摘要
目的观察温肾升白方结合艾灸防治乳腺癌患者化疗性骨髓抑制的疗效。方法选取2018年1月—2019年6月上海中医药大学附属岳阳中西医结合医院乳腺科治疗的261例原发性乳腺癌患者,按照1∶2的比例随机分为对照组87例与灸药组174例。2组均给予4~8个疗程的化疗,在化疗过程中对照组根据患者骨髓抑制情况给予粒细胞集落刺激因子(rhG-CSF)治疗,灸药组给予rhG-CSF联合温肾升白方及艾灸治疗。比较2组患者每个化疗周期白细胞、中性粒细胞计数和应用rhG-CSF的剂量,分层比较不同化疗药物(蒽环类和紫杉类)和不同月经状态(未绝经和已绝经)患者白细胞、中性粒细胞计数,记录2组患者治疗结束时不良反应发生情况。结果对照组83例、灸药组167例完成研究。化疗前4个周期,灸药组白细胞和中性粒细胞计数均明显高于同期对照组(P均<0.05),使用rhG-CSF剂量明显少于同期对照组(P均<0.05);化疗后4个周期,2组白细胞和中性粒细胞计数及使用rhG-CSF剂量比较差异均无统计学意义(P均>0.05)。化疗前4个周期,灸药组使用蒽环方案化疗者和已绝经者白细胞和中性粒细胞计数均明显高于对照组使用蒽环方案化疗者和已绝经者(P均<0.05),2组使用紫杉方案化疗者和未绝经者白细胞和中性粒细胞计数比较差异均无统计学意义(P均>0.05)。2组化疗结束时均未见肝肾功能异常,灸药组无中药和艾灸相关不良反应发生。结论温肾升白方结合艾灸干预可以抑制乳腺癌化疗患者白细胞、中性粒细胞计数降低,减少化疗期间rhG-CSF使用剂量,尤其是对使用蒽环方案化疗和已绝经患者疗效更明显,且安全。
Objective It is to explore the curative effect of Wenshen Shengbai decoction combined with moxibustion in the prevention and treatment of chemotherapeutic myelosuppression in breast cancer patients.Methods A total of 261 patients with primary breast cancer treated at the Breast Department of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine(TCM)from January 2018 to June 2019 were selected as the research subjects,and randomly divided into control group(n=87)and combination group(n=174)at a ratio of 1:2.Both groups were given 4-8 courses of chemotherapy.During the chemotherapy process,the control group was given recombinant human granulocyte colony-stimulating factor(rhG-CSF)according to the patient's bone marrow suppression,and the combination group was given rhG-CSF combined with Wenshen Shengbai decoction and moxibustion.The white blood cell count,neutrophil count and the dosage of rhG-CSF applied were compared between the two groups,and the leukocyte and neutrophil counts in patients with different chemotherapy drugs(anthracyclines and taxanes)and different menstrual states(premenopausal and menopausal)were further compared,the occurrence of adverse reactions of patients in both groups were recorded at the end of treatment.Results Eighty-three cases in the control group and 167 cases in the combination group completed the study.After the former 4 cycles of chemotherapy,the counts of leukocytes and neutrophils in the combination group were significantly higher than those in the control group at the same period(all P<0.05),and the dosage of rhG-CSF was significantly lower than that in the control group at the same period(P<0.05);There was no significant difference in leukocyte and neutrophil counts and rhG-CSF dosage between the two groups after the latter 4 cycles of chemotherapy(all P>0.05).After the former 4 cycles of chemotherapy,the leukocyte and neutrophil counts of the patients receiving anthracycline chemotherapy and
作者
李思雨
季亚婕
张馨月
陈玮黎
陆清
李琼
沙珊焱
薛晓红
LI Siyu;JI Yajie;ZHANG Xinyue;CHEN Weili;LU Qing;LI Qiong;SHA Shanyan;XUE Xiaohong(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)
出处
《现代中西医结合杂志》
CAS
2022年第21期2945-2950,共6页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
第一轮促进市级医院临床技能与临床创新能力三年行动计划-疑难疾病精准诊治攻关项目(16CR2026B)
第二轮促进市级医院临床技能与临床创新能力三年行动计划-临床研究青年项目(SHD2020CR4057)
上海市科委项目(20Y21901100)。
关键词
温肾升白方
艾灸
原发性乳腺癌
骨髓抑制
Wenshen Shengbai decoction
moxibustion
primary breast cancer
leukocytes
myelosuppression
