健脾益肾、调肝解毒法与TP方案化疗联合治疗晚期乳腺癌的临床研究

【作者】 郝淑芳；

【导师】 吴勉华；

【作者基本信息】 南京中医药大学 ， 中医内科， 2004， 硕士

【摘要】 本文遵循中医理论，结合临床实践，从理论、临床两方面对晚期乳腺癌进行系统深入的研究。在理论研究中，对该病的中医病证范围、病因病机、辨证要点等作了阐述和探析。认为该病的基本病机是脾肾两虚、肝郁痰凝。脾肾两虚为病之本，气郁、痰浊、瘀毒为病之标。据此，确立了健脾益肾、调肝解毒的治疗方法，拟方乳岩方，并根据乳腺癌的化疗进展，采用TP化疗方案，联合治疗晚期乳腺癌。临床治疗晚期乳腺癌50例，随机分为治疗组（中药加化疗）26例和对照组（单纯化疗组）24例。治疗组的肿瘤客观疗效有效率73.1％，略好于对照组66.7％，两组比较无统计学差异（P＞0.05）；治疗组中医证候疗效有效率84.6％，对照组有效率58.3％，治疗组的中医证候疗效明显优于对照组（P＜0.01）；治疗组病人在治疗后体力状况优于对照组（P＜0.01）；治疗组治疗后，免疫功能指标（CD₃⁺、CD₄⁺、CD₈⁺）较治疗前有所好转（P＜0.05），而对照组免疫功能指标继续下降，治疗后治疗组病人的免疫功能明显优于对照组（P＜0.01）；治疗的不良反应经过检验，白细胞、血小板减少及恶心、呕吐方面两组比较有统计学差异，其余方面无差异。治疗组和对照组在肿瘤近期客观疗效方面没有太大差别，但治疗组在改善患者症状、体力情况、提高免疫功能、减轻毒副反应方面，优于对照组。健脾益肾、调肝解毒法起到了减毒增效的作用。更多还原

【Abstract】 A series of study on advanced breast cancer were conducted, following the theories of TCM and clinical practice.Results of theoretical study. Insufficiency of spleen is the intrinsic factor of the occurrence of this disease. Its basic pathogenesis is the deficiency of spleen and kidney , the stasis of liver Qi and poison. Therefore, the therapeutic principles for advanced breast cancer is supplementing spleen and kidney, regulaterring liver and relieving poison. Based on it, the Ruyanfang is built.Results of clinical study. 50 cases of advanced breast cancer patients were randomly divided into therapy group(Chinese herbs combined with chemotherapy) and control group(chemotherapy alone). There is no significant difference in objective curative effect between the two groups. The therapy group is superior to control group in clinical syndrome, immune function, side effect and life quality.Conclusion. Ruyanfang combined with chemotherapy is an effective method in treating advanced breast cancer. It can decrease toxic response, enhance clinical efficacy and improve the quality of life.更多还原