健脾益肾法联合内分泌治疗乳腺癌术后患者的临床疗效及对其不良反应、生活质量及复发转移情况的影响  

Clinical Efficacy of Spleen-strengthening and Kidney-tonifying Therapy Combined with Endocrine Therapy on Postoperative Patients with Breast Cancer and Its Effect on Adverse Reactions,Quality of Life,Recurrence,and Metastasis

作　　者：林丹 柴妮 姚依勍 龚亚斌[1] LIN Dan;CHAI Ni;YAO Yi-qing;GONG Ya-bin(Oncology Department I,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院肿瘤一科,上海200437

出　　处：《世界中西医结合杂志》2024年第11期2262-2268,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：上海市卫生健康委员会科研项目(20204Y0401)。

摘　　要：目的探讨健脾益肾法联合内分泌治疗乳腺癌术后患者的临床疗效及对其不良反应、生活质量及复发转移情况的影响。方法回顾性分析2020年1月—2022年1月期间上海中医药大学附属岳阳中西医结合医院收治的乳腺癌患者78例,按随机数字表法分为对照组和观察组,每组各39例。对照组接受常规内分泌治疗,观察组在此基础上应用中医健脾益肾法治疗。治疗3个月后,观察比较两组患者临床疗效、不良反应及复发转移情况,治疗前后中医证候评分、Kupperman评分、Karnofsky的功能状态(Karnofsky′s functional status,KPS)评分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)和癌症治疗功能评价系统-乳腺癌特异性模块(Functional assessment of cancer therapy-breast cancer,FACT-B)评分,血清雌激素[雌二醇(Estrogen,E2)]、肿瘤标志物[癌胚抗原(Carcinoembryonic antigen,CEA)、糖类抗原125(Carbohydrate antigen 125,CA125)、糖链抗原15-3(Carbohydrate antigen 15-3,CA153)]、血脂指标[甘油三酯(Triglycerides,TG)、总胆固醇(Total cholesterol,TC)、低密度脂蛋白(Low-density lipoprotein,LDL-C)和高密度脂蛋白(High-density lipoprotein,HDL-C)]变化。结果治疗后观察组总有效率94.87%(37/39)明显高于对照组69.23%(27/39),差异有统计学意义(χ^(2)=20.611,P<0.01)。治疗后观察组各项证候评分及总分均较治疗前明显降低,差异有统计学意义(P<0.05);对照组除腰膝酸软及胸肋胀满外,其余评分均显著降低(P<0.05),且观察组各项证候评分及总分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者改良Kupperman评分及PSQI均较治疗前明显降低,KPS评分较治疗前升高,差异有统计学意义(P<0.05);且观察组改良Kupperman评分及PSQI均明显低于对照组,KPS评分明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者FACT-B各维度评分及总评分均较治疗前升高,差异有统计学意义(P<0.05Objective To investigate the clinical efficacy of the spleen-strengthening and kidney-tonifying therapy combined with endocrine therapy in postoperative breast cancer patients and its effect on adverse reactions,quality of life,recurrence,and metastasis.Methods A retrospective analysis was conducted on 78 breast cancer patients treated at Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated with Shanghai University of Traditional Chinese Medicine from January 2020 to January 2022.Patients were randomly divided into a control group and an observation group according to a random number table,with 39 cases in each group.The control group received standard endocrine therapy,while the observation group was additionally treated with the spleen-strengthening and kidney-tonifying therapy in traditional Chinese medicine(TCM).After three months of treatment,clinical efficacy,adverse reactions,and recurrence and metastasis rates in both groups,as well as TCM syndrome scores,Kupperman scores,Karnofsky Performance Status(KPS)scores,Pittsburgh Sleep Quality Index(PSQI)scores,and Functional Assessment of Cancer Therapy:Breast Cancer(FACT-B)scores before and after treatment,were compared.Changes in serum estrogen(E2),tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 15-3(CA153)],and lipid levels[triglycerides(TG),total cholesterol(TC),low-density lipoprotein(LDL-C),and high-density lipoprotein(HDL C)]were also analyzed.Results The total effective rate in the observation group was 94.87%(37/39),significantly higher than 69.23%(27/39)in the control group(χ^(2)=20.611,P<0.01).The observation group showed significant reductions in all syndrome scores and total scores after treatment(P<0.05),while the control group showed significant reductions except for lumbar and knee soreness and chest distension(P<0.05),with the scores of the observation group lower than those of the control group(P<0.05).Both groups had significant reductions in modified Kupperman sco

关 键 词：乳腺癌 内分泌治疗 健脾益肾法 不良反应 生活质量 复发 转移 

分 类 号：R737.9[医药卫生—肿瘤]