【摘要】：目的:觀察益腎方與唑來膦酸注射液聯(lián)合使用治療腎虛型乳腺癌骨轉(zhuǎn)移患者的臨床療效。方法:收集符合診斷標(biāo)準(zhǔn)的腎虛型乳腺癌骨轉(zhuǎn)移患者60例。采用隨機(jī)數(shù)字表分配的原則分為兩組,即治療組30例和對照組30例。治療組服用自擬益腎方,以中藥顆粒劑(999牌,購自河南中醫(yī)藥大學(xué)第三附屬院),并按規(guī)定用量服用,每日1劑,早晚各一次沖服;并輸注唑來膦酸注射液4mg(天晴依泰),配入0.9%氯化鈉注射液100m L中,持續(xù)靜脈滴注15~30min,每4周1次,4周后觀察臨床療效。對照組則單獨(dú)應(yīng)用唑來膦酸注射液(方法、劑量、頻次同上)。治療時(shí)間每4周為1周期,共3周期。治療結(jié)束后分別觀察治療組和對照組用藥前后疼痛緩解程度、生活質(zhì)量指數(shù)的變化、中醫(yī)證候積分及患者治療前后ECT、CT、X線等影像學(xué)檢查的對比,并對結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:治療前兩組患者在年齡、疼痛程度、KPS評分、中醫(yī)證候積分、影像學(xué)檢查等方面,經(jīng)統(tǒng)計(jì)學(xué)分析無顯著性差異,對比具有可行性。治療結(jié)束后,兩組患者均有不同程度的好轉(zhuǎn),治療組在總體療效上優(yōu)于對照組,且毒副作用輕微。結(jié)論:1.自擬益腎方聯(lián)合唑來膦酸注射液治療腎虛型乳腺癌骨轉(zhuǎn)移可顯著提高唑來膦酸注射液臨床療效,改善患者腎虛狀態(tài);2.本研究表明補(bǔ)腎類中藥既抑制破骨細(xì)胞對骨的溶解作用,又增強(qiáng)成骨細(xì)胞的活性,明顯緩解骨轉(zhuǎn)移疼痛,提高了患者的生活質(zhì)量;并能促進(jìn)溶骨性病灶的恢復(fù),減慢了疾病的進(jìn)展。
[Abstract]:Objective: to observe the clinical effect of Yishen recipe combined with zoledronic acid injection in the treatment of bone metastasis of breast cancer with kidney deficiency. Methods: 60 patients with bone metastasis of kidney deficiency breast cancer were collected. According to the principle of random digital table distribution, the treatment group (n = 30) and the control group (n = 30) were divided into two groups. The treatment group took self-made Yishen recipe, with traditional Chinese medicine granules (999 brand, purchased from the third affiliated Hospital of Henan University of traditional Chinese Medicine), and according to the prescribed dosage, 1 dose a day, each time in the morning and evening. Zoledronic acid injection 4mg (Tianqing Yitai) was infused with 0.9% sodium chloride injection 100m L, continuous intravenous drip for 15 min, once every 4 weeks, and the clinical effect was observed after 4 weeks. The control group was treated with zoledronic acid injection (method, dose, frequency as above). The treatment time was 1 cycle every 4 weeks for a total of 3 cycles. After treatment, the changes of pain relief degree, quality of life index, TCM syndrome score and ECT,CT, X-ray examination before and after treatment were observed between the treatment group and the control group. The results were statistically analyzed. Results: there was no significant difference in age, pain degree, KPS score, TCM syndrome score and imaging examination between the two groups before treatment. After treatment, the patients in both groups were improved in varying degrees, and the overall curative effect of the treatment group was better than that of the control group, and the toxic and side effects were mild. Conclusion: 1. Self-made Yishen recipe combined with zoledronic acid injection in the treatment of bone metastasis of breast cancer with kidney deficiency can significantly improve the clinical efficacy of zoledronic acid injection and improve the condition of kidney deficiency. 2. This study showed that traditional Chinese medicine for tonifying the kidney not only inhibited the osteolysis of osteoclasts, but also enhanced the activity of osteoblasts, obviously alleviated bone metastasis pain and improved the quality of life of patients. It can also promote the recovery of osteolytic lesions and slow down the progress of the disease.
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R273

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