复康灵治疗三阴性乳腺癌新辅助化疗患者的临床观察  

Clinical Application of Fukangling in Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer Based on MP Grade

作　　者：林森[1] 王强[1] 唐瑞俊 梁云[3] LIN Sen;WANG Qiang;TANG Rui-jun;LIANG Yun(Galactophore Department,Guilin Municipal Hospital of Traditional Chinese Medicine,Guilin Guangxi 541001;Department of Pathology,Guilin Municipal Hospital of Traditional Chinese Medicine,Guilin Guangxi 541001;Depatment of Radiology,Guilin Municipal Hospital of Traditional Chinese Medicine,Guilin Guangxi 541001)

机构地区：[1]广西桂林市中医医院乳腺科,广西桂林541001 [2]广西桂林市中医医院病理科,广西桂林541001 [3]广西桂林市中医医院放射科,广西桂林541001

出　　处：《世界中西医结合杂志》2023年第1期157-163,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：广西壮族自治区中医药管理局自筹经费科研课题(GXZYZ20210202)。

摘　　要：目的探究中药复康灵对三阴性乳腺癌新辅助化疗的脾胃虚弱型患者的临床疗效、病理、化疗不良反应及中医症状的影响。方法选取2015年12月—2021年12月期间广西桂林市中医医院收治的三阴性乳腺癌且新辅助化疗的脾胃虚弱型患者120例,按照随机数字表法分为对照组和观察组,每组各60例。对照组单纯使用Tcb(多西他赛+卡铂(docetaxel+carboplatin))方案化疗;治疗组给予TCb方案化疗同时使用中药复康灵。治疗6个周期后,观察比较两组患者病理MP(Miller&Payne,MP)分级标准的改善率、血清内分泌激素[雌二醇(Estradiol,E2)、黄体酮(Progesterone,P)、泌乳素(Prolactin,PRL)]水平、骨髓抑制、中医症状量表评分及临床缓解率。结果治疗后治疗组疾病控制率96.67%(58/60)高于对照组91.67%(55/60),差异有统计学意义(P<0.05)。治疗后两组患者病理MP改善率显示,治疗组病理总改善率58.33%(35/60)高于对照组51.67%(31/60),差异有统计学意义(P<0.05);MP5级(Pcp)率显示,治疗组38.34%(23/60)优于对照组30%(18/60),差异有统计学意义(P<0.05)。治疗后两组患者血清E2和PRL水平较治疗前降低,血清P水平较治疗前升高,差异有统计学意义(P<0.05);且治疗组血清E2和PRL水平低于对照组,血清P水平高于对照组,差异有统计学意义(P<0.05)。治疗后治疗组中性粒细胞、白细胞、血小板、血红蛋白的发生率均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者中医症状量表积分较治疗前降低,差异有统计学意义(P<0.05);且治疗组低于对照组,差异有统计学意义(P<0.05)。结论中药复康灵在三阴性乳腺癌新辅助化疗后脾胃虚弱型患者的应用,能改善临床缓解率、病理MP分级、中医症状,降低化疗后Ⅳ度骨髓抑制发生。Objective To explore Fukangling in neoadjuvant chemotherapy for triple-negative breast cancer patients of spleen-stomach weakness syndrome and to investigate the effect on the clinical conditions,pathological changes,adverse reactions,and traditional Chinese medicine(TCM)symptoms of the patients.Methods A total of 120 triple-negative breast cancer patients of spleen-stomach weakness syndrome who were treated by neoadjuvant chemotherapy in Guilin Municipal Hospital of Traditional Chinese Medicine from December 2015 to December 2021 were included and randomized into the observation group(n=60)and the control group(n=60).The control group was treated by the Tcb(docetaxel+carboplatin)chemotherapy regimen,and the observation group was applied with the Tcb regimen and Fukangling.After 6 cycles of chemotherapy,the Miller-Payne(MP)grade-based pathological remission rate,serum levels of endocrine hormones[estradiol(E2),progesterone(P),prolactin(PRL)],myelosuppression,TCM syndrome score and clinical remission rate were compared between the two groups.Results After the 6 cycles of chemotherapy,the disease control rate was 96.67%(58/60)in the observation group,higher than that 91.67%(55/60)in the control group(P<0.05).After treatment,the MP-based pathological remission rate in the observation group(58.33%,35/60)was higher than that in thecontrol group(51.67%,31/60)(P<0.05),and percentage of patients with MP5(Pcp)was higher in the observation group(38.34%,23/60)than that in the control group(30%,18/60)(P<0.05).After treatment,serum levels of E2 and PRL were lower than those before treatment and the level of P was higher than that before treatment in both groups(P<0.05).In addition,the levels of E2 and PRL were lower in the observation group than in the control group,and the level of P was higher in the observation group than that in the control group(P<0.05).After the chemotherapy,the incidence of low levels of neutrophils,white blood cells,platelets,and hemoglobin was lower in the observation group than those in the control

关 键 词：三阴性乳腺癌 复康灵 新辅助化疗 临床缓解率 

分 类 号：R737.9[医药卫生—肿瘤]