中医治疗对乳腺癌化疗患者的增效与减毒作用研究进展
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摘要
乳腺癌的发生是情志失调、痰浊阻滞,肝肾内伤,脾虚体弱,气滞火旺等多种因素共同作用的结果。化疗治疗乳腺癌的同时也被认为是外邪入侵,客于五脏六腑,可加重阴虚火旺、肝肾亏损之症,痰瘀互结之象更甚,且毒副作用严重。常用于乳腺癌化疗患者中以达到增效与减毒作用的中药成分有黄芪多糖、薄芝糖肽、白藜芦醇等,中成药制剂有参芪扶正注射液、康莱特注射液等,汤剂大多是选用经验方并辨证加减,其他中医技术包括时辰化疗、针灸、经络按摩、穴位按摩、中药沐足等。未来,需进一步研究如何对乳腺癌化疗患者选用规范的中医治疗方案以达到最理想、最经济的增效与减毒效果。
The occurrence of breast cancer is the result of emotional disorder,phlegm blockade,liver and kidney injury,spleen deficiency and weakness,qi stagnation and fire hyperactivity and other factors. When treating breast cancer,chemotherapy is also recognised as the exogenous evil invading the internal organs,which can aggravate the deficiency of yin,excessiveness of fire,and liver and kidney deficiency. The phenomenon of phlegm and blood stasis can get even worse,which has serious toxic and side effects. The traditional Chinese medicine ingredients commonly used in breast cancer chemotherapy patients to achieve synergistic and toxicity reduction effects are Astragalus polysaccharide,Bozhi glycopeptide,resveratrol,etc. The traditional Chinese medicine preparations are Shenqi Fuzheng injection,Kanglaite injection,etc. Most of the decoctions are based on empirical prescriptions with adds or subtracts according to syndrome differentiation. Other traditional Chinese medicine technologies include chrono-chemotherapy,acupuncture,meridian massage,acupoint massage,foot bathing with traditional Chinese medicine,etc. In the future,it is necessary to further study how to select standard traditional Chinese medicine treatment for breast cancer patients undergoing chemotherapy in order to achieve the most ideal and economic efficiency and toxicity reduction effect.
The occurrence of breast cancer is the result of emotional disorder,phlegm blockade,liver and kidney injury,spleen deficiency and weakness,qi stagnation and fire hyperactivity and other factors. When treating breast cancer,chemotherapy is also recognised as the exogenous evil invading the internal organs,which can aggravate the deficiency of yin,excessiveness of fire,and liver and kidney deficiency. The phenomenon of phlegm and blood stasis can get even worse,which has serious toxic and side effects. The traditional Chinese medicine ingredients commonly used in breast cancer chemotherapy patients to achieve synergistic and toxicity reduction effects are Astragalus polysaccharide,Bozhi glycopeptide,resveratrol,etc. The traditional Chinese medicine preparations are Shenqi Fuzheng injection,Kanglaite injection,etc. Most of the decoctions are based on empirical prescriptions with adds or subtracts according to syndrome differentiation. Other traditional Chinese medicine technologies include chrono-chemotherapy,acupuncture,meridian massage,acupoint massage,foot bathing with traditional Chinese medicine,etc. In the future,it is necessary to further study how to select standard traditional Chinese medicine treatment for breast cancer patients undergoing chemotherapy in order to achieve the most ideal and economic efficiency and toxicity reduction effect.
引文
[1]邵志敏.乳腺外科的回顾与展望[J].上海医学,2017,40(8):462-465.
[2]Ma Y,Liu W,Li J,et al.Gastric cancer with breast metastasis:Clinical features and prognostic factors[J].Oncol Lett,2018,16(5):5565-5574.
[3]杜沛玲,方佳英,贾潇岳,等.1994~2013年中国女性乳腺癌流行病学特征[J].汕头大学医学院学报,2016,29(2):124-126.
[4]Zhang B,Wu J,Zheng R,et al.Evaluation of menopausal status among breast cancer patients with chemotherapy-induced amenorrhea[J].Chin J Cancer Res,2018,30(4):468-476.
