扶正抗癌方联合化疗治疗中晚...疗效及对患者免疫功能的影响_党明.pdf

癌症进展2023 年 3 月第 21 卷第 6 期ONCOLOGY PROGRESS,Mar 2023 V ol.21,No.6*论著*扶正抗癌方联合化疗治疗中晚期乳腺癌的疗效及对患者免疫功能的扶正抗癌方联合化疗治疗中晚期乳腺癌的疗效及对患者免疫功能的影响影响党明，马红兵，奚颖，翟鑫#安康市中医医院肿瘤科，陕西 安康 7250000 0摘要摘要：目的目的探讨扶正抗癌方联合化疗治疗中晚期乳腺癌的疗效及对患者免疫功能的影响。方法方法根据治疗方式的不同将80例中晚期乳腺癌患者分为对照组和观察组，每组40例，对照组患者给予化疗，观察组患者给予扶正抗癌方联合化疗。比较两组患者的临床疗效、免疫功能指标（CD3+、CD4+、CD8+水平，计算CD4+/CD8+）、血清肿瘤标志物癌胚抗原（CEA）、糖类抗原125（CA125）、糖类抗原153（CA153）及不良反应发生情况。结果结果 观察组患者的治疗总有效率为55.00%，高于对照组患者的32.50%，差异有统计学意义（P0.05）。治疗后，两组患者血清 CEA、CA125、CA153 水平均低于本组治疗前，且观察组患者血清 CEA、CA125、CA153 水平均低于对照组，差异均有统计学意义（P0.05）。治疗后，两组患者CD3+、CD4+水平和CD4+/CD8+均高于本组治疗前，CD8+水平均低于本组治疗前，且观察组患者CD3+、CD4+水平和CD4+/CD8+均高于对照组，CD8+水平低于对照组，差异均有统计学意义（P0.05）。观察组患者不良反应总发生率为22.50%，低于对照组患者的37.50%，差异有统计学意义（P0.05）。结论结论扶正抗癌方联合化疗可提高中晚期乳腺癌的疗效，有助于肿瘤控制，改善患者的免疫功能，降低不良反应发生率。关键词关键词：乳腺癌；免疫功能；扶正抗癌方；化疗中图分类号中图分类号：R R737737.9 9文献标志码文献标志码：AdoiAdoi：10.11877/j.issn.1672-1535.2023.21.06.22Effect of fuzheng anti-cancer formula combined with chemotherapy in theEffect of fuzheng anti-cancer formula combined with chemotherapy in thetreatment of advanced breast cancer and its influence on the immunetreatment of advanced breast cancer and its influence on the immunefunction of patientsfunction of patientsDANG Ming,MA Hongbing,XI Ying,ZHAI Xin#Department of Oncology,Ankang Hospital of Traditional Chinese Medicine,Ankang 725000,Shaanxi,ChinaAbstractAbstract:ObjectiveObjectiveTo explore the effect of fuzheng anti-cancer formula combined with chemotherapy in the treatment of advanced breast cancer and its influence on the immune function of patients.MethodMethodA total of 80 patients withadvanced breast cancer were divided into control group and observation group according to different treatment methods,with 40 cases in each group.The patients in the control group were given chemotherapy,and the patients in the observation group were given fuzheng anti-cancer formula combined with chemotherapy.The clinical efficacy,immune functionindexes(CD3+,CD4+,CD8+,and CD4+/CD8+),serum tumor markers carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153)and adverse events of the two groups were compared.ResultResultThetotal response rate of treatment in the observation group was 55.00%,which was higher than 32.50%in the control group,and the difference was statistically significant(P0.05).After the treatment,the serum CEA,CA125,and CA153 levelsof the two groups were lower than those before the treatment,and the serum CEA,CA125 and CA153 levels in the observation group were lower