生脉散加味对乳腺癌接受含蒽环类药物化疗患者的心脏保护作用  

Protective Effect of Modified Shengjiang Powder on Cardiotoxidty in Breast Cancer Patients Who Received Anthracycline-Containing Chemotherapy

作　　者：张新峰 乔翠霞[2] 程旭锋[3] 刘琦[3] 高启龙 王怀璋 杨峰 

机构地区：[1]郑州大学附属肿瘤医院中西医科,河南郑州450008 [2]河南省中医药研究院,河南郑州450008 [3]河南中医药大学,河南郑州450008

出　　处：《辽宁中医杂志》2016年第11期2307-2310,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81603469;U1304822);河南省医学科技攻关计划项目(201304099);河南省科技攻关项目(162102310331);河南省基础与前沿技术研究(132300410042;152300410240)

摘　　要：目的:探讨生脉散加味对乳腺癌患者应用蒽环类抗肿瘤药物化疗中出现的心脏毒性的防治作用及安全性。方法:45例乳腺癌患者,随机分为实验组和对照组;对照组单用TAC方案化疗,生脉组除给予TAC方案化疗外,还给予生脉散加味口服治疗。观察两组患者化疗前后的心电图(ECG)、左室射血分数(LVEF)、肌酐蛋白T(c Tn T)、脑钠肽(BNP)、化疗骨髓抑制和化疗消化道反应的变化。结果:随着化疗次数的增加,对照组和生脉组患者的LVEF均呈下降趋势、心电图、c Tn T、BNP的异常改变率均呈上升趋势(P<0.05,P<0.01);与对照组比较,生脉组化疗4周期及化疗6周期LVEF均明显升高,生脉组化疗6周期心律失常和ST-T段、c Tn T及BNP异常改变率均明显降低(P<0.05,P<0.01),且生脉组患者白细胞减少、中性粒细胞减少、血小板减少及食欲减退的发生率均明显减少(P<0.05)。结论:生脉散加味可明显降低蒽环类药物化疗方案(TAC)患者的心脏毒性,并可减轻化疗药物的部分骨髓抑制及消化道反应。Objective：To evaluate the cardioprotective effects of Modified Shengjiang Powder on female breast cancer patients who received anthracycline - containing chemotherapy. Methods ： Forty - five patients with breast cancer were randomly divided into the control group and the Modified Shengmai Powder group. The control group only received chemotherapy by regimen of docetaxel, doxorubicin and cyclophosphamide （TAC）. The Modified Shengmai Powder group received chemotherapy by TAC regimen and Modified Shengiiang Powder. Electrocardiogram（ ECG）, LVEF, cTnT, BNP and the diverse reactions of chemotherapy drugs on bone marrow and gastrointestinal tract were observed before and after chemotherapy. Results ： LVEF was decreased and the frequency of abnormalities of ECG, cTnT and BNP increased with the prolongation of chemotherapy in the Modified Shengjiang Powder group and control group（P 〈 0.05 ,P 〈 0. 01 ）. Compared with the controls, LVEFs of the Modified Shengjiang Powder group increased after four and six cycles of chemotherapy and the frequencies of arrhythmia, abnormalities on ST - T cTnT and BNP were decreased after six cycles of chemotherapy （ P 〈 0. 05, P 〈 0. 01 ） and the frequencies of leukopenia, neutrophilic, thrombocytopenia and anorexia decreased significantly（P 〈 0. 05）. Conclusion：Modified Shengjiang Powder could be used to reduce the cardiac toxicity, partial adverse reactions on bone marrow suppression and gastrointestinal reaction by anthracycline regimen.

关 键 词：心脏毒性 乳腺癌 蒽环类抗肿瘤药物 生脉散加味 

分 类 号：R737.9[医药卫生—肿瘤]