紫杉醇-顺铂(PT方案)化疗对绝经后女性性激素的动态影响与补肾益气中药的保护作用

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目的:观察PT方案联合化疗对女性绝经后性激素的动态影响及补肾益气类中药的解毒保护作用。方法:采用随机区组对照和自身对照实验设计,回顾性调查接受PT联合化疗的女性结肺癌术后患者的黄体生成素(LH)、雌二醇(E2)、泌乳素(PRL)、孕酮(P)、睾酮(T)和促卵泡激素(FSH)的变化。61例患者分为单纯中药组、PT组、PT+中药组和对照等4组,化疗均为1疗程/月,共6疗程。分别在化疗前、化疗结束时(化疗开始6个月)和化疗开始12个月时监测各组的LH、E2、PRL、P、T和FSH。结果:PT组的LH、PRL和E2、和T均明显下降,化疗结束时有所回升,但化疗结束后6个月(化疗开始12个月时)仍低于化疗前和对照组的水平;PT+中药组的LH、PRL、E和T下降不明显,化疗开始12个月时回升于化疗前和对照组的水平。FSH则相反,PT组的FSH化疗后血液浓度明显升高,化疗开始12个月时仍未降至化疗前和对照组的水平;PT+中药组的FSH升高不明显。单纯中药组及对照组的上述指标无明显变化;各组观察期内P无明显变化。结论:PT方案联合化疗均可导致女性肺癌术后患者多种性激素水平失常。补肾益气类中药有不同程度的解毒保护作用。 OBJECTIVE: To observe the dynamic effects of PT regimen combined with chemotherapy on sex hormones in postmenopausal women and the detoxification and protective effect of Bushen Yiqi herbs. Methods: Randomized block control and self-controlled experimental design were used to retrospectively investigate the correlation between LH, estradiol (E2), prolactin (PRL), progesterone (P), testosterone (T) and follicle stimulating hormone (FSH). 61 patients were divided into simple Chinese medicine group, PT group, PT + traditional Chinese medicine group and control group. The chemotherapy was 1 course / month for a total of 6 courses. The levels of LH, E2, PRL, P, T and FSH in each group were monitored before chemotherapy, at the end of chemotherapy (6 months after the start of chemotherapy) and 12 months after the start of chemotherapy. Results: The levels of LH, PRL, E2, and T in PT group decreased significantly and returned to the level at the end of chemotherapy. However, the levels of LH, PRL, E2 and T in PT group were still lower than those before chemotherapy and control group at 6 months after the start of chemotherapy The decrease of LH, PRL, E and T in PT + TCM group was not obvious, and the level of chemotherapeutics and control group rose back to the level of 12 months after the start of chemotherapy. On the contrary, in FSH group, the blood concentration of FSH in PT group was significantly increased. The level of FSH in PT + TCM group was not significantly reduced at 12 months after chemotherapy. The simple Chinese medicine group and the control group of the above indicators no significant change; each group during the observation period P no significant change. Conclusion: PT combination chemotherapy can lead to a variety of hormone levels in women with postoperative lung cancer. Bushen Yiqi herbs have different degrees of detoxification protection.
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