注射用益气复脉(冻干)对乳腺癌靶向治疗后心肌损伤的防治作用  

Preventive and therapeutic effects of Yiqi Fumai Lyophilized Injection on myocardial injury after targeted therapy for breast cancer

作　　者：邓有金 DENG Youjin(Department of Traditional Chinese Medicine,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China)

机构地区：[1]贵州医科大学附属医院中医科,贵州贵阳550004

出　　处：《药物评价研究》2025年第2期378-385,共8页Drug Evaluation Research

摘　　要：目的 探讨注射用益气复脉(冻干,YQFM)对乳腺癌术后靶向治疗(注射用曲妥珠单抗+甲苯磺酸拉帕替尼片)后心肌损伤的防治效果。方法 选取2021年3月—2024年3月贵州医科大学附属医院收治的HER-2阳性乳腺癌术后患者100例,随机分为观察组、对照组各50例。对照组给予注射用曲妥珠单抗+甲苯磺酸拉帕替尼片治疗,21 d为1个周期;观察组靶向治疗同对照组,每个周期靶向治疗前3 d使用YQFM,每次8瓶(5.2 g)静脉滴注,每天1次,连续使用14 d,于靶向治疗前和治疗2、4个周期后对两组患者中医症状进行评分,超声检查心脏左室射血分数(LVEF),检测血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)水平,检测心肌损伤标志物[心肌肌钙蛋白(c TnI)、脑利尿钠肽(BNP)]及心电图变化,并进行生活质量评分。结果 靶向治疗前,两组中医症状积分、心功能、心肌酶、心肌损伤标志物等各项指标比较,差异均无统计学意义(P>0.05)。治疗4个周期后,观察组和对照组总有效率分别为92%、72%,组间比较差异有统计学意义(P<0.05)。靶向治疗前两组患者心肌损伤相应症状(胸闷、胸痛、心悸、畏寒制冷、下肢水肿)的中医症状积分比较,差异无统计学意义(P>0.05)。对照组治疗4个周期后心肌损伤中医症状积分高于同组靶向治疗前和治疗2个周期(P<0.05);观察组治疗2个周期后中医症状积分显著高于本组靶向治疗前(P<0.05),治疗4个周期后中医症状积分较本组治疗2个周期显著降低(P<0.05),基本恢复至靶向治疗前水平;且治疗2、4个周期后心肌损伤中医症状积分观察组明显低于同时间点对照组(P<0.05)。治疗2个周期和4个周期后,两组LVEF均明显低于同组靶向治疗前(P<0.05),且治疗4个周期后明显低于治疗2个周期后(P<0.05);但观察组治疗2个周期和4个周期后LVEF均明显高于对照组(P<0.05)。对照组治疗2、4个周期后血清CK、CK-MB�Objective To investigate the preventive and therapeutic effect of Yiqi Fumai Lyophilized Injection(YQFM)on myocardial injury after targeted therapy(trastuzumab for injection+lapatinib toluenesulfonate tablets)for breast cancer surgery.Methods A total of 100 patients with HER-2 positive breast cancer admitted to the Affiliated Hospital of Guizhou Medical University from 2021 March to 2024 March were randomly divided into an observation group and a control group with 50 patients in each group. The controlgroup was treated with injection of trastuzumab and lapatinib tosylate tablets for 21 d per cycle. The observation group received targetedtherapy similar to the control group. Three days before each targeted therapy cycle, YQFM was used, with eight bottles (5.2 g)intravenously administered once a day for 14 consecutive days. The traditional Chinese medicine symptoms of the two groups ofpatients were scored before targeted therapy and after two and four cycles of treatment. The left ventricular ejection fraction (LVEF)was examined by ultrasound, serum creatine kinase (CK), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH) levelswere detected, myocardial injury markers [cardiac troponin (I), brain natriuretic peptide (BNP)] and electrocardiogram changes weredetected, and the quality of life was evaluated. Results Before targeted therapy, there was no statistically significant difference invarious indicators such as traditional Chinese medicine symptom scores, heart function, myocardial enzymes, and myocardial injurymarkers between the two groups (P > 0.05). After four cycles of treatment, the total effective rates of the observation group and thecontrol group were 92% and 72%, respectively, and the difference between the groups was statistically significant (P < 0.05). Therewas no statistically significant difference (P > 0.05) in the TCM symptom scores of myocardial injury symptoms (chest tightness, chestpain, palpitations, chills, and lower limb edema) between the two groups of patients before targeted

关 键 词：注射用益气复脉(冻干) HER-2阳性乳腺癌 注射用曲妥珠单抗 甲苯磺酸拉帕替尼片 靶向治疗 心肌损伤 

分 类 号：R972[医药卫生—药品]