均<0.05),血清MAD、肌钙蛋白I(cTnI)、氨基末端B型利钠肽前体(NT-proBNP)水平均明显升高(P均<0.05),但观察组上述指标升高和降低程度均轻于对照组(P均<0.05);2组治疗3个疗程、6个疗程左心室射血分数、左房室瓣舒张早期最大峰值速度及E/A值均显著恶化(P均<0.05),但观察组上述指标均显著优于对照组(P均<0.05);观察组治疗期间心电图异常率显著低于对照组(P<0.05),且治疗期间心悸、气短、胸闷等不良症状的发生率均显著低于对照组(P均<0.05).结论 自拟参麦养心汤联合磷酸肌酸能够有效清除接受CAF化疗方案的乳腺癌患者机体氧自由基及氧化物,减轻心肌损害,保护心肌细胞,从而缓解化疗药物对患者的心脏毒性.%Objective It is to observe the effect of Shenmai Yangxin decoction combined with phosphocreatine on oxygen free radical and cardiac function in patients with breast cancer patients teated with CAF chemotherapy.Methods 144 cases of breast cancer patients were randomly divided into observation group (72 cases) and control group (72 cases).Both groups were given conventional CAF chemotherapy regimens, additionally the control group was treated with phosphocreatine, while the observation group was treated with Shenmai Yangxin decoction plus phosphocreatine.21 d as a period of treatment, both groups were treated for 6 courses.The changes of levels of serum superoxide dismutase (SOD), total oxidation capacity (TAC) and malondialdehyde (MDA) and myocardial injury markers, echocardiographic related indicators before treatment and after 3 and 6 course''s treatment were observed in both groups.The abnormal rate of ECG and the adverse cardiac reaction were recorded in the two groups.Results After three or six cycles of treatment, the levels of serum SOD and TAC were significantly decreased, while that of serum MAD, cTnI and NT-proBNP were significantly increased in both groups(P<0.05), and the decrease or increase of these indexes in observation group were less than that in control group;left ventricular ejection fraction, early diastolic peak velocity of left atrioventricular valve and E/A value were significantly deteriorated in both groups, but these indexes in observation group were superior to the control group (P<0.05).The abnormal rate of ECG and the incidence of heart palpitation, shortness of breath and chest tightness during treatment in observation group were lower than those in the control group (P<0.05).Conclusion Shenmai Yangxin decoction combined with phosphocreatine can effectively clear body oxygen free radicals and oxide, alleviate myocardial damage, protect myocardial cells, so as to alleviate cardiac toxicity of chemotherapy drugs in the patients with breast cancer treated with CAF chemotherapy regimens.