逐瘀通络血痹汤加减治疗乳腺癌术后化疗相关性手足综合征的疗效分析

Efficacy of modified Zhuyu Tongluo Xuebi Decoction in the treatment of chemotherapy-related hand-foot syndrome after breast cancer surgery

摘要:

目的 观察逐瘀通络血痹汤加减治疗乳腺癌术后化疗相关性手足综合征（HFS）的临床疗效。方法 选取2019年10月—2021年9月海南省人民医院收治的乳腺癌术后化疗相关性HFS患者94例，随机分为对照组（给予常规治疗）和观察组（在常规治疗基础上另给予逐瘀通络血痹汤加减治疗），每组47例。对比两组患者中医症候评分、临床疗效、HFS分级、相关量表评分［卡氏功能状态评分（KPS）、数字疼痛量表评分（NRS）］、免疫功能及不良反应。结果 观察组治疗前后主症、次症评分及总分的下降程度大于对照组（P <0.05）。观察组总有效率高于对照组（P <0.05）。观察组HFS分级改善情况优于对照组（P <0.05）。观察组治疗前后KPS评分的差值大于对照组（P <0.05），NRS评分的下降程度大于对照组（P <0.05）。观察组CD4^＋、CD4^＋/CD8^＋及NK的差值大于对照组（P <0.05）。两组治疗期间不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 逐瘀通络血痹汤加减治疗乳腺癌术后化疗相关性HFS可缓解临床症状，提高临床疗效，改善HFS分级，降低疼痛，恢复体力状况，提高免疫功能，且安全可靠。

Abstract:

Objective To observe the clinical efficacy of modified Zhuyu Tongluo Xuebi Decoction in the treatment of chemotherapy-related hand-foot syndrome (HFS) after breast cancer surgery.Methods From October 2019 to September 2021, 94 patients with HFS associated with chemotherapy after breast cancer surgery in our hospital were selected and divided into the control group (conventional treatment) and the observation group (modified Zhuyu Tongluo Xuebi Decoction plus conventional treatment) by random number table method, with 47 cases in each group. The traditional Chinese medicine (TCM) symptom scores, clinical efficacy, HFS grade, scores of Karnofsky Performance Status (KPS) and Numeric Pain Rating Scale (NRS), immune function and adverse reactions were compared between the two groups.Results The decreases in the scores of the main symptoms and the secondary symptoms and the total score after the treatment in the observation group were higher than those in the control group (P < 0.05). The overall effective rate in the observation group was higher than that in the control group (P < 0.05). The improvement in HFS grade in the observation group was greater than that in the control group (P < 0.05). The differences of KPS and NRS scores before and after the treatment in the observation group were higher than those in the control group (P < 0.05). The differences of the frequency of CD4⁺, CD4⁺/CD8⁺ and NK cells before and after the treatment in the observation group were higher than those in the control group (P < 0.05). There was no significant difference in the overall incidence of adverse reactions between the observation group and the control group during treatment (P > 0.05).Conclusions Modified Zhuyu Tongluo Xuebi Decoction can relieve clinical symptoms, improve clinical efficacy and HFS grade, reduce the pain, and enhance the performance status and immune function in the treatment of postoperative chemotherapy-related HFS in patients with breast cancer, and is safe and reliable.