疏肝健脾益肾汤联合化疗对晚期肝郁脾虚型乳腺癌患者血清炎性因子及肿瘤标志物的影响

doi:10.3969/j.issn.2095-1264.2022.06.15

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疏肝健脾益肾汤联合化疗对晚期肝郁脾虚型乳腺癌患者血清炎性因子及肿瘤标志物的影响
DOI:
                        10.3969/j.issn.2095-1264.2022.06.15
                    
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作者单位:1.烟台市烟台山医院 乳腺外科，山东 烟台，264001;2.深圳市中医院 乳甲外科，广东 深圳，518033
作者简介:李淑艳，女，硕士研究生，主治医师，研究方向：乳腺癌综合诊治。
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中图分类号:R737.9
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Effects of Shugan Jianpi Yishen decoction combined with chemotherapy on serum inflammatory factors and tumor markers of advanced breast cancer patients with liver stagnation and spleen deficiency

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Affiliation:

1.Department of Breast Surgery, Yantaishan Hospital, Yantai, 264001, Shandong, China;2.Department of Breast Surgery, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, 518033,Guangdong, China

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摘要:

目的探讨疏肝健脾益肾汤联合化疗对晚期肝郁脾虚型乳腺癌患者血清炎性因子及肿瘤标志物的影响。方法选择2017年7月—2018年6月烟台市烟台山医院收治的晚期肝郁脾虚型乳腺癌患者120例为研究对象，采用随机数字表法分为观察组62例、对照组58例。对照组采用GP方案（吉西他滨+顺铂）化疗，观察组在对照组的基础上联合疏肝健脾益肾汤，两组均治疗18周。比较两组患者中医症状临床疗效、实体瘤临床疗效、血清炎性因子、肿瘤标志物、毒副反应等指标。结果治疗后，观察组中医证候积分（8.43±1.35）显著低于对照组（12.52±2.45）（P<0.05），有效率（82.86%）明显高于对照组（60.34%）（P<0.05），缓解率（58.06%）明显高于对照组（39.66%）（P<0.05）；观察组血清白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、超敏C反应蛋白（hs-CRP）水平均显著低于对照组［（28.32±4.34） μg·L^-1 vs. （35.45±5.12） μg·L^-1、（76.45±9.21） pg·L^-1 vs. （82.35±9.54） pg·L^-1、（5.45±0.78） mg·L^-1 vs. （7.12±1.24） mg·L^-1； P<0.05］；观察组血清癌胚抗原（CEA）、糖类抗原125（CA125）、CA15-3水平均显著低于对照组［（6.45±1.12） ng·mL^-1 vs. （10.24±1.4） ng·mL^-1、（22.32±4.12） U·mL^-1 vs. （28.65±5.20） U·mL^-1、（18.45±3.65） U·mL^-1 vs. （24.74±4.32） U·mL^-1； P<0.05］；观察组Ⅲ-Ⅳ级白细胞减少、血小板减少、恶心呕吐的发生率（15.52%、9.68%、11.29%）均明显低于对照组（31.03%、24.14%、53.45%）（P<0.05）。结论疏肝健脾益肾汤联合化疗有助于提高晚期肝郁脾虚型乳腺癌患者的临床疗效，减轻毒副反应，可能与抑制炎症反应、降低血清肿瘤标志物水平等因素有关。

Abstract:

Objective To explore the effects of Shugan Jianpi Yishen decoction combined with chemotherapy on the serum inflammatory factors and tumor markers of advanced breast cancer patients with liver stagnation and spleen deficiency.Methods A total of 120 advanced breast cancer patients with liver stagnation and spleen deficiency admitted in Yantaishan Hospital between July 2017 and June 2018 were selected as the research subjects. They were divided into the observation group (n=62) and the control group (n=58) according to the random number method. The control group was given GP regimen chemotherapy (gemcitabine + cisplatin), and the observation group was additionally given Shugan Jianpi Yishen decoction on the basis of the control group. The traditional Chinese medicine (TCM) syndrome scores and clinical effects, response rate in solid tumor, serum inflammatory factors, tumor markers and toxic and side effects were recorded and compared between the two groups after 18 weeks of treatment.Results After treatment, the TCM syndrome score of the observation group (8.43±1.35) was significantly lower than that of the control group (12.52±2.45) (P<0.05), and the effective rate of the observation group (82.86%) was significantly higher than that of control group (60.34%) (P<0.05). The remission rate of the observation group (58.06%) was also significantly higher than that of the control group (39.66%) (P<0.05). The serum levels of IL-6, TNF-α, and hs-CRP were significantly lower than those of the control group [(28.32±4.34) μg·L^-1 vs. (35.45±5.12) μg·L^-1, (76.45±9.21) pg·L^-1vs. (82.35±9.54) pg·L^-1, (5.45±0.78) mg·L^-1 vs. (7.12±1.24) mg·L^-1; P<0.05]. The serum levels of CEA, CA125 and CA15-3 were also significantly lower than those of the control group [(6.45±1.12) ng·mL^-1 vs. (10.24±1.4) ng·mL^-1, (22.32±4.12) U·mL^-1 vs. (28.65±5.20) U·mL^-1, (18.45±3.65) U·mL^-1 vs. (24.74±4.32) U·mL^-1; P<0.05]. The incidence rates of white blood cells reduction, thrombocytopenia, nausea and vomiting were significantly lower in the observation group (respectively 15.52%, 9.68%, 11.29%) than in the control group (respectively 31.03%, 24.14%, 53.45%) (P<0.05).Conclusion Shugan Jianpi Yishen decoction combined with chemotherapy helps to improve the clinical efficacy of advanced breast cancer patients with liver stagnation and spleen deficiency, and reduce the toxic and side effects. Such effects may be related to its suppression on inflammatory responses and levels of tumor markers.