[5]Takada K,Kashiwagi S,Goto W,et al.Novel evaluation scale for QOL(QOL-ACD-BP)in preoperative chemotherapy for breast cancer[J].J Cancer Res Clin Oncol,2018,144(8):1547-1559.
[6]刘丹,谢枫枫,陈莹.香砂六君子汤对乳腺癌化疗患者的减毒及增效作用观察[J].湖南中医药大学学报,2018,38(4):455-458.
[7]苏泊盛,田菲.扶正合剂联合化疗治疗晚期三阴性乳腺癌的临床观察[J].中医药导报,2016,22(20):23-25.
[8]周锐,董慧明,黄建康,等.斑蝥酸钠维生素B6注射液对青年乳腺癌术后化疗的影响[J].安徽医药,2018,22(8):1575-1578.
[9]林金棠,谢甦,李丽红,等.薯蓣丸对化疗期间乳腺癌患者减毒增效作用的临床研究[J].世界中医药,2015,15(10):1540-1542.
[10]周维维,彭海燕.略论因“郁”致乳腺癌[J].辽宁中医药大学学报,2016,18(9):146-149.
[11]岳振松,姜战胜,李燕巍,等.不同分期乳腺癌证候分布规律研究[J].中华中医药杂志,2016,31(11):4790-4793.
[12]章慧,董丽花.黎月恒教授分期论治乳腺癌临床经验总结[J].中医药导报,2016,22(13):75-77.
[13]刘静.陆德铭教授运用扶正祛邪法治疗乳腺癌经验[J].中医学报,2016,31(4):470-473.
[14]张欣萌,郝云,吴红彦,等.基于妇人杂病视角探究乳腺癌病机治则[J].辽宁中医杂志,2018,45(5):182-185.
[15]翟怡然,何小鹤,蔡小平.蔡小平教授治疗乳腺癌经验总结[J].亚太传统医药,2017,13(14):100-101.
[16]孙雨朦,孙涛.乳腺癌的中医研究概况[J].中国民族民间医药,2016,25(24):63-65.
[17]张文娴,李澜,贾波.从温阳论治乳腺癌[J].亚太传统医药,2017,13(8):89-90.
[18]高妮娜,李丽.黄芪调节免疫功能的应用研究[J].长春中医药大学学报,2008,24(6):671-671.
[19]汪蓓,毛艳,杨淼.黄芪多糖对阿霉素治疗小鼠乳腺癌的增效减毒机制研究[J].中国医院药学杂志,2017,37(6):497-501.
[20]孙宇,邹燕鹏,尹宝娇,等.薄芝糖肽对乳腺癌化疗患者的免疫增强、减毒作用[J].现代肿瘤医学,2016,24(2):242-245.
[21]郑家芬,谭超.白藜芦醇增加乳腺癌细胞对阿霉素化疗敏感作用研究[J].现代预防医学,2017,44(11):2035-2039.
[22]陆蓉,沈忠卫,曹柳云.参芪扶正注射液联合多西他赛对乳腺癌患者细胞免疫功能影响[J].中国中西医结合外科杂志,2018,24(2):149-155.
[23]唐翠萍,吴阳,周寒静,等.康莱特注射液联合紫杉醇对人乳腺癌细胞的化疗增效作用[J].重庆医学,2016,45(24):3336-3339.
[24]蒋雪梅,贾新建,易瑛,等.中药康莱特联合化疗对乳腺癌患者T细胞亚群及肿瘤标志物的影响研究[J].中国卫生检验杂志,2017,27(17):2527-2529.
[25]柯红,崔洁,金锦莲,等.华蟾素胶囊联合CAF方案治疗中晚期乳腺癌的临床效果分析[J].世界中医药,2017,12(10):2358-2361.
[26]陈超,李华峰,谢洪玲.逍遥散对肝郁脾虚型乳腺癌患者辅助放疗的减毒增敏作用研究[J].中华全科医学,2017,15(11):1956-1958.
[27]陈超,李华峰,谢洪玲.逍遥散防治肝郁脾虚乳腺癌患者辅助放疗副反应40例临床观察[J].浙江中医杂志,2016,51(5):354.
