摘要
目的研究补气活血法防治表柔比星致心脏毒性的临床疗效。方法将100例含表柔比星化疗方案的肿瘤患者随机分为治疗组和对照组,治疗组化疗前3天即予补气活血中药口服,1日1剂。对照组化疗的同时不使用心肌保护药物。观察治疗前后心电图和心脏彩超的变化。结果治疗组心电图异常的发生率(12%)比对照组(34%)要低得多,差异有统计学意义(P<0.05)。两组患者化疗后的左室射血分数、每搏指数、左心室舒张末期内径、收缩末期内径和左室短轴缩短率分别与同组化疗前各项指标纵向比较,P<0.05;同时两组化疗后各项指标作横向比较,治疗组心功能损害小于对照组,差异有统计学意义(P<0.05)。结论补气活血法可有效防治表柔比星致心脏毒性。
Objective To study clinical curative effect of Complement qi and activate blood circulation method in preventing and controlling cardiac toxicity caused by epirubicin.Methods 100 patients with containing epirubicin chemotherapy scheme were randomly divided into treatment group and control group,all line containing epirubicin chemotherapy regimen at 3 days before chemotherapy,the treatment group take orally medicine of Complement qi and activate blood circulation,twice per day,2 weeks for a period of treatment.Control group at the same time did not use chemotherapy drugs myocardial protection.And the changes of electrocardiogram and Color Doppler Echocardiography before and after the treatment were observed.Results The incidence of abnormal electrocardiogram of treatment group(12%) were lower than that of the control group(34%),after statistics processing,they had significant difference(P<0.05).the left ventricular ejection fraction,each stroke index,left ventricular short shaft shorten rate and left ventricular end-diastolic diameter and end systolic diameter of two groups of patients were better after chemotherapy,P<0.05;At the same time,the indicators of two groups after chemotherapy for horizontal comparison,the treatment group cardiac damage was less than control group,after statistics processing,they had significant difference,P<0.05.Conclusion Complement qi and activate blood circulation method can effectively control cardiac toxicity caused by epirubicin.
引文
[1]高春恒,沈伟生,邹大中,等.含表柔比星联合化疗患者左室收缩功能及同步性实时三维超声心动图的评价[J].中华肿瘤防治杂志,2011,18(1):63-65.
[2]Oliveira PJ,Santos MS,Wallace KB.Doxorubicin-inducedthiol-de-pendent alteration of cardiac mitochondrial permeability transition andrespiration[J].Biochem(Mosc),2006,71(2):194-199.
[3]邵维维,周笳,安晓彤,等.吡柔比星治疗恶性血液病致心肌损害的分析[J].天津医药,2009,37(9):796-797.
[4]沈伟生,高春恒,张华,等.红景天预防含表柔比星方案化疗所致心脏毒性临床观察[J].新中医,2008,44(2):18-21.
[5]陈玲.蒽环类化疗药物心脏毒性的监护[J].国外医学内科分册,2000,27(12):525-528.
[6]孙江波,于彩娜,徐丹,等.中药人参、附子及其小复方参附汤抑制阿霉素心脏毒性损伤大鼠细胞凋亡的研究[J].辽宁中医杂志,2012,39(4):754-756.
[7]张小卿.复方生脉饮防治吡柔比星心肌毒性的临床分析[J].肿瘤研究与临床,2003,15(5):346.
[8]李茜,张文杰,马巧珍,等.参麦注射液治疗阿霉素致心脏毒性的心电图观察[J].东南国防医药,2008,10(2):43-45.
[9]顾晓怡,姜藻,董丽钧.参芪扶正液抗蒽环类化疗药物所致心脏毒性的作用[J].东南大学学报,2008,27(5):375-377.
[10]蔡亚丽,李瑾,炙甘草汤加味缓解阿霉素化疗心脏毒副作用20例[J].江西中医药,2008,6(6):56.
[11]张颖,嵇平.组织速度成像对蒽环类药物心脏毒性的评价[J].中华全科医学,2011,9(1):10-12.