2025 年第 8 期 第 20 卷

补阳还五汤加减缓解晚期三阴性乳腺癌化疗相关周围神经毒性的疗效观察

Observation on therapeutic effect of modified Buyang Huanwu decoction in relieving chemotherapy related peripheral neurotoxicity of advanced triple negative breast cancer

作者：苏菲娄彦妮程志强万冬桂

英文作者：Su Fei Lou Yanni Cheng Zhiqiang Wan Donggui

单位：中日友好医院中西医结合肿瘤内科，北京100029

英文单位：Department of Integrated Traditional Chinese and Western Medicine Oncology China-Japan Friendship Hospital Beijing 100029 China

关键词：三阴性乳腺癌；益气活血法；补阳还五汤；化疗

英文关键词：Triplenegativebreastcancer;InvigoratingQiandactivatingbloodprescriptions;BuyangHuanwudecoction;Chemotherapy

• 摘要：

• 目的 探讨补阳还五汤加减联合化疗治疗晚期三阴性乳腺癌（TNBC）的临床效果及安全性。方法 收集2021年1月至2024年1月中日友好医院确诊晚期TNBC并行化疗的162例住院患者的临床资料进行回顾性分析。根据治疗方案的不同分为单纯化疗组（采用白蛋白结合型紫杉醇、优替德隆或卡培他滨标准方案化疗）和中西医结合治疗组（采用补阳还五汤加减联合标准化疗），各81例。观察患者治疗后2组的临床疗效、不良反应及疼痛方面的生存质量。结果 中西医结合治疗组疾病稳定比例和疾病控制率均高于单纯化疗组［24.5%（19/81）比12.3%（10/81）、69.1%（56/81）比50.6%（41/81）］（均P<0.05）。中西医结合治疗组无进展生存期长于单纯化疗组［（4.6±1.9）个月比（4.0±1.6）个月］（P<0.05）。治疗3个月随访时中西医结合治疗组周围神经毒性治疗总有效率高于单纯化疗组［91.8%（45/49）比90.8%（59/65）］（P<0.05）。末次化疗后及3个月随访时中西医结合治疗组疼痛数字评分量表评分均低于单纯化疗组［（1.2±0.8）分比（2.9±1.0）分、（1.4±0.7）分比（2.5±1.2）分］（均P<0.05）。结论  补阳还五汤加减联合化疗治疗晚期TNBC具有较好的临床效果，同时明显降低化疗相关周围神经毒性、提升晚期TNBC患者的生存质量。

• Objective To investigate the clinical effect and safety of modified Buyang Huanwu decoction combined with chemotherapy in the treatment of advanced triple negative breast cancer (TNBC). Methods The clinical data of 162 hospitalized patients diagnosed with advanced TNBC and received chemotherapy in China-Japan Friendship Hospital from January 2021 to January 2024 were retrospectively analyzed. According to the different treatment regimens, the patients were divided into simple chemotherapy group (treated with albumin-bound paclitaxel, eutidrone or capecitabine standard chemotherapy) and integrated traditional Chinese and western medicine treatment group (treated with modified Buyang Huanwu decoction combined with standard chemotherapy), with 81 cases in each group. The clinical efficacy, adverse reactions and quality of life in terms of pain were observed after treatment. Results The proportion of stable disease and disease control rate in the integrated traditional Chinese and western medicine treatment group were higher than those in the simple chemotherapy group ［24.5%(19/81) vs 12.3%(10/81), 69.1%(56/81) vs 50.6%(41/81)］(both P<0.05). The progression-free survival of the integrated traditional Chinese and western medicine treatment group was longer than that of the simple chemotherapy group ［(4.6±1.9)months vs (4.0±1.6)months］(P<0.05). After 3 months of treatment, the total effective rate of peripheral neurotoxicity in the integrated traditional Chinese and western medicine treatment group was higher than that in the simple chemotherapy group ［91.8%(45/49) vs 90.8%(59/65)］(P<0.05). After the last chemotherapy and at the 3-month follow-up, the pain numerical rating scale score of the integrated traditional Chinese and western medicine treatment group was lower than that of the simple chemotherapy group ［(1.2±0.8) vs (2.9±1.0), (1.4±0.7) vs (2.5±1.2)］(both P<0.05). Conclusion Buyang Huanwu decoction combined with chemotherapy has a good clinical effect in the treatment of advanced TNBC, and it can significantly reduce chemotherapy-related peripheral neurotoxicity and improve the quality of life of patients with advanced TNBC.