归芍升白方改善乳腺癌术后化疗骨髓抑制的临床观察*
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(成都中医药大学附属医院乳腺外科,四川 成都 610072)

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R273

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收稿日期: 2021 - 11- 13
* 基金项目: 四川省中医药科学技术研究专项项目(2016Q015)
第一作者简介: 马璐(1994-),女,护师,研究方向:乳腺病的中医药治疗。


Clinical observation of Guishao Shengbai Decoction on Improving Bone Marrow Suppression in Breast Cancer Chemotherapy after Surgery
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(Department of Breast Surgery, Affiliated Hospital of Chengdu Universityof Traditional Chinese Medicine, Chengdu 610072, China)

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    摘要:

    目的 探究归芍升白方对乳腺癌术后化疗患者骨髓抑制的临床疗效。方法 选取2018年1月-2020年12月我院收治乳腺癌术后化疗患者106例,随机分为对照组和观察组,每组53例,对照组采用CEF化疗方案,观察组在化疗同时给予归芍升白方,观察一个化疗周期(21 d)后临床疗效、中医证候评分、骨髓抑制程度、生活质量评分并评价药物安全性。结果 化疗后,观察组中医证候积分降低(P<0.05),对照组中医证候积分升高(P<0.05),观察组化疗后中医证候积分各项均显著低于对照组(P<0.05);与化疗前比较,2组化疗后各时间点的外周血WBC、Hb、PLT水平均降低(P<0.05),而观察组化疗后各时间点上述指标均显著高于对照组(P<0.05);化疗后,观察组骨髓抑制≥III级发生率为9.43%,显著低于对照组的24.53%(P<0.05);化疗后,2组KPS评分均降低(P<0.05),但化疗后观察组KPS评分高于对照组(P<0.05);化疗期间,观察组恶心呕吐、腹泻和便秘的发生率显著低于对照组(P<0.05),2组肝肾功能异常率差异不具有统计学意义(P>0.05)。结论 归芍升白方可有效抑制乳腺癌术后化疗患者骨髓抑制,安全性较高,值得临床推广。

    Abstract:

    Objective To explore the clinical efficacy of Guishao Shengbai decoction on bone marrow suppression in patients undergoing chemotherapy after breast cancer surgery. Methods 106 patients undergoing chemotherapy after breast cancer surgery in the hospital were selected between January 2018 and December 2020, and they were randomly divided into control group and observation group with 53 cases in each group. The control group was treated with CEF chemotherapy, and the observation group was given Guishao Shengbai decoction during chemotherapy. The clinical efficacy, scores of TCM syndromes, bone marrow suppression degree and quality of life score were observed after a chemotherapy cycle (21 d), and the drug safety was evaluated. Results After chemotherapy, the scores of TCM syndromes were decreased in observation group (P<0.05) while the scores were increased in control group (P<0.05). After chemotherapy, the scores of various TCM syndromes in observation group were significantly lower than those in control group(P<0.05). Compared with before chemotherapy, the levels of peripheral blood WBC, Hb and PLT were reduced at each time point after chemotherapy in the two groups (P<0.05), and the above indicators in observation group at each time point after chemotherapy were significantly higher than those in control group (P<0.05) After chemotherapy, the incidence rate of bone marrow suppression≥ grade III of 9.43% in observation group was significantly lower than 24.53% in control group(P<0.05). The KPS scores in the two groups were lowered after chemotherapy(P<0.05), but the KPS score was higher in observation group than that in control group after chemotherapy(P<0.05). During chemotherapy, the incidence rates of nausea and vomiting, diarrhea and constipation in observation group were significantly lower than those in control group(P<0.05), and there was no statistically significant difference in abnormal rate of liver-kidney function between the two groups(P>0.05). Conclusion Guishao Shengbai decoction can effectively inhibit the bone marrow suppression in patients undergoing chemotherapy after breast cancer surgery, and it has high safety and is worthy of clinical promotion.

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