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目的:观察参苓白术散加减联合新辅助化疗治疗乳腺癌的增效减毒作用。方法:采用随机数字表法将88例患者分为对照组和观察组各44例。对照采用TAC方案,多西他赛,75 mg/m2;阿霉素,50 mg/m2;环磷酰胺,500 mg/m2,静脉滴注,3周1次。共3疗程。观察组在对照组基础上加用参苓白术散加减治疗。2组疗程均为10周。进行治疗前后实体肿瘤大小、骨髓抑制情况和全身不良反应情况评价,采用KPS评价患者生活质量,采用流式细胞仪检测治疗前后外周血T淋巴细胞亚群(CD3+,CD4+,CD8+,CD4+/CD8+)及自然杀伤细胞(NK)水平。结果:观察组实体肿瘤疗效有效率(RR)79.55%,对照组63.64%,观察组高于对照组,但2组间比较,差异均无统计学意义(P>0.05);观察组骨髓抑制程度低于对照组(P<0.05);KPS评分有效率(提高+稳定)对照组65.91%,观察组95.45%,观察组高于对照组,差异有统计学意义(P<0.01);治疗后观察组CD3+、CD4+、CD8+、CD4+/CD8+、NK水平均高于对照组,差异有统计学意义(P<0.05或P<0.01);观察组不良反应发生率45.45%,低于对照组70.45%,差异有统计学意义(P<0.05)。结论:参苓白术散加减联合TAC方案能减轻化疗药物的毒副反应,提高乳腺癌患者生活质量和免疫功能,起到了增效减毒作用。
Objective: To observe the effect of Shenling Baizhu San combined with neoadjuvant chemotherapy in the treatment of breast cancer. Methods: 88 cases were divided into control group and observation group by random number table. The control group was given TAC regimen, docetaxel 75 mg / m2, doxorubicin 50 mg / m2, cyclophosphamide 500 mg / m2, intravenously once a week for 3 weeks. A total of 3 courses. Observation group on the basis of the control group plus Shenling Baizhu addition and subtraction treatment. The two groups of treatment were 10 weeks. The tumor size, bone marrow suppression and systemic adverse reactions were evaluated before and after treatment. KPS was used to evaluate the quality of life of patients. The levels of T lymphocyte subsets (CD3 +, CD4 +, CD8 +, CD4 + / CD8 +) in peripheral blood were measured by flow cytometry And natural killer (NK) levels. Results: The effective rate (79.55%) of observation group was 63.5%, the control group was 63.64%, the observation group was higher than that of the control group, but there was no significant difference between the two groups (P> 0.05); the degree of myelosuppression (P <0.05). The KPS score was improved (65.91%) in the control group and 95.45% in the observation group (P <0.01), and the difference was statistically significant (P <0.01) The levels of CD3 +, CD4 +, CD8 +, CD4 + / CD8 + and NK in the observation group were significantly higher than those in the control group (P <0.05 or P <0.01). The incidence of adverse reactions in the observation group was 45.45% The difference was statistically significant (P <0.05). Conclusion: Shenling Baizhu combined with TAC regimen can reduce the toxic and side effects of chemotherapy drugs, improve the quality of life and immune function of patients with breast cancer, play a synergistic effect attenuated.