| 引用本文:孙学然，杨克，吕玲玲，陈敬贤，郭元彪，阮铭，应海峰，沈小珩，郑岚.调肝补肾消积分期疗法治疗晚期乳腺癌的临床疗效[J].世界中医药,2019,(01):. |
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| 调肝补肾消积分期疗法治疗晚期乳腺癌的临床疗效 |
| Evaluation on Clinical Efficacy of Liver-regulating，Kidney-tonifying and Mass-eliminating Therapy by Stage for Advanced Breast Cancer |
| 投稿时间：2018-08-03 |
| DOI：10.3969/j.issn.1673-7202.2019.01.023 |
| 中文关键词: 调肝补肾消积分期疗法 乳腺癌 生命质量 免疫功能 无进展生存期 |
| English Keywords:Traditional Chinese medicine therapy of regulating liver and tonifying kidney and eliminating mass by stage Advanced breast Cancer Life quality Immune function Progression-free survival |
| 基金项目:上海市科委基金项目（14401971100）——基于“同病异治”理论的晚期乳腺癌中医干预方案研究及疗效评价 |
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| 中文摘要: |
| 目的：探讨中医调肝补肾消积分期疗法对稳定期晚期乳腺癌患者生命质量、免疫功能、疾病进展的影响。方法:采用单中心、前瞻性队列设计的研究方法，收集2014年9月至2017年9月上海交通大学医学院附属瑞金医院收治的一线化疗结束后病情稳定的晚期乳腺癌患者100例，分为观察组和对照组，对照组采用西医常规治疗，观察组在西医治疗的基础上配合中医调肝补肾消积分期疗法。分析比较2组治疗后卡氏评分（Kanofsky Score，KPS）、生命质量评分（EORTC-QLQ-C30）、汉密尔顿抑郁量表评分（HAMD）、中医证候积分、外周血细胞免疫、体液免疫水平、无进展生存期（PFS）、中位无进展生存期（M-PFS）。结果:观察组KPS评分好转率优于对照组（P<0.05），生命质量（EORTC-QLQ-C30）评分中躯体、角色、情绪功能及总体生命质量评分高于对照组（P<0.05），HAMD评分有效率优于对照组（P<0.05）；观察组治疗后中医证候积分明显下降，证候总分、情志抑郁、不寐、心烦易怒、自汗盗汗、五心烦热、腰膝酸软、肢体麻木、口干舌燥中医证候积分低于对照组（P<0.05）；治疗后观察组CD3+水平、CD4+水平、CD4+/CD8+比值、NK细胞水平、免疫球蛋白IgG、IgM、IgA水平高于对照组（P<0.05）；治疗后观察组PFS、M-PFS较对照组延长（P<0.05）。结论:中医调肝补肾消积分期疗法能缓解稳定期晚期乳腺癌患者的中医证候及抑郁状态，提高生命质量，改善免疫功能，延缓疾病进展。 |
| English Summary: |
| To explore the effects of liver-regulating，kidney-tonifying and mass-eliminating therapy by stage on life quality，immune function and disease progression in patients with advanced breast cancer in stable period. Methods:A total of 100 patients admitted to Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine with advanced breast cancer who were in stable period after the first-line chemotherapy from September 2014 to September 2017 were randomly divided into treatment group (50 cases) and control group (50 cases). The control group was treated with routine therapy of Western medicine，on the basis of which the treatment group was combined with traditional Chinese medicine (TCM) therapy to regulate liver，tonify kidney and eliminate the mass by stage. Analysis and comparison of post-treatment Kanofsky score (KPS)，quality of life score (EORTC-QLQ-C30)，Hamilton Depression Scale score (HAMD)，TCM syndrome score，peripheral blood cell immunity，humoral immunity，progression-free survival (PFS)，and median progression-free survival (M-PFS) of two groups were made. Results:The improvement rate of KPS score in the treatment group was better than that in the control group (P<0.05). The physical，character，emotion function and overall quality of life scores were higher than those of the control group (P<0.05). The effective rate of HAMD score was significantly higher than that of the control group (P<0.05). In terms of TCM syndrome scores，the scores of the treatment group decreased significantly after treatment. The total syndrome scores，depression，insomnia，upset，irritability，spontaneous sweating，night sweating，dysphoria with feverish sensation in chest，palms and soles，soreness and weakness of waist and knees，limb numbness，and dry mouth symptoms scores were lower than those of the control group (P<0.05). After treatment，the levels of CD3+，CD4+，CD4+/CD8+，NK cells，immunoglobulin IgG，IgM，IgA were higher in the treatment group than those in the control group (P<0.05). After treatment，PFS and M-PFS in the treatment group were longer than those in the control group (P<0.05). Conclusion:TCM liver-regulating，kidney-tonifying and mass-eliminating therapy by stage can alleviate TCM syndromes and depression in patients with advanced breast cancer in stable period，improve quality of life，improve immune function，and delay disease progression. |
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