than those in the control group,and the differences were statistically significant(P0.05).Afterthe treatment,the CD3+,CD4+,and CD4+/CD8+levels in the two groups were higher than those before the treatment,theCD8+levels were lower than those before the treatment,and the CD3+,CD4+and CD4+/CD8+levels in the observationgroup were higher than those in the control group,and the CD8+levels was lower than that in the control group,and thedifferences were statistically significant(P0.05).The total incidence of adverse events in the observation group was22.50%,which was lower than 37.50%in the control group,and the difference was statistically significant(P0.05).ConCon clusionclusionFuzheng anti-cancer formula combined with chemotherapy can improve the curative effect of advanced breastcancer,help tumor control,improve immune function,and reduce the incidence of adverse reactions.Key wordsKey words:breast cancer;immune function;fuzheng anti-cancer formula;chemotherapyOncol Prog,2023,21(6)乳腺癌是临床常见的妇科恶性肿瘤之一，具有较高的发病率及病死率，若不及时治疗，将严重威#通信作者（corresponding author），邮箱：670ONCOLOGY PROGRESS,Mar 2023 V ol.21 No.6胁女性生命健康1-2。乳腺癌早期无明显症状，多数患者就诊时已进展为中晚期，失去了手术治疗的最佳时机。中晚期乳腺癌通常采用化疗，能够控制疾病进展，延长生存时间，但化疗的不良反应较严重，会影响治疗效果，造成机体免疫功能紊乱，影响生活质量3-4。通过与其他治疗方法联合来减轻化疗药物的不良反应、增强免疫功能，一直是临床研究的重点5。扶正抗癌方中含有山慈菇、石见穿等成分，能够解毒散结、祛邪扶正，且多数患者适应性较强，不良反应较少。本研究探讨扶正抗癌方联合化疗治疗中晚期乳腺癌的疗效及对患者免疫功能的影响，现报道如下。1 1资料与方法资料与方法1 1.1 1 一般资料一般资料选取 2020 年 1 月至 2022 年 3 月安康市中医医院收治的中晚期乳腺癌患者。纳入标准：符合中国抗癌协会乳腺癌诊治指南与规范（2015版）6中乳腺癌的诊断标准；近期未接受放化疗治疗；病历资料完整。排除标准：凝血功能异常；合并其他恶性肿瘤；合并肝、肾功能不全。依据纳入和排除标准，本研究共纳入 80 例中晚期乳腺癌患者，根据治疗方式的不同分为对照组和观察组，每组 40 例，对照组患者给予化疗，观察组患者给予扶正抗癌方联合化疗。对照组患者年龄 3168 岁，平均（44.825.39）岁；文化程度：小学 11 例，中学 14 例，大学 15 例；临床分期：A 期 4 例，B期 16例，A 期 17例，B 期 3例。观察组患者年龄 3167 岁，平均（44.425.29）岁；文化程度：小学12 例，中学 13 例，大学 15 例；临床分期：A 期 5例，B期15例，A期16例，B期4例。两组患者年龄、临床分期和文化程度比较，差异均无统计学意义（P0.05），具有可比性。本研究经医院伦理委员会批准通过，所有患者均知情同意。1 1.2 2 治疗方法治疗方法对照组患者给予表柔比星+环磷酰胺化疗，表柔比星 75 mg/m2+环磷酰胺 600 mg/m2，3 周为 1 个疗程，共治疗4个疗程。观察组患者给予化疗联合扶正抗癌方治疗，化疗方案同对照组，扶正抗癌方方剂组成：石见穿、白英各 30 g，蛇莓、山慈菇各 30g，北沙参、黄精、麦冬、浙贝各15 g，太子参20 g，陈皮、佛手、威灵仙各10 g，炙甘草5 g，水煎滤渣取汁300 ml早晚分别服用。3周为1个疗程，共治疗4个疗程。1 1.3 3 观察指标和评价标准观察指标和评价标准依据实体瘤疗效评价标准7评估两组患者的临床疗效，完全缓解，目标病灶完全消失，无新病灶出现，至少维持4周；部分缓解，目标病灶最大径总和缩小30%，至少维持 4 周；疾病稳定，目标病灶最大径总和缩小30%或增大20%；疾病进展，目标病灶最大径总和增大20%或绝对值增加5 mm。总有效率=（完全缓解+部分缓解）例数/总例数100%。治疗前后，抽取两组患者清晨空腹肘静脉血 5 ml，4000 r/min 离心 10 min，离心半径 8 min，-40 冰箱保存备用，采用电化学发光法比较两组患者的肿瘤标志物水平，包括癌胚抗原（carcinoembryonic antigen，CEA）、糖 类 抗 原 125（carbohydrate antigen 125，CA125）、糖类抗原 153（carbohydrate antigen 153，CA153）。治疗前后，抽取两组患者外周