[28]王鹏,刘彩香,诸华健,等.西黄丸联合CAF方案治疗晚期乳腺癌患者的增效减毒效果观察[J].中药药理与临床,2017,33(5):186-189.
[29]陈克秀.流式细胞术检测乳腺癌患者循环肿瘤细胞的表达及其与中医辨证分型的关系[D].福州:福建中医药大学,2013.
[30]范媛柯.基于“六经辨证”理论探讨乳腺癌化疗所致消化道反应辨证规律[D].广州:广州中医药大学,2017.
[31]念家云,于明薇,王笑民.健脾疏肝法治疗乳腺癌的临床研究概况[J].中华中医药学刊,2016,34(10):2472-2474.
[32]岑东芝,丛鹏,全天一,等.乳腺癌中医辨证分型对新辅助化疗疗效及预后的影响[J].中医杂志,2016,57(10):856-859.
[33]张文芳,王昕光,孔秋梅,等.健脾化痰方结合托烷司琼治疗乳腺癌化疗后呕吐60例[J].环球中医药,2016,9(3):310-311.
[34]张艳.健脾化痰方联合托烷司琼治疗乳腺癌放化疗后呕吐疗效观察[J].实用中医药杂志,2018,34(5):561-562.
[35]郜娜娜,邹明雷,马馨,等.扶正减毒类中药对乳腺癌术后化疗的影响[J].现代中医临床,2018,25(2):22-25.
[36]张俊生,车洪勇.养气养血活血化瘀中药配伍联合化疗治疗乳腺癌临床观察[J].四川中医,2016,34(2):123-125.
[37]程赟,章永红.扶正解毒法联合化疗治疗晚期乳腺癌20例临床研究[J].江苏中医药,2016,48(8):40-42.
[38]黄利,李利民,唐丽燕.白术水煎剂对小鼠免疫功能的影响[J].中药药理与临床,2012,28(1):114-115.
[39]徐川,于小伟,李莎罗,等.益气健脾汤联合化疗对乳腺癌生活质量和免疫功能的影响[J].陕西中医,2016,37(9):1160-1161.
[40]钟蕊.疏肝调理冲任方联合TE方案治疗乳腺癌患者QOL临床研究[D].南京:南京中医药大学,2009.
[41]刘先娣,谢丹.乳腺癌时辰化疗的临床疗效观察[J].实用中西医结合临床,2016,16(9):36-37.
[42]何晓璐,谢丹.乳腺癌TAC丑时化疗对化疗毒副作用影响的研究[J].湖南中医药大学学报,2017,37(9):977-981.
[43]刘先娣.丑时行TEC新辅助化疗治疗乳腺癌的疗效观察[D].广州:广州中医药大学,2015.
[44]何晓璐.乳腺癌时辰化疗对化疗毒副作用影响的研究[D].广州:广州中医药大学,2016.
[45]吴建军,戚玲娟.针灸足三里治疗乳腺癌放化疗后白细胞减少21例[J].浙江中医杂志,2008,43(1):46.
[46]卢珊.温针灸对乳腺癌化疗引起毒副反应的影响[D].哈尔滨:黑龙江中医药大学,2016.
[47]刘翔宇.应用营养支持配合经络按摩改善乳腺癌患者免疫功能的研究[D].长沙:中南大学,2008.
[48]秦红宇,马署丹,江丽敏.耳穴贴压联合穴位按摩防治乳腺癌术后化疗恶心呕吐30例[J].中国中医急症,2011,20(12):1955,1965.
[49]徐永萍,朱晓,高烨.益气中药足浴治疗乳腺癌化疗癌因性疲乏28例临床观察[J].中医药导报,2013,19(7):31-33.
[50]周江红,赵辉,华鸿彦,等.中药足浴联合足部按摩减轻乳腺癌化疗后胃肠道反应的效果观察[J].甘肃医药,2017,36(6):478-479.
[2]Ma Y,Liu W,Li J,et al.Gastric cancer with breast metastasis:Clinical features and prognostic factors[J].Oncol Lett,2018,16(5):5565-5574.
[3]杜沛玲,方佳英,贾潇岳,等.1994~2013年中国女性乳腺癌流行病学特征[J].汕头大学医学院学报,2016,29(2):124-126.
