文章摘要

槐耳颗粒在三阴性乳腺癌术后辅助治疗的临床研究

作者: 1雷姗姗, 1王映, 1顾晓文, 2喻宏, 1范培芝, 3张志功, 1张超杰, 1何杰, 1谢靖, 1李洋
1 湖南省人民医院/湖南师范大学附属第一医院乳腺甲状腺外科，湖南 长沙 410005
2 湖南省人民医院/湖南师范大学附属第一医院病理科，湖南 长沙 410005
3 湖南省人民医院/湖南师范大学附属第一医院心胸外科，湖南 长沙 410005
通讯: 张超杰 Email: zhangchaojie74@126.com
DOI: 10.3978/.10.3978/j.issn.1005-6947.2016.05.016
基金: 湖南省中医药管理局科研基金资助项目, 201374

摘要

目的：探讨槐耳颗粒辅助治疗对三阴性乳腺癌患者免疫功能及术后生存状态的影响。方法：将95例改良根治术后行辅助化疗的三阴性乳腺癌患者非随机分为观察组（56例）及对照组（39例），观察组的患者于化放疗同时及后期口服槐耳颗粒（每日3次，每次20 g，持续1.5年），对照组在辅助治疗过程中不使用任何中药制剂。比较两组在治疗及随访期间的生存质量、无病生存时间（DFS）及术后3、6个月与1、2年血清T细胞亚群的构成比。结果：与对照组比较，观察组Karnofsky评分（KPS）提高率明显增加，DFS明显延长（均P<0.05）。两组术后各时间点CD3+细胞百分率无明显差异（均P>0.05），但观察组CD4+细胞百分率、CD4+/CD8+比值、NK细胞百分率在术后各时间点均明显高于对照组（均P<0.05）。与术前比较，观察组术后3个月CD3+细胞百分率减少（P<0.05），但6个月后恢复（均P>0.05），术后6个月至2年的CD4+、CD4+/CD8+比值、NK细胞均明显增高（均P<0.05）；对照组术后3~6个月CD3+、NK细胞百分率明显降低（均P<0.05），1年后开始恢复（均P>0.05），术后3个月至1年的CD4+百分率、CD4+/CD8+比值均明显降低（均P<0.05）。结论：三阴性乳腺癌患者在辅助治疗阶段服用槐耳颗粒有助于免疫功能的改善、生存质量的提高以及无病生存时间的延长。
关键词： 乳腺肿瘤 槐耳颗粒 免疫功能

Clinical observation of Huaier granule adjuvant therapy for triple negative breast cancer after mastectomy

Authors: 1LEI Shanshan, 1WANG Ying, 1GU Xiaowen, 2YU Hong, 1FAN Peizhi, 3ZHANG Zhigong, 1ZHANG Chaojie, 1HE Jie, 1XIE Jing, 1LI Yang
1 Department of Thyroid and Breast Surgery, Hunan Provincial People’s Hospital/the First Affiliated Hospital, Hunan Normal University, Changsha 410005, China
2 Department of Pathology, Hunan Provincial People’s Hospital/the First Affiliated Hospital, Hunan Normal University, Changsha 410005, China
3 Department of Cardiothoracic Surgery, Hunan Provincial People’s Hospital/the First Affiliated Hospital, Hunan Normal University, Changsha 410005, China

CorrespondingAuthor:ZHANG Chaojie Email: zhangchaojie74@126.com

Abstract

Objective: To study the influence of Huaier granule adjuvant therapy on immune function and postoperative survival status in patients with triple negative breast cancer (TNBC) after modified radical mastectomy. Methods: Ninety-five TNBC patients undergoing adjuvant chemotherapy after modified radical mastectomy were divided into observational group (56 cases) and control group (39 cases). Patients in the observational group received oral administration of Huaier granule during and after chemotherapy and radiotherapy (20 g, 3 times daily for 1.5 years), while those in the control group did not receive any traditional Chinese medicine preparations during adjuvant therapy. The quality of life, disease free survival (DFS) during treatment and follow-up period and serum T cell subset composition at 3, 6, 12 and 24 months after surgery between the two groups were compared. Results: In observational group compared with control group, the improvement rate of Karnofsky score was significantly increased and DFS was significantly prolonged (all P<0.05). There was no significant difference in the percentage of CD3+ cells between the two groups at any time points after surgery (all P>0.05), but the percentages of CD4+ and NK cells and CD4+/CD8+ ratio in observational group were all significantly higher than those in control group at each time point (all P<0.05). Compared with their preoperative value, in observational group, the percentage of CD3+ cells at 3 months after surgery of treatment was significantly decreased (P<0.05), but began to return to normal 6 months later (all P>0.05), and the percentages of CD4+ and NK cells and CD4+/CD8+ ratio were significantly increased during 6 to 24 months after surgery (all P<0.05); in the control group, the percentages of CD3+ cells were significantly reduced during 3 to 6 months after surgery (all P<0.05), and began to recover 12 months later (all P>0.05), and the percentage of CD4+ cells and CD4+/CD8+ ratio were significantly lowered during 3 to 12 months after surgery (all P<0.05). Conclusion: For TNBC patients, Huaier granule administration during postoperative adjuvant therapy may help improve the immune function, increase quality of life and prolong the DFS.
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