【摘要】：目的:通過觀察西黃膠囊輔助化療治療早期乳腺癌的療效,對上肢水腫的發(fā)生是否有預(yù)防作用以及觀察患者生活質(zhì)量、免疫功能是否獲益等,從而客觀評價在乳腺癌的治療過程西黃膠囊的使用是否有益。為乳腺癌的綜合治療提供臨床支撐,提高乳腺癌患者總體生存質(zhì)量及生理機(jī)能,并指導(dǎo)今后臨床工作中的正確用藥。方法:選擇山西醫(yī)科大學(xué)第二醫(yī)院乳腺外科符合本研究納入標(biāo)準(zhǔn)的乳腺癌術(shù)后患者60例,隨機(jī)分為治療組26例、對照組34例,治療組在常規(guī)化療、上肢功能鍛煉基礎(chǔ)上加入口服西黃膠囊,兩組參與研究患者均采用AC-T(吡柔吡星+環(huán)磷酰胺-多西他賽)化療方案8個周期,觀察組加服西黃膠囊8粒/次,2次/天于手術(shù)后48小時開始使用,連用一周后停止,化療的8個周期均以此方法用藥。于治療前、治療4周、12周分別測定兩組觀察患者上肢水腫發(fā)生率情況、有關(guān)影響水腫相關(guān)因素以及生存質(zhì)量、免疫功能等近期療效來評價在乳腺癌全程化療中西黃膠囊所發(fā)揮的作用。本研究采用SPSS19.0統(tǒng)計軟件對實驗數(shù)據(jù)進(jìn)行統(tǒng)計并予以分析。結(jié)果1、上肢水腫改善情況:治療組與對照組比較,P=0.9310.05.說明西黃膠囊在預(yù)防術(shù)后上肢水腫方面并未顯示出明顯優(yōu)勢。對水腫相關(guān)因素研究分析發(fā)現(xiàn):BMI與上肢水腫發(fā)生率有關(guān):P=0.0210.05,而年齡(P=0.1360.05)、淋巴結(jié)轉(zhuǎn)移(P=0.4430.05)、患肢是否是受力側(cè)(P=0.0730.05)與其無關(guān)。2、生活質(zhì)量改善情況(KPS評分):治療前兩組KPS評分P0.05,兩組間并無任何統(tǒng)計學(xué)差異。治療后,治療組P0.001,差別具有統(tǒng)計學(xué)意義。對照組P0.05,差異無意義。治療后兩組間比較P0.001,具有比較顯著的統(tǒng)計學(xué)意義。3、免疫功能改善評價而言,分別于治療前、治療4周、12周檢驗兩組免疫功能指標(biāo),后經(jīng)t檢驗后顯示P0.05,均無顯著性差異。結(jié)論1、在乳腺癌全程化療過程中輔助應(yīng)用西黃膠囊對術(shù)后上肢水腫的發(fā)生并未起到預(yù)防及治療的作用。與水腫相關(guān)影響因素分析顯示,影響乳腺癌患者術(shù)后上肢淋巴水腫的獨(dú)立危險因素便是體重指數(shù)(BMI),而年齡、淋巴結(jié)轉(zhuǎn)移情況、患肢是否主力側(cè)等與乳腺癌患者術(shù)后上肢水腫的發(fā)生無明顯相關(guān)。2、輔助應(yīng)用西黃膠囊能夠不同程度的改善乳腺癌術(shù)后患者的KPS,提高患者體力狀況及生活質(zhì)量,適合臨床應(yīng)用并廣泛推廣;3、輔助應(yīng)用西黃膠囊未能顯示出對乳腺癌術(shù)后患者免疫細(xì)胞功能的調(diào)節(jié)。
[Abstract]:Objective: to observe the efficacy of Xihuang capsule in the treatment of early breast cancer, whether it has preventive effect on the occurrence of upper limb edema, and whether the patients' quality of life and immune function benefit. Therefore, objective evaluation in the treatment of breast cancer Xihuang capsule is useful. To provide clinical support for comprehensive treatment of breast cancer, improve the overall quality of life and physiological function of breast cancer patients, and guide the correct use of drugs in clinical work in the future. Methods: sixty breast cancer patients who met the criteria of breast surgery in the second Hospital of Shanxi Medical University were randomly divided into treatment group (n = 26) and control group (n = 34). On the basis of upper limb function exercise, Xihuang capsule was taken orally. Both patients in the study group were treated with AC-T chemotherapy regimen for 8 cycles, and the observation group received 8 capsules of Xihuang capsule every time. Two times a day, 48 hours after operation, and then stopped for one week. The eight cycles of chemotherapy were all used in this way. Before treatment, 4 weeks and 12 weeks of treatment, the incidence of upper limb edema, factors related to edema and quality of life were measured in the two groups. The short-term efficacy of immune function to evaluate the role of Huihuang capsule in the whole course of chemotherapy for breast cancer. In this study, SPSS19.0 statistical software was used to analyze the experimental data. Results 1. The improvement of upper limb edema: compared with the control group, the treatment group was 0.9310.05. It shows that Xihuang capsule has no obvious advantage in preventing edema of upper limb after operation. The analysis of the related factors of edema showed that BMI was related to the incidence of edema in upper extremity: P0. 0210.05, age (P0. 1360.05), lymph node metastasis (P0. 4433. 05), and the relationship between Edema and Edema (P0. 0210.05). (2) the improvement of quality of life (KPS score): before treatment, there was no significant difference in KPS score between the two groups (P 0.05). After treatment, the treatment group P 0.001, the difference was statistically significant. There was no significant difference in the control group (P 0.05). Compared with P0.001 after treatment, there was significant statistical significance between the two groups. 3. In the evaluation of immune function improvement, the immune function indexes of the two groups were tested before, 4 and 12 weeks of treatment, respectively, and then showed P0.05 after t test. There was no significant difference between the two groups. Conclusion 1. The application of Xihuang capsule in the whole course of breast cancer chemotherapy did not play a preventive and therapeutic role in the occurrence of upper limb edema after operation. The analysis of factors related to edema showed that the independent risk factors of lymphedema in upper limb of breast cancer patients after operation were body mass index (BMI),) age and lymph node metastasis. There was no significant correlation between the occurrence of edema in the upper limb of breast cancer patients and the main side of the affected limbs. 2. The application of Xihuang capsule can improve the KPS, of patients with breast cancer and improve their physical condition and quality of life in varying degrees. Suitable for clinical application and wide spread; 3. The adjuvant application of Xihuang capsule failed to show the regulation of immune cell function in postoperative breast cancer patients.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.9

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