【摘要】 目的 观察散结消瘤颗粒联合化疗对晚期乳腺癌患者中医证候、肿瘤标志物及免疫功能的影响，评价其临床疗效。方法 选取IV期乳腺癌患者72例作为观察对象，将其随机分为颗粒组和化疗组，各36例。化疗组给予脂质体紫杉醇单药化疗，颗粒组在化疗组基础上加用散结消瘤颗粒口服治疗，每21 d为1个治疗周期，共治疗4个周期。疗程结束后，对2组临床疗效进行评定，比较2组治疗前后中医证候评分、KPS评分的变化，取患者治疗前后静脉血，采用ELISA法检测血清癌抗原15-3(CA15-3）、癌抗原125(CA125）、癌胚抗原（CEA）的水平变化及外周血T淋巴细胞亚群（CD3~+、CD4~+、CD8~+、CD4~+/CD8~+）变化。结果 治疗前，2组各项指标差异均无统计学意义（P>0.05），治疗4个周期后，颗粒组临床总有效率明显高于化疗组（P<0.05),2组中医证候评分较治疗前明显降低，KPS评分显著提高（P<0.05），血清CA15-3、CA125和CEA的水平明显降低（P<0.05）；颗粒组患者中医证候评分明显低于化疗组，KPS评分较化疗组明显提升（P<0.05),CA15-3、CA125、CEA水平明显低于化疗组，外周血CD3~+、CD4~+及CD8~+绝对值下降程度明显低于化疗组（P<0.05）。结论 散结消瘤颗粒联合化疗可有效改善晚期乳腺癌症状，提高患者生存质量，减少化疗对细胞免疫功能的损伤，进一步提高临床疗效。更多还原

【Abstract】 Objective To observe the effects of Sanjie Xiaoliu granules combined with chemotherapy on the TCM syndromes,tumor markers and immune function in patients with advanced breast cancer,and to evaluate its clinical efficacy.Methods Seventy-two patients with stage Ⅳ breast cancer were selected and randomly divided into two groups:a granule group and a chemotherapy group,with 36 cases in each group.The chemotherapy group was treated with paclitaxel liposome alone,while the granule group was treated with Sanjie Xiaoliu granules on the basis of that.Every 21 days was a treatment cycle,with a total of 4 cycles.After the treatment,the clinical efficacy of the two groups was evaluated,and the changes of TCM syndrome scores and KPS score before and after treatment were compared between the two groups.The venous blood of the patients before and after treatment was taken,and the levels of serum cancer antigen 15-3 (CA15-3),cancer antigen 125 (CA125),carcinoembryonic antigen (CEA) and peripheral blood T lymphocyte subsets (CD3~+,CD4~+,CD8~+,CD4~+/CD8~+) were detected by ELISA.Results Before treatment,there was no statistically significant difference in all the indicators between the two groups (P>0.05).After 4 cycles of treatment,the total clinical effective rate of the granule group was significantly higher than that of the chemotherapy group (P<0.05),and the TCM syndrome scores of the two groups were significantly reduced,while the KPS scores were significantly increased (P<0.05),and the levels of serum CA15-3,CA125 and CEA were significantly decreased(P<0.05).The TCM syndrome scores of the granule group were significantly lower than those of the chemotherapy group,while the KPS score was significantly improved compared to the chemotherapy group (P<0.05).The levels of CA15-3,CA125 and CEA were significantly lower than those of the chemotherapy group,and the absolute values of peripheral blood CD3~+,CD4~+,and CD8~+were decreased significantly compared to the chemotherapy group (P<0.05).Conclusion Sanjie Xiaoliu granules combined with chemotherapy can effectively improve the symptoms of advanced breast cancer,improve the quality of life of patients,reduce the damage of chemotherapy to cellular immune function,and further improve the clinical efficacy.更多还原