三黄三仙汤治疗脾肾亏虚型晚期乳腺癌患者癌因性疲乏的效果观察

任莉莉; 姚庆华; 曹文明; 胡轶娟; 张永军; 张波; 蔡鹄

doi:10.16766/j.cnki.issn.1674-4152.002427

三黄三仙汤治疗脾肾亏虚型晚期乳腺癌患者癌因性疲乏的效果观察

doi: 10.16766/j.cnki.issn.1674-4152.002427

1.
中国科学院大学附属肿瘤医院(浙江省肿瘤医院)中西医结合科，浙江杭州 310022
2.
中国科学院大学附属肿瘤医院(浙江省肿瘤医院)乳腺肿瘤内科
3.
浙江省中医药研究院药用资源研究中心，浙江杭州 310000

基金项目:

浙江省中医药科技计划项目 2019ZB016

详细信息

通讯作者:
任莉莉，E-mail: renlili759@sina.com

中图分类号: R737.9 R289.55
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出版历程
- 收稿日期: 2021-03-10

Effect of Sanhuang Sanxian Decoction on cancer-related fatigue in patients with advanced breast cancer of spleen and kidney deficiency type

1.
Department of Integrated Chinese and Western Medicine, Cancer Hospital Affiliated to the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, Zhejiang 310022, China

摘要

摘要: 目的观察三黄三仙汤治疗脾肾亏虚型晚期乳腺癌患者癌因性疲乏(CRF)的疗效，为提高晚期乳腺癌患者的生存质量提供参考。方法采用随机数字表法将浙江省肿瘤医院2019年9月—2020年5月收治的80例脾肾亏虚型晚期乳腺癌患者分为对照组(40例)与观察组(40例)，对照组给予姑息性化疗及相应的对症治疗；观察组在对照组的基础上联合中药“三黄三仙汤”治疗。对比分析2组治疗前后的生活质量(KPS)与中医临床症状评分、Piper疲乏量表评分，血清细胞因子与T淋巴细胞亚群各指标的变化，并记录不良反应情况。结果观察组治疗后中医临床症状评分、Piper疲乏量表评分、肿瘤坏死因子-α(TNF-α)和白细胞介素-4(IL-4)水平低于对照组，KPS评分、干扰素-γ(IFN-γ)和白细胞介素-2(IL-2)水平高于对照组(P < 0.05)。观察组治疗后CD4⁺、CD8⁺、CD4⁺/CD8⁺比值均优于对照组[(40.30±11.21)% vs.(35.06±9.37)%、(15.30±3.29)% vs.(17.17±3.53)%、(2.52±0.48)vs.(1.90±0.41)，均P < 0.05]。观察组不良反应发生率低于对照组(10.00% vs. 27.50%，P < 0.05)。结论三黄三仙汤能有效改善脾肾亏虚型晚期乳腺癌患者临床症状和生活质量，缓解患者癌因性疲乏症状，降低炎性因子水平，提高机体免疫能力，且安全有效。
- 三黄三仙汤 /
- 脾肾亏虚型 /
- 晚期乳腺癌 /
- 癌因性疲乏 /
- 疗效分析
Abstract: Objective To observe the effect of Sanhuang Sanxian Decoction on cancer-related fatigue (CRF) in patients with advanced breast cancer of spleen kidney deficiency type and to provide reference for improving the quality of life of patients with advanced breast cancer. Methods Eighty cases of advanced breast cancer patients of spleen kidney deficiency type in Zhejiang Cancer Hospital from September 2019 to May 2020 were randomly divided into the control group (40 cases) and observation group (40 cases). The control group was given palliative chemotherapy and symptomatic treatment, whereas the observation group was treated on the basis of the control group in combination with Sanhuang Sanxian Decoction. The Karnofsky performance scale (KPS), traditional Chinese medicine (TCM) clinical symptom score, Piper Fatigue Scale scores, serum cytokines and T lymphocyte subsets were compared before and after treatment, and the adverse reactions were recorded. Results After treatment, the TCM clinical symptom score, Piper Fatigue Scale score and tumour necrosis factor-α and interleukin (IL)-4 levels in the observation group were lower than those in the control group, whereas the KPS score and interferon-γ and IL-2 levels in the observation group were higher than those in the control group (P < 0.05). After treatment, the CD4⁺, CD8⁺ and CD4⁺/CD8⁺ ratio in the observation group were better than those in the control group (40.30±11.21)% vs. (35.06±9.37)%, (15.30±3.29)% vs. (17.17±3.53)%, (2.52±0.48)% vs. (1.90±0.41)%, respectively, all P < 0.05. The incidence of adverse reactions in the observation group was lower than that in the control group (10.00% vs. 27.50%, P < 0.05). Conclusion Sanhuang Sanxian Decoction can effectively improve the clinical symptoms and quality of life of patients with advanced breast cancer of spleen kidney deficiency type, relieve CRF symptoms of patients with advanced breast cancer, reduce the level of inflammatory factors and improve the immune capacity of the body, and it is safe and effective.
- Sanhuang Sanxian Decoction /
- Deficiency of spleen and kidney /
- Advanced breast cancer /
- Cancer-related fatigue /
- Efficacy analysis
利益冲突 无

