世界中医药

目的：探究舒肝益肾方联合内分泌对激素依赖型乳腺癌疗效，以期丰富治疗方法，提高疗效。方法：选取2014年1月至2018年12月秦皇岛市中医医院收治的激素依赖型乳腺癌患者94例作为研究对象，按照就诊顺序编号随机分为对照组和观察组，每组47例。对照组常规内分泌治疗，观察组在对照组基础上加用舒肝益肾方治疗，同时治疗4周。观察2组治疗前、治疗后肿瘤标志物、免疫功能、肝功能、凝血功能、生命质量、中医证候积分变化并比较。结果：治疗后2组癌抗原153(CA153)、糖链型抗原125(CA125)较治疗前显著下降，差异有统计学意义（P<0.05），治疗后观察组以上指标显著低于对照组，差异有统计学意义（P<0.05）。治疗后观察组CD3+、CD4+、CD4+/CD8+、自然杀伤细胞（NK）、IgA、IgG、IgM较治疗前显著升高，CD8+则显著下降，差异有统计学意义（P<0.05），对照组治疗前、治疗后比较，差异无统计学意义（P>0.05），治疗后观察组CD8+显著低于对照组，余均显著高于对照组，差异有统计学意义（P<0.05）。治疗后对照组总胆固醇（TC）、谷氨酰转肽酶（GCT）、纤维蛋白原（FIB）、部分凝血酶时间（APTT）较治疗前显著上升，差异有统计学意义（P<0.05），观察组治疗后和治疗前比较，差异无统计学意义（P>0.05），治疗后观察组以上指标显著低于对照组，差异有统计学意义（P<0.05）。治疗后2组躯体功能、角色功能、情绪功能、认知功能、社会功能、整体生命质量较治疗前显著升高，差异有统计学意义（P<0.05），治疗后观察组以上指标显著高于对照组，差异有统计学意义（P<0.05）。治疗后2组情志抑郁、不寐、心烦易怒、腰膝酸软、肢体受限较治疗前显著下降，差异有统计学意义（P<0.05），治疗后观察组以上指标显著低于对照组，差异有统计学意义（P<0.05）。结论：舒肝益肾方联合内分泌能提高激素依赖型乳腺癌免疫功能，抑制肿瘤进展，从而改善临床症状，提高生命质量。

English Summary:

To explore the therapeutic effects of Shugan Yishen Decoction combined with endocrine on hormone-dependent breast cancer, in order to enrich the treatment methods and improve the curative effect.Methods:A total of 94 patients with hormone-dependent breast cancer hospitalized in Qinhuangdao Chinese Medicine Hospital from January 2014 to December 2018 were randomly divided into a control group(47 cases)and an observation group(47 cases).The control group received routine endocrine therapy, while the observation group received Shugan Yishen Decoction on the basis of the control group for 4 weeks.The changes of tumor markers, immune function, liver function, blood coagulation function, quality of life and TCM syndrome scores before and after treatment were observed and compared between the 2 groups.Results:1)After treatment, CA125 and CA153 in the 2 groups were significantly decreased than those before treatment(P<0.05), and the above indexes in the observation group were significantly lower than those in the control group(P<0.05).2)After treatment, CD3+, CD4+, CD4+/CD8+, NK, IgA, IgG and IgM in the observation group increased significantly, while CD8+ decreased significantly(P<0.05).There was no significant difference between the control group before and after treatment(P>0.05).After treatment, CD8+ in the observation group was significantly lower than that in the control group, and the rest was significantly higher than that in the control group(P<0.05).3)After treatment, total cholesterol(TC), glutamyl transpeptidase(GCT), fibrinogen(FIB), and partial thrombin time(APTT)in the control group were significantly increased than those before treatment(P<0.05).There was no significant difference between the observation group after treatment and before treatment(P>0.05), and the above indexes in the observation group after treatment were significantly lower than those in the control group(P<0.05).4)After treatment, the physical function, role function, emotional function, cognitive function, social function and overall quality of life in the 2 groups were significantly increased than those before treatment(P<0.05), and the above indexes in the observation group were significantly higher than those in the control group(P<0.05).5)After treatment, depression, insomnia, irritability, weakness of waist and knee, limb limitation in both groups decreased significantly compared with before treatment(P<0.05).After treatment, the above indicators in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Shugan Yishen Decoction combined with endocrine can improve the immune function of hormone-dependent breast cancer, inhibit the progress of tumors, thereby improving clinical symptoms and quality of life.

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