【作者】 张卫红；

【导师】 卞卫和；

【作者基本信息】 南京中医药大学 ， 中医外科学， 2007， 硕士

【摘要】 目的：评价中药益气活血方对乳腺癌术后化疗患者细胞免疫功能的影响及生活质量的改善。方法：选取符合纳入标准的20例乳腺癌术后患者，随机分为实验组(10例)和对照组(10例)，两组均采用蒽环类联合化疗方案(CAF或CEF)化疗，实验组加服益气活血方，两组观察对象均于治疗前一天、治疗第7、21、28、42天空腹抽取外周静脉血测定T淋巴细胞亚群CD3~+、CD4~+、CD8~+水平、CD4~+／CD8~+、CD16~+／CD56~+(NKcell)进行比较，同时观察临床症状、KPS评分及化疗毒副反应的变化。结果：实验组第28天CD3~+水平升高与治疗前比有非常显著性差异(p〈0.01)，对照组第28天CD3~+水平升高与治疗前比有显著性差异(p〈0.05)，但组间对比无显著性差异(P〉0.05)；实验组第28天出现NK细胞水平下降，与治疗前比有显著性差异(P〈0.05)，对照组第7天、第28天NK细胞水平下降与治疗前比均有显著性差异(P〈0.05)，组间比无显著性差异(P〉0.05)；CD4~+、CD8~+、以及CD4~+／CD8~+比值组间、组内各观察时间点均无差异；实验组在临床症状、KPS评分以及化疗毒副反应方面(胃肠道反应、肝功能损害及心脏毒性)均优于对照组(p〈0.01)。结论：化疗可以提高乳腺癌患者外周血CD3~+水平，同时也能抑制NK细胞的水平，而益气活血方能延缓化疗对NK细胞的抑制作用，从而能部分调节乳腺癌患者的细胞免疫功能；可明显改善患者的临床症状及体力状况，并能明显减轻化疗毒副反应，提高患者的生活质量，不失为治疗乳腺癌的有效方法之一。更多还原

【Abstract】 Objective: To evaluat the therapeutic effect on cellular immune function and quality of life ofYiQiHuoXue Decoction on the postoperative patients with breast cancer who are treated withchemotherapy.Methods: 20 cases of postoperative patients with breast cancer were randomly divided intotwo groups, of which 10 cases of patients in experimental group with YiQiHuoXue Decoctioncombined with chemotherapy (CAFor CEF regimen), and 10 cases in control group withchemotherapy alone. The T lymphocyte subsets such as CD3~+, CD4~+, CD8~+, CD4~+/CD8~+, CD16~+/CD56~+, as well as the clinical symptoms, KPS score and the adverse reaction ofchemotherapy were observed in both groups on the pretherapy and the 7d, 21d, 28d, 42dpost-therapy.Results: significant difference with CD3~+ on 28d much higher than pretherapy was found inexperimental group(P＜0.01); The similar result was found in control group (P＜0.05); nosignificant difference was found in two groups. The amount of NK on 7 d and 28d were muchlower than pretherapy in controull group(P＜0.05), and only lower amount of NK on 28dwas found in experimental group (P＜0.05); The clinical symptoms and KPS score wereimproved in experimental group better than in control group (p＜0.05); THe adverse reaction ofchemotherapy were found mainly on heart and liver and gastrointestinal disturbance. Thetoxical degree was slighter in experimental group than in control group (p＜0.05).Conclusion: Chemotherapy can raise the CD3~+ level and also can decrease the NKcell level inplasma of postoperative patients with breast cancer. Yi Qi Huo Xue Decoction can alleviate anddelay the inhibition of chemotherapy on NK and partly regulate the cellular immune functionof patients with breast cancer. It can obviously improve patients’ clinical symptoms, physical condition and their life quality.更多还原