滋阴润燥法配合放化疗治疗乳腺癌阴津亏虚证的临床研究
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摘要
目的：观察并分析滋阴润燥法配合放化疗治疗中晚期乳腺癌阴津亏虚证的近期疗效及远期疗效,通过评估患者中医症状变化、卡氏评分、癌灶大小变化、远期生存率等指标,了解中医滋阴润燥法在治疗中晚期乳腺癌阴津亏虚证中的作用,为中医药防治中晚期乳腺癌阴津亏虚证提供参考。
方法：选择105例新加坡田农中医肿瘤诊所就诊的中晚期乳腺癌阴津亏虚证患者,分为2组,其中治疗组(滋阴润燥法配合放化疗)70例、对照组(单纯放化疗)35例。治疗4个周期以上,分别观察治疗前后两组的中医症候、生存质量等方面的近期疗效。同时,进行远期疗效观察,观察治疗后两组患者的远期中医症候改善变化、生存率等方面的情况。
结果：
(1)中医症候比较：治疗组中医症候疗效显效11例,有效52例,无效7例,有效率为90.0%；对照组显效3例,有效21例,无效11例,有效率为68.6%。经统计学检验,两组有显著性差异(P<0.05)。提示滋阴润燥法配合放化疗的中医症候疗效优于单纯放化对照组。
(2)癌灶变化比较：治疗组完全缓解0例,部分缓解17例,稳定48例,疾病进展5例,病灶稳定率为92.9%；对照组完全缓解0例,部分缓解7例,稳定23例,疾病进展5例,病灶稳定率为85.7%。两组比较无明显差异(P>0.05)。
(3)卡氏评分比较：治疗组治疗后见KPS评分明显提高,与治疗前比较有显著差异(P<0.05)。对照组治疗后KPS评分亦有所提高,有统计学差异(P<0.05)。两组治疗后比较存在显著统计学差异(P<0.05),提示滋阴润燥法配合放化疗治疗中晚期乳腺癌阴津亏虚证,患者体力状况改善方面更为明显。
另外,远期疗效观察结果表明,70例患者在放化疗的基础上加中药治疗后,生存期疗效显效10例,占14.3%；有效51例,占72.8%；无效9例,占12.9%；总有效率为87.1%。对照组生存期疗效总有效率为74.3%。治疗组患者生存期3年生存率为67.1%；5年生存率为31.4%。对照组患者生存期3年生存率为45.7%；5年生存率为17.1%。
结论：
滋阴润燥法配合放化疗治疗中晚期乳腺癌阴津亏虚证具有较好的近期疗效和远期疗效,能明显改善患者的临床症状和体力状况,并能延长患者的生存期。
Objective:To observe the short and long-term treatment effect of Nourish yin and Moisturize dryness Prescription united chemoradiotherapy in the breast cancer which belong to Deficiency of Yin. Through the assessments of patients in the aspects such as TCM clinical symptoms, quality of life, tumor size changes, the long-term survival indicators, obtain more about the treatment value in clinic, and exploit more wider future in TCM remedy to breast cancer.
Methods:105patients with advanced breast cancer belong to deficiency of yin were devided into two groups, treatment group (nourish yin and moisturize dryness prescription united chemoradiotherapy with70cases), control group (treated with radiotherapy and chemotherapy)35cases. Four times of treatment were observed in the two groups before and after treatment, clinical symptoms, quality of life changes. At the same time, long-term efficacy such as long-term TCM symptoms, survival rate were be observed.
Results:
(1) TCM symptoms:treatment group TCM Syndrome cured,11cases,52cases effective, ineffective in7cases, the effective rate of90.0%; control group,3cases markedly effective21cases,11cases, the effective rate of68.6%. The statistical test, two groups have differences (P <0.05). It means nourish yin and moisturize dryness prescription united chemoradiotherapy is superior to the control group.
(2) Tumor size change:the treatment group complete remission0cases, partial remission in17cases, stable48cases,5cases of disease progression, lesions and stable rate of92.9%; the control group, complete remission0cases,7cases of partial remission, stable23cases, five cases of disease progression and stable lesions was85.7%. Showed no significant difference (P>0.05).
(3) Karnofsky score:After treatment, see KPS score was significantly improved compared with before treatment were significantly different (P<0.05). The control group after treatment KPS score also improved significantly (P<0.05). After treatment, statistically significant differences (P<0.05), suggesting that the Yin and moistening method with radiotherapy and chemotherapy in advanced breast cancer Yin Jin deficiency syndrome patients physical status of the improvement is more obvious.
In addition, the long-term efficacy results show that70patients plus traditional Chinese medicine on the basis of radiotherapy and chemotherapy, the survival of the efficacy effective in10cases, accounting for14.3%; effective51cases, accounting for72.8%; ineffective in9cases, accounting for12.9%; The total effective rate was87.1%. The control group survival of total effective rate was74.3%. The treatment group survival in patients with3-year survival rate was67.1%;5-year survival rate was31.4%.3-year survival of the patients in the control group survival was45.7%;5-year survival rate was17.1%.
Conclusion:
Nourish yin and Moisturize dryness Prescription united chemoradiotherapy has good efficacy in short and long-term in advanced breast cancer belong to deficiency of yin syndrome, can significantly improve the clinical symptoms and physical condition, and can prolong the survival of patients.