[4]Zhang B,Wu J,Zheng R,et al.Evaluation of menopausal status among breast cancer patients with chemotherapy-induced amenorrhea[J].Chin J Cancer Res,2018,30(4):468-476.
[5]Takada K,Kashiwagi S,Goto W,et al.Novel evaluation scale for QOL(QOL-ACD-BP)in preoperative chemotherapy for breast cancer[J].J Cancer Res Clin Oncol,2018,144(8):1547-1559.
[6]刘丹,谢枫枫,陈莹.香砂六君子汤对乳腺癌化疗患者的减毒及增效作用观察[J].湖南中医药大学学报,2018,38(4):455-458.
[7]苏泊盛,田菲.扶正合剂联合化疗治疗晚期三阴性乳腺癌的临床观察[J].中医药导报,2016,22(20):23-25.
[8]周锐,董慧明,黄建康,等.斑蝥酸钠维生素B6注射液对青年乳腺癌术后化疗的影响[J].安徽医药,2018,22(8):1575-1578.
[9]林金棠,谢甦,李丽红,等.薯蓣丸对化疗期间乳腺癌患者减毒增效作用的临床研究[J].世界中医药,2015,15(10):1540-1542.
[10]周维维,彭海燕.略论因“郁”致乳腺癌[J].辽宁中医药大学学报,2016,18(9):146-149.
[11]岳振松,姜战胜,李燕巍,等.不同分期乳腺癌证候分布规律研究[J].中华中医药杂志,2016,31(11):4790-4793.
[12]章慧,董丽花.黎月恒教授分期论治乳腺癌临床经验总结[J].中医药导报,2016,22(13):75-77.
[13]刘静.陆德铭教授运用扶正祛邪法治疗乳腺癌经验[J].中医学报,2016,31(4):470-473.
[14]张欣萌,郝云,吴红彦,等.基于妇人杂病视角探究乳腺癌病机治则[J].辽宁中医杂志,2018,45(5):182-185.
[15]翟怡然,何小鹤,蔡小平.蔡小平教授治疗乳腺癌经验总结[J].亚太传统医药,2017,13(14):100-101.
[16]孙雨朦,孙涛.乳腺癌的中医研究概况[J].中国民族民间医药,2016,25(24):63-65.
[17]张文娴,李澜,贾波.从温阳论治乳腺癌[J].亚太传统医药,2017,13(8):89-90.
[18]高妮娜,李丽.黄芪调节免疫功能的应用研究[J].长春中医药大学学报,2008,24(6):671-671.
[19]汪蓓,毛艳,杨淼.黄芪多糖对阿霉素治疗小鼠乳腺癌的增效减毒机制研究[J].中国医院药学杂志,2017,37(6):497-501.
[20]孙宇,邹燕鹏,尹宝娇,等.薄芝糖肽对乳腺癌化疗患者的免疫增强、减毒作用[J].现代肿瘤医学,2016,24(2):242-245.
[21]郑家芬,谭超.白藜芦醇增加乳腺癌细胞对阿霉素化疗敏感作用研究[J].现代预防医学,2017,44(11):2035-2039.
[22]陆蓉,沈忠卫,曹柳云.参芪扶正注射液联合多西他赛对乳腺癌患者细胞免疫功能影响[J].中国中西医结合外科杂志,2018,24(2):149-155.
[23]唐翠萍,吴阳,周寒静,等.康莱特注射液联合紫杉醇对人乳腺癌细胞的化疗增效作用[J].重庆医学,2016,45(24):3336-3339.
[24]蒋雪梅,贾新建,易瑛,等.中药康莱特联合化疗对乳腺癌患者T细胞亚群及肿瘤标志物的影响研究[J].中国卫生检验杂志,2017,27(17):2527-2529.
[25]柯红,崔洁,金锦莲,等.华蟾素胶囊联合CAF方案治疗中晚期乳腺癌的临床效果分析[J].世界中医药,2017,12(10):2358-2361.
[26]陈超,李华峰,谢洪玲.逍遥散对肝郁脾虚型乳腺癌患者辅助放疗的减毒增敏作用研究[J].中华全科医学,2017,15(11):1956-1958.
