疏肝补肾法干预乳腺癌类围绝经期综合症临床研究

发布时间：2018-07-03 15:52

本文选题：疏肝补肾法 + 乳腺癌　；参考：《广州中医药大学》2017年博士论文

【摘要】：目的:1.观察两组乳腺癌类围绝经期综合征患者治疗前后血清性激素水平、T细胞亚群、血脂以及Kupperman积分、生活质量(KPS)变化及证候积分变化,探讨疏肝补肾作用的中药组方(归苓调经汤)对乳腺癌类围绝经期综合征发病过程中某些有代表性细胞因子的影响,揭示性激素水平与T细胞亚群失衡在乳腺癌类围绝经期综合征的致病机理和相关调节作用,综合客观评价两组方案对乳腺癌类围绝经期综合征的影响与疗效。2.揭示具有疏肝补肾作用的中药组方(归苓调经汤)在治疗乳腺癌类围绝经期综合征过程中可能通过调控相关因子改善患者相关症状,以及归苓调经汤组方的安全性和有效性,为进一步用于乳腺癌类围绝经期综合征的预测及靶点治疗提供理论及数据上的依据,从古方基础上多方位、多靶点和整体调节角度探索乳腺癌类围绝经期综合征的治疗新思路,为临床诊断、治疗提供新的视角。方法:选择郑州市肿瘤医院肿瘤科住院部2015年12月～2016年12月符合收治入组条件的中医辨证为肝郁肾虚型乳腺癌类围绝经期综合征患者80人,按随机数字法将患者随机分为两组,分别为治疗组40例,对照组40例,对照组的患者给予常规谷维素、维生素B1对症处理;治疗组在对照组治疗基础上加服自拟归苓调经汤,对比观察患者治疗前后性激素水平、T细胞亚群、血脂、Kupperman积分、生活质量(KPS)变化及证候积分、血常规及肝肾功能变化,以综合评估归苓调经汤治疗肝郁肾虚型乳腺癌类围绝经期综合征的临床疗效和安全性,并揭示归苓调经汤干预、调节相关因子的作用机制,为进一步中西医研究提供科研理论依据。结果:观察两组治疗前、后组内与组间性激素水平、T细胞亚群、血脂、Kupperman积分、生活质量(KPS)变化及证候积分情况,发现均有不同程度的变化;分别将两组治疗前、后性激素水平、T细胞亚群、血脂、Kupperman积分、生活质量(KPS)变化及证候积分变化,进行组内比较,得出组内治疗前、后变化水平差值有统计学意义(P0.01)。比较治疗后两组组间性激素水平、T细胞亚群、血脂、Kupperman积分、生活质量(KPS)变化及证候积分变化,发现治疗组治疗后性激素水平、T细胞亚群、血脂、Kupperman积分、生活质量(KPS)变化及证候积分变化显著高于对照组。将两组治疗前、后的差值分别经独立样本t检验,得出P0.01,说明两组间治疗前后性激素水平、T细胞亚群、血脂、Kupperman积分、生活质量(KPS)变化及证候积分变化差值比较有统计学意义。结论:1.两组治疗后均可使性激素水平、T细胞亚群、Kupperman积分、生活质量(KPS)评分、证候积分、血脂不同程度改变,相关症状改善;组间比较变化、改善程度存在显著差异,比较有统计学意义。2.归苓调经汤对肝郁肾虚型乳腺癌类围绝经期综合征患者不仅可调节性激素水平/T细胞亚群失衡状态,促进患者激素水平调节、增强机体免疫力、减轻药物的毒副性、改善患者临床症状和提高患者生活质量。特别是在缓解潮热盗汗、失眠、倦怠乏力、焦虑等方面显著高于对照组。
[Abstract]:Objective: 1. to observe the serum sex hormone level, T cell subgroup, blood lipid and Kupperman score, the change of quality of life (KPS) and the change of syndrome score before and after treatment of the two groups of perimenopausal syndrome of breast cancer, and discuss some of the Chinese medicine groups (GUI Ling tonifying soup) for the liver and tonifying the kidney (GUI Ling tonifying soup) in the course of the pathogenesis of perimenopausal syndrome of breast cancer The effect of sex hormone level and T cell subgroup imbalance on the pathogenesis and regulation of perimenopausal syndrome of breast cancer, the effect of the two groups on the perimenopausal syndrome of breast cancer and the effect of.2. were evaluated. In the course of the treatment of perimenopausal syndrome of breast cancer, it is possible to improve the related symptoms by regulating the related factors, and the safety and effectiveness of the prescription of GUI Ling Jing Jing decoction, and provide the theoretical and data basis for the further use of the prediction and target treatment of the perimenopausal syndrome of breast cancer, and the multi-target and multi target on the basis of the ancient recipe. In order to provide a new perspective for the clinical diagnosis and treatment of perimenopausal syndrome of breast cancer, a new perspective on the treatment of perimenopausal syndrome of breast cancer is provided by the point and the overall adjustment angle. Method: the Chinese traditional medicine of the inpatient department of the oncology department of Zhengzhou city from December 2015 to December 2016 was based on the syndrome of the liver depression and kidney deficiency type of perimenopause syndrome of 8 patients. 0 people were randomly divided into two groups according to the random number method, which were 40 cases in the treatment group and 40 in the control group. The patients in the control group were given conventional orovidin and vitamin B1 treatment, and the treatment group was treated with the self-made GUI Ling regulating Decoction on the basis of the control group, and the level of sex hormone, the T cell subgroup, the blood lipid, and the Kupperman product before and after treatment were compared. The changes of quality of life (KPS), syndrome score, blood routine and liver and kidney function change, in order to comprehensively evaluate the clinical efficacy and safety of GUI Ling Jing Jing Decoction on the treatment of perimenopausal syndrome of breast cancer with liver depression and kidney deficiency, and reveal the mechanism of regulating the related factors to provide scientific research theory for further Chinese and Western medicine research. Results: before the treatment of the two groups, the levels of sex hormone, T cell subgroup, blood lipid, Kupperman score, quality of life (KPS) and syndrome integral were observed in the posterior group, and the levels of sex hormone, T subgroup, blood lipid, Kupperman score, quality of life (KPS), and syndrome product before the treatment of the two groups were observed. The difference between the two groups was statistically significant (P0.01). The levels of sex hormone, T cell subgroup, blood lipid, Kupperman score, quality of life (KPS) and syndrome scores were compared between the two groups after treatment, and the level of sex hormone, T cell subgroup, blood lipid, and Kupperman score after treatment were found. The change of quality of life (KPS) and the change of syndrome score were significantly higher than that of the control group. The difference between the two groups before and after the treatment was tested by independent sample t, and P0.01 was obtained. The difference between the levels of sex hormone, T cell subgroup, blood lipid, Kupperman score, quality of life (KPS) and the difference of syndrome integral changes before and after treatment were statistically significant. 1. the two groups can make the level of sex hormone, T cell subgroup, Kupperman integral, quality of life (KPS) score, syndrome score, different degree of blood lipid, and the improvement of the related symptoms; there is a significant difference in the degree of improvement between the groups, and the comparison is statistically significant to the comprehensive perimenopausal period synthesis of the liver qi stagnation and kidney deficiency type of.2. The patients can not only regulate the imbalance of the /T cell subgroup of sex hormone level, promote the regulation of hormone level, enhance the immunity of the body, reduce the side effects of the drug, improve the clinical symptoms and improve the quality of life of the patients, especially in alleviating hot flashes, sweating, insomnia, tired tired, anxiety and so on.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R273

【参考文献】