2019 年第 1 期 第 14 卷

六味地黄汤联合多西他赛和卡培他滨及曲妥珠单抗治疗晚期乳腺癌患者的效果及安全性分析

Clinical efficacy and safety of six-ingredient rehmannia decoction combined with docetaxel, capecitabine and trotozumab in treatment of advanced breast cancer

作者：张立平王蓓马建文张洪亮

英文作者：

单位：830000乌鲁木齐，新疆医科大学附属中医医院肿瘤二科

英文单位：

关键词：晚期乳腺癌；六味地黄汤；多西他赛；卡培他滨；曲妥珠单抗

英文关键词：

• 摘要：

• 【摘要】目的    探讨六味地黄汤联合多西他赛和卡培他滨及曲妥珠单抗(TXH)方案治疗晚期乳腺癌患者的效果及安全性。方法    选取2016年5月至2017年5月新疆医科大学附属中医医院收治的晚期乳腺癌患者90例，完全随机分为对照组和观察组，各45例。对照组应用TXH方案一线解救治疗；观察组在对照组基础上联合应用六味地黄汤治疗。比较2组患者近期疗效、治疗前后免疫功能、不良反应发生情况和SF-36健康状况调查量表生活质量评分。结果    观察组与对照组治疗有效率比较［73.3%(33/45)比68.9%(31/45)］，差异无统计学意义（P＞0.05）。治疗后观察组患者CD+3、CD+4水平和CD+4/CD+8比值明显高于对照组，CD+8水平明显低于对照组［（64±8）%比（59±7）%、（35±4）%比（33±4）%、（1.23±0.34）比（0.93±0.46）、（34±5）%比（39±4）%］，差异均有统计学意义（均P＜0.05）。观察组患者不良反应发生率明显低于对照组［4.4%(2/45)比24.4%(11/45)］，差异有统计学意义（P＜0.05）。治疗前，2组患者生活质量评分差异无统计学意义（P＞0.05），治疗后，观察组患者生活质量评分均明显高于对照组，差异均有统计学意义［社会功能：（80±5）分比（74±5）分；躯体功能：（80±4）分比（71±3）分；角色功能：（81±5）分比（72±4）分；认识功能：（81±5）分比（74±4）分］（均P＜0.05）。结论    晚期乳腺癌患者采用TXH方案联合六味地黄汤治疗，有利于改善患者免疫功能，同时降低不良反应发生风险。

• 【Abstract】Objective    To explore the clinical efficacy and safety of six-ingredient rehmannia decoction combined with docetaxel, capecitabine and trotozumab(TXH) in treatment of advanced breast cancer. Methods    Ninety patients with advanced breast cancer admitted from May 2016 to May 2017 in Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University were enrolled. They were randomly divided into control group and observation group, with 45 patients in each group. The control group was treated with TXH therapy. The observation group was treated with TXH therapy combined with six-ingredient rehmannia decoction. Short-term efficacy, immune function, adverse events and SF-36 life quality score were analyzed. Results    Therapeutic effective rate showed no significant difference between observation group and control group［73.3%(33/45) vs 68.9%(31/45)］（P＞0.05）. After treatment, CD+3, CD+4 level and CD+4/CD+8 ratio in observation group were significantly higher than those in control group; CD+8 level in observation group was significantly lower than that in control group［（64±8）% vs （59±7）%, （35±4）% vs （33±4）%, （1.23±0.34） vs （0.93±0.46）, （34±5）% vs （39±4）%］（P＜0.05）. Incidence rate of adverse events in observation group was significantly lower than that in control group［4.4%(2/45) vs 24.4%(11/45)］(P＜0.05). There was no significant difference of SF-36 scores between groups before treatment（P＞0.05）. After treatment, SF-36 scores in observation group were significantly higher than those in control group［social functioning：（80±5） vs （74±5）；physical functioning：（80±4） vs （71±3）；role physical functioning：（81±5） vs （72±4）；cognitive functioning：（81±5） vs （74±4）］(P＜0.05). Conclusion    TXH therapy combined with six-ingredient rehmannia decoction treating advanced breast cancer can effectively improve immune function and reduce adverse events.