扶正类中药对三阴性乳腺癌新辅助化疗增效减毒的研究  

Effect of Strengthening The Body Chinese Medicine on Effect of Neoadjuvant Chemotherapy on Triple-Negative Breast Cancer

作　　者：祝旭龙 程冲 张菲菲 吴姝涵 蔺光帅 闫柯 田有伏 刘鑫淼 霍斌亮[1] ZHU Xulong;CHENG Chong;ZHANG Feifei;WU Shuhan;LIN Guangshuai;YAN Ke;TIAN Youfu;LIU Xinmiao;HUO Binliang(Shaanxi Provincial People's Hospital,Xi'an 710068,Shaanxi,China;School of Life Science and Technology,Xi'an Jiaotong University,Xi'an 710049,Shaanxi,China)

机构地区：[1]陕西省人民医院,陕西西安710068 [2]西安交通大学生命科学与技术学院,陕西西安710049

出　　处：《中华中医药学刊》2023年第2期85-89,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：吴阶平基金会乳腺肿瘤靶向治疗专项项目(320.6750.2021-10-39);中国临床肿瘤学会北京希思科临床肿瘤学基金项目(Y-L2020-0013);陕西省自然科学基础研究计划项目(2020JQ-936)。

摘　　要：目的探讨扶正类中药对三阴性乳腺癌新辅助化疗增效减毒的临床研究。方法选取陕西省人民医院肿瘤外科2019年1月—2021年6月收治的108例三阴性乳腺癌患者,将其随机分为研究组(58例)和对照组(50例)。对照组行多西他赛+表柔比星+环磷酰胺(TAC)方案,研究组在此基础上加用扶正抑瘤汤。比较两组临床疗效、血清指标、免疫功能、不良反应发生及化疗完成情况。结果化疗后,研究组完全缓解(complete response,CR)22例(37.93%),部分缓解(partial response,PR)25例(43.10%),疾病稳定(stable disease,SD)10例(17.24%),疾病进展(progressive disease,PD)1例(1.72%),对照组CR 14例(28.00%),PR 12例(24.00%),SD 20例(40.00%),PD4例(8.00%),研究组总缓解率(81.03%,47/58)高于对照组(52.00%,26/50)(P<0.05),总有效率(98.28%,57/58)高于对照组(92.00%,46/50),但差异无统计学意义(P>0.05)。化疗前两组红细胞计数(red blood cell count,RBC)、白细胞计数(white blood cell count,WBC)、血小板计数(platelet count,PLT)、血红蛋白(hemoglobin,Hb)指标差异均无统计学意义(P>0.05);化疗后,研究组RBC、WBC、PLT、Hb指标无明显变化(P>0.05),对照组指标明显下降(P<0.05),研究组指标高于对照组(P<0.05)。治疗前两组自然杀伤细胞(natural killer cell,NK)细胞、调节性T细胞(tegulatory T-cells,Treg)、辅助性T细胞17(helper T cells,Th17)以及Treg/Th17比值差异均无统计学意义(P>0.05)。治疗后,研究组NK细胞由(25.68±6.73)%上升到(29.22±7.38)%,Treg由(3.43±0.52)%下降到(1.19±0.46)%,Th17由(2.51±0.53)%上升到(4.12±0.71)%,Treg/Th17比值由(0.68±0.16)上升到(2.52±0.27),变化均有统计学意义(P<0.05)。对照组NK、Th17以及Treg/Th17比值下降(P<0.05),Treg上升(P<0.05)。治疗后研究组NK、Th17细胞比例以及Treg/Th17比值均高于对照组(P<0.05),Treg细胞比例低于对照组(P<0.05)。在化疗期间,两组均发生了白细胞减少、中性粒细胞减少、血小板减少、上消化道反应Objective To study the synergism and attenuation effects of strengthening the body Chinese medicine on triple neg⁃ative breast cancer receiving neoadjuvant chemotherapy.Methods A total of 108 patients with triple negative breast cancer admit⁃ted to the Department of Tumor Surgery of Shaanxi Provincial People's Hospital from January 2019 to June 2021 were randomly enrolled,and classified into study group(58 cases)and control group(50 cases).The control group received the Docetaxel/Epi⁃rubicin/Cyclophosphamide(TAC)regimen,based on this,the study group received Fuzheng Yiliu Decoction(扶正抑瘤汤).The clinical efficacy,serum indexes,immune function,occurrence of adverse reactions and completion of chemotherapy were compared between the two groups.Results The complete response(CR),partial response(PR),stable disease(SD)and progressive disease(PD)rates were 37.93%(22/58),43.10%(25/58),17.24%(10/58)and 1.72%(1/58)in the study group,which were sig⁃nificantly higher than 28.00%(14/50),24.00%(12/50),40.00%(20/50)and 8.00%(4/50)in the control group.The total remission rate was 81.03%in the study group,which were significantly higher than 52.00%in the control group.The efficacy rate was 98.28%(57/58)in the study group,which was slightly higher than 92.00%(46/50)in the control group,with no sta⁃tistical difference(P>0.05).The values of red blood cell count(RBC),white blood cell count(WBC),platelet count(PLT)and hemoglobin(Hb)at the baseline manifested no significant difference between two groups(P>0.05).After chemotherapy,the values of RBC,WBC,PLT and Hb had no significant changes in the study group(P>0.05),while were significantly de⁃creased in the control group(P<0.05),and so the values of RBC,WBC,PLT and Hb were significantly higher in the study group than those in the control group(P<0.05).NK cells,Treg cells,Th17 cells and Treg/Th17 ratio at the baseline demonstrated no significant difference between two groups(P>0.05).Within the study group after chemotherapy,NK cells increased from(25.68±6.73)%to(29.2

关 键 词：三阴性乳腺癌 增效减毒 新辅助化疗 扶正抑瘤汤 恶性肿瘤 

分 类 号：R273.379[医药卫生—中西医结合]