方法：选择105例新加坡田农中医肿瘤诊所就诊的中晚期乳腺癌阴津亏虚证患者,分为2组,其中治疗组(滋阴润燥法配合放化疗)70例、对照组(单纯放化疗)35例。治疗4个周期以上,分别观察治疗前后两组的中医症候、生存质量等方面的近期疗效。同时,进行远期疗效观察,观察治疗后两组患者的远期中医症候改善变化、生存率等方面的情况。
结果：
(1)中医症候比较：治疗组中医症候疗效显效11例,有效52例,无效7例,有效率为90.0%；对照组显效3例,有效21例,无效11例,有效率为68.6%。经统计学检验,两组有显著性差异(P<0.05)。提示滋阴润燥法配合放化疗的中医症候疗效优于单纯放化对照组。
(2)癌灶变化比较：治疗组完全缓解0例,部分缓解17例,稳定48例,疾病进展5例,病灶稳定率为92.9%；对照组完全缓解0例,部分缓解7例,稳定23例,疾病进展5例,病灶稳定率为85.7%。两组比较无明显差异(P>0.05)。
(3)卡氏评分比较：治疗组治疗后见KPS评分明显提高,与治疗前比较有显著差异(P<0.05)。对照组治疗后KPS评分亦有所提高,有统计学差异(P<0.05)。两组治疗后比较存在显著统计学差异(P<0.05),提示滋阴润燥法配合放化疗治疗中晚期乳腺癌阴津亏虚证,患者体力状况改善方面更为明显。
另外,远期疗效观察结果表明,70例患者在放化疗的基础上加中药治疗后,生存期疗效显效10例,占14.3%；有效51例,占72.8%；无效9例,占12.9%；总有效率为87.1%。对照组生存期疗效总有效率为74.3%。治疗组患者生存期3年生存率为67.1%；5年生存率为31.4%。对照组患者生存期3年生存率为45.7%；5年生存率为17.1%。
结论：
滋阴润燥法配合放化疗治疗中晚期乳腺癌阴津亏虚证具有较好的近期疗效和远期疗效,能明显改善患者的临床症状和体力状况,并能延长患者的生存期。
Objective:To observe the short and long-term treatment effect of Nourish yin and Moisturize dryness Prescription united chemoradiotherapy in the breast cancer which belong to Deficiency of Yin. Through the assessments of patients in the aspects such as TCM clinical symptoms, quality of life, tumor size changes, the long-term survival indicators, obtain more about the treatment value in clinic, and exploit more wider future in TCM remedy to breast cancer.
Methods:105patients with advanced breast cancer belong to deficiency of yin were devided into two groups, treatment group (nourish yin and moisturize dryness prescription united chemoradiotherapy with70cases), control group (treated with radiotherapy and chemotherapy)35cases. Four times of treatment were observed in the two groups before and after treatment, clinical symptoms, quality of life changes. At the same time, long-term efficacy such as long-term TCM symptoms, survival rate were be observed.
Results:
(1) TCM symptoms:treatment group TCM Syndrome cured,11cases,52cases effective, ineffective in7cases, the effective rate of90.0%; control group,3cases markedly effective21cases,11cases, the effective rate of68.6%. The statistical test, two groups have differences (P <0.05). It means nourish yin and moisturize dryness prescription united chemoradiotherapy is superior to the control group.
(2) Tumor size change:the treatment group complete remission0cases, partial remission in17cases, stable48cases,5cases of disease progression, lesions and stable rate of92.9%; the control group, complete remission0cases,7cases of partial remission, stable23cases, five cases of disease progression and stable lesions was85.7%. Showed no significant difference (P>0.05).
(3) Karnofsky score:After treatment, see KPS score was significantly improved compared with before treatment were significantly different (P<0.05). The control group after treatment KPS score also improved significantly (P<0.05). After treatment, statistically significant differences (P<0.05), suggesting that the Yin and moistening method with radiotherapy and chemotherapy in advanced breast cancer Yin Jin deficiency syndrome patients physical status of the improvement is more obvious.
In addition, the long-term efficacy results show that70patients plus traditional Chinese medicine on the basis of radiotherapy and chemotherapy, the survival of the efficacy effective in10cases, accounting for14.3%; effective51cases, accounting for72.8%; ineffective in9cases, accounting for12.9%; The total effective rate was87.1%. The control group survival of total effective rate was74.3%. The treatment group survival in patients with3-year survival rate was67.1%;5-year survival rate was31.4%.3-year survival of the patients in the control group survival was45.7%;5-year survival rate was17.1%.
Conclusion:
Nourish yin and Moisturize dryness Prescription united chemoradiotherapy has good efficacy in short and long-term in advanced breast cancer belong to deficiency of yin syndrome, can significantly improve the clinical symptoms and physical condition, and can prolong the survival of patients.
引文
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[2]唐汉钧,高尚璞,郑勇,等.中医药治疗乳腺癌术后患者288例临床观察[J].上海中医药大学学报,2002,16(3)：23-24.
[3]章永红.抗癌中药大全[M].南京：江苏科学技术出版社,2000.470-472.
[4]万华,吴雪卿,陆德铭。扶正祛邪在治疗乳腺癌中的运用[J].上海中医药大学学报,2002,16(1)：30-31.
[5]章永红,叶丽红,彭海燕,等.论癌症从虚毒治疗[J].南京中医药大学学报,2009,25(6)：408-411.
[6]孙燕.内科肿瘤学.北京：人民卫生出版社,2001.426
[7]刘胜, 吴雪卿, 陈前军, 等,407例乳腺癌术后患者辨证分型规律探讨[J].辽宁中医杂志,1999,6(9)：387-388
[8]周菊英1中西医结合治疗晚期乳腺癌86例临床观察[J]1山西中医,2000,16(6)30-311
[9]吴雪卿,万华[1]赵晶等,乳腺癌术后患者中医辨证分型试探,上海中医药杂志.2005,39(8).-3-4
[10]周维顺, 吴林生,试述乳腺癌的中西医诊治原则,实用中医药杂志,-2004年,20(2).-100-101
[11]唐汉钧,乳腺癌的中医临床与实验研究,中医药学刊,2003 21(2).-168-172
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