[27]陈超,李华峰,谢洪玲.逍遥散防治肝郁脾虚乳腺癌患者辅助放疗副反应40例临床观察[J].浙江中医杂志,2016,51(5):354.
[28]王鹏,刘彩香,诸华健,等.西黄丸联合CAF方案治疗晚期乳腺癌患者的增效减毒效果观察[J].中药药理与临床,2017,33(5):186-189.
[29]陈克秀.流式细胞术检测乳腺癌患者循环肿瘤细胞的表达及其与中医辨证分型的关系[D].福州:福建中医药大学,2013.
[30]范媛柯.基于“六经辨证”理论探讨乳腺癌化疗所致消化道反应辨证规律[D].广州:广州中医药大学,2017.
[31]念家云,于明薇,王笑民.健脾疏肝法治疗乳腺癌的临床研究概况[J].中华中医药学刊,2016,34(10):2472-2474.
[32]岑东芝,丛鹏,全天一,等.乳腺癌中医辨证分型对新辅助化疗疗效及预后的影响[J].中医杂志,2016,57(10):856-859.
[33]张文芳,王昕光,孔秋梅,等.健脾化痰方结合托烷司琼治疗乳腺癌化疗后呕吐60例[J].环球中医药,2016,9(3):310-311.
[34]张艳.健脾化痰方联合托烷司琼治疗乳腺癌放化疗后呕吐疗效观察[J].实用中医药杂志,2018,34(5):561-562.
[35]郜娜娜,邹明雷,马馨,等.扶正减毒类中药对乳腺癌术后化疗的影响[J].现代中医临床,2018,25(2):22-25.
[36]张俊生,车洪勇.养气养血活血化瘀中药配伍联合化疗治疗乳腺癌临床观察[J].四川中医,2016,34(2):123-125.
[37]程赟,章永红.扶正解毒法联合化疗治疗晚期乳腺癌20例临床研究[J].江苏中医药,2016,48(8):40-42.
[38]黄利,李利民,唐丽燕.白术水煎剂对小鼠免疫功能的影响[J].中药药理与临床,2012,28(1):114-115.
[39]徐川,于小伟,李莎罗,等.益气健脾汤联合化疗对乳腺癌生活质量和免疫功能的影响[J].陕西中医,2016,37(9):1160-1161.
[40]钟蕊.疏肝调理冲任方联合TE方案治疗乳腺癌患者QOL临床研究[D].南京:南京中医药大学,2009.
[41]刘先娣,谢丹.乳腺癌时辰化疗的临床疗效观察[J].实用中西医结合临床,2016,16(9):36-37.
[42]何晓璐,谢丹.乳腺癌TAC丑时化疗对化疗毒副作用影响的研究[J].湖南中医药大学学报,2017,37(9):977-981.
[43]刘先娣.丑时行TEC新辅助化疗治疗乳腺癌的疗效观察[D].广州:广州中医药大学,2015.
[44]何晓璐.乳腺癌时辰化疗对化疗毒副作用影响的研究[D].广州:广州中医药大学,2016.
[45]吴建军,戚玲娟.针灸足三里治疗乳腺癌放化疗后白细胞减少21例[J].浙江中医杂志,2008,43(1):46.
[46]卢珊.温针灸对乳腺癌化疗引起毒副反应的影响[D].哈尔滨:黑龙江中医药大学,2016.
[47]刘翔宇.应用营养支持配合经络按摩改善乳腺癌患者免疫功能的研究[D].长沙:中南大学,2008.
[48]秦红宇,马署丹,江丽敏.耳穴贴压联合穴位按摩防治乳腺癌术后化疗恶心呕吐30例[J].中国中医急症,2011,20(12):1955,1965.
[49]徐永萍,朱晓,高烨.益气中药足浴治疗乳腺癌化疗癌因性疲乏28例临床观察[J].中医药导报,2013,19(7):31-33.
[50]周江红,赵辉,华鸿彦,等.中药足浴联合足部按摩减轻乳腺癌化疗后胃肠道反应的效果观察[J].甘肃医药,2017,36(6):478-479.