温阳益气法干预蒽环类化疗药物心脏毒性的研究  

Study on the intervention of therapy for warming yang and supplementing qi on cardiotoxicity of anthracycline chemotherapy drugs

作　　者：解晓青 陈玉 李洁 XIE Xiaoqing;CHEN Yu;LI Jie(Qingdao Hospital of Traditional Chinese Medicine/Qingdao Haici Hospital,Qingdao 266033,Shandong,China;Qingdao Sida Heart Hospital,Qingdao 266000,Shandong,China)

机构地区：[1]青岛市中医医院/青岛市海慈医院,山东青岛266033 [2]青岛思达心脏医院,山东青岛266000

出　　处：《现代中西医结合杂志》2023年第6期786-791,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：青岛市中医药科研计划课题(2020-zyy008)。

摘　　要：目的探讨温阳益气法对蒽环类化疗药物心脏毒性的干预效果。方法选择2019年10月-2021年10月青岛市中医医院收治的88例使用蒽环类化疗药物(多西他赛+表柔比星+环磷酰胺)治疗2个周期后致心脏毒性患者,随机分成对照组和观察组,2组均继续采用原方案化疗2个周期,于化疗第1天开始口服辅酶Q10,对照组不予其他干预,观察组则同时予温阳益气方口服,直至化疗结束。观察比较2组入组时和继续化疗2个周期后中医证候评分(胸闷、胸痛、心悸、畏寒肢冷、下肢水肿)、心肌损伤相关指标[肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、B型钠尿肽(BNP)]、心功能指标[左室射血分数(LVEF)]、生活质量评分(EORTC QLQ-C30),记录2组继续化疗2个周期后心电图异常发生情况、临床总有效率及不良反应发生情况。结果继续化疗2个周期后,观察组胸闷、胸痛、心悸、畏寒肢冷、下肢水肿评分均明显低于入组时及同期对照组(P均<0.05),对照组各项评分与入组时比较差异均无统计学意义(P均>0.05);2组心功能及心肌损伤指标与入组时比较虽有改善,但差异均无统计学意义(P均>0.05);观察组角色功能、躯体功能、情绪功能、社会功能、认知功能及总体生活质量评分均明显高于入组时及同期对照组(P均<0.05),对照组各项生活质量评分与入组时比较差异均无统计学意义(P均>0.05);观察组心电图异常总发生率与入组时比较差异无统计学意义(P>0.05),但明显低于对照组(P<0.05),对照组心电图异常总发生率明显高于入组时(P<0.05)。观察组总有效率为93.3%(28/44),明显高于对照组的66.7%(20/44),差异有统计学意义(P<0.05);观察组不良反应发生率为34.1%(14/44),低于对照组的68.2%(29/44),差异有统计学意义(P<0.05)。结论温阳益气法能够显著减轻蒽环类化疗药物心脏毒性患者临床症状,提高患者生活质量,不会增加心电图异常发生率,且�Objective It is to explore the intervention effect of therapy for warming yang and supplementing qi on the cardiotoxicity of anthracycline chemotherapy drugs.Methods Eighty-eight patients with cardiotoxicity caused by anthracycline chemotherapy drugs(docetaxel,epirubicin,and cyclophosphamide)treated at Qingdao Hospital of Traditional Chinese Medicine from October 2019 to October 2021 were randomly divided into a control group and an observation group.Both groups continued to receive the original chemotherapy regimen for 2 cycles,and began oral administration of coenzyme Q10 on the first day of chemotherapy.The control group received no other intervention,while the observation group received oral administration of Wenyang Yiqi decoction until the end of chemotherapy.The traditional Chinese medicine syndrome scores(chest tightness,chest pain,palpitations,chills,lower limb edema),myocardial injury related indicators[creatine kinase isoenzyme(CK-MB),troponin I(cTnI),B-type natriuretic peptide(BNP)],cardiac function indicators[left ventricular ejection fraction(LVEF)],and scores of quality of life(EORTC QLQ-C30)at enrollment and after 2 cycles of continuous chemotherapy were observed and compared between the two groups,the occurrence of electrocardiogram abnormalities in the two groups after 2 cycles of continuous chemotherapy and incidence of adverse reactions were recorded,and the clinical efficacy was evaluated in the two groups.Results After continuing chemotherapy for 2 cycles,the scores of chest tightness,chest pain,palpitations,chills,and lower limb edema in the observation group were significantly lower than those at enrollment and in the control group at the same period(all P<0.05),there was no statistically significant difference in the scores of the control group compared with those at enrollment(all P>0.05);The indicators of cardiac function and myocardial injury were improved compared with those at enrollment,but the differences were not significant(all P>0.05);The scores of role function,physical functio

关 键 词：蒽环类化疗药物 心脏毒性 温阳益气法 心肌损伤 EORTC QLQ-C30 心电图异常 

分 类 号：R453[医药卫生—治疗学]