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表 1 2组乳腺癌患者一般资料比较

Table 1. Comparison of general data of two groups of breast cancer patients

组别	例数	年龄 (x±s，岁)	病程 (x±s，月)	BMI (x±s)	合并高血压[例(%)]	合并糖尿病[例(%)]	肿瘤转移(肝转移/骨转移/肺转移，例)	病理类型(浸润性腺癌/导管癌/小叶癌，例)
对照组	40	57.08±8.62	12.64±1.25	21.08±3.12	18(45.00)	15(37.50)	16/14/10	20/13/7
观察组	40	57.13±8.67	12.58±1.19	21.10±3.09	19(47.50)	13(32.50)	15/13/12	22/10/8
统计量		0.026^a	0.220^a	0.029^a	0.050^b	0.220^b	0.251^b	0.553^b
P值		0.979	0.827	0.977	0.823	0.639	0.882	0.758
注：^a为t值，^b为χ²值。

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表 2 2组患者治疗前后中医临床症状与KPS评分比较(x±s，分)

Table 2. Comparison of clinical symptoms of traditional Chinese Medicine and KPS scores between the patients in two groups before and after treatment (x±s, points)

组别	例数	中医临床症状评分		KPS评分
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	40	1.50±0.46	1.30±0.48^a	62.39±6.08	64.71±6.30
观察组	40	1.48±0.47	0.98±0.27^a	61.22±6.02	70.09±6.81^a
t值		0.192	3.675	0.865	3.668
P值		0.848	0.001	0.390	0.001
注：与同组治疗前比较，^aP < 0.05。

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表 3 2组患者治疗前后Piper疲乏量表评分比较(x±s，分)

Table 3. Comparison of Piper Fatigue Scale scores between the patients in two groups before and after treatment (x±s, points)

组别	例数	行为维度		情感维度		感觉维度		认知维度		总分
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	40	4.50±1.40	4.14±0.87	4.38±1.37	4.08±0.92	4.60±1.38	4.18±0.85	4.61±1.42	4.15±0.76	4.39±1.35	4.17±0.85
观察组	40	4.40±1.38	2.69±0.92^a	4.40±1.39	2.60±0.68^a	4.56±1.34	2.61±0.63^a	4.56±1.38	2.70±0.52^a	4.42±1.37	2.54±0.52^a
t值		0.322	7.243	0.065	8.182	0.132	9.385	0.160	9.959	0.099	10.346
P值		0.749	< 0.001	0.949	< 0.001	0.896	< 0.001	0.874	< 0.001	0.099	< 0.001
注：与同组治疗前比较，^aP < 0.05。

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表 4 2组患者治疗前后血清细胞因子水平比较(x±s，ng/L)

Table 4. Comparison of serum cytokine levels between the patients in two groups before and after treatment (x±s, ng/L)

组别	例数	TNF-α		IFN-γ		IL-2		IL-4
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	40	47.85±10.64	23.83±4.61^a	31.03±8.72	47.92±14.51^a	23.94±6.02	53.21±8.69^a	44.18±9.08	35.27±8.52^a
观察组	40	47.72±10.86	7.84±2.35^a	31.18±8.54	58.52±17.42^a	24.42±6.08	71.96±11.48^a	45.20±8.96	31.38±6.46^a
t值		0.054	19.544	0.078	2.957	0.355	8.236	0.506	2.301
P值		0.957	< 0.001	0.938	0.004	0.724	< 0.001	0.615	0.024
注：与同组治疗前比较，^aP < 0.05。

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表 5 观察组与对照组患者治疗前后的免疫功能指标情况比较(x±s)

Table 5. Comparison of immune function indexes between the patients in observation group and control group before and after treatment (x±s)

组别	例数	CD4⁺(%)		CD8⁺(%)		CD4⁺/CD8⁺
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	40	30.89±9.32	35.06±9.37^a	21.09±6.10	17.17±3.53^a	1.68±0.39	1.90±0.41^a
观察组	40	30.24±9.28	40.30±11.21^a	21.15±6.23	15.30±3.29^a	1.62±0.37	2.52±0.48^a
t值		0.313	2.268	0.044	2.909	0.706	6.212
P值		0.755	0.026	0.965	0.005	0.482	< 0.001
注：与同组治疗前比较，^aP < 0.05。

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