中药联合来曲唑治疗对激素依赖型乳腺癌患者的NLR、PLR水平及临床疗效的影响

发布时间：2018-05-17 05:36

本文选题：乳腺癌 + 中药联合来曲唑治疗　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：目的:通过观察中药联合来曲唑治疗激素依赖型乳腺癌患者病例,分析中药联合来曲唑治疗对患者治疗前后NLR、PLR水平及临床疗效的影响,探讨中药治疗在激素依赖型乳腺癌临床治疗中的价值。材料与方法:选取2013年9月-2016年12月期间于辽宁中医药大学附属第二医院肿瘤科住院部符合纳入标准乳腺癌病例36例,其中治疗组16例,对照组20例。收集相关的临床资料,包括年龄、中医辨证分型、中医证候积分、治疗前后的KPS评分(卡劳夫斯基行为状况评分)、中性粒细胞计数、血小板计数与淋巴细胞计数等。对照组口服来曲唑片2.5mg日一次行内分泌治疗;治疗组在接受上述治疗的同时持续口服中药汤剂4周。应用SPSS19.0软件对治疗前后NLR、PLR水平、KPS评分及中医证候疗效积分变化情况进行分析。检验水准定为P㩳0.05。结果:1.治疗后治疗组患者治疗后NLR水平积分均值为2.10±0.78分,对照组患者治疗后NLR水平积分均值为1.61±0.55分,两组患者NLR水平差异有统计学意义(P0.05)。2.治疗组可使患者PLR水平降低,差异有统计学意义(P0.05)。对照组对患者PLR水平降低无明显影响。治疗组患者治疗前后PLR水平变化差异均值为26.52±43.27,对照组患者治疗前后PLR水平变化差异均值为-8.18±35.81,两组差异有统计学意义(P0.05)。3.治疗组及对照组均可使患者KPS评分升高,差异有统计学意义(P0.05)。治疗后组间KPS评分变化差异有统计学意义。治疗组差值秩均值为22.41,秩和为358.5,对照组差值秩均值为15.38,秩和为307.5,两组差值经秩和检验P=0.009,差异有统计学意义。4.治疗组及对照组均可使患者中医证候积分降低,且观察组效果优于对照组,差异有统计学意义(P0.05)。5.PLR水平变化、患者KPS评分水平变化、中医症效积分水平变化与中医证型无关。结论:1.在降低患者NLR水平方面,中药联合来曲唑治疗及单纯来曲唑治疗均无明显疗效。2.中药联合来曲唑治疗可降低患者PLR水平,并且中药联合来曲唑治疗疗效优于单纯来曲唑治疗。3.中药联合来曲唑治疗及单纯来曲唑治疗均可改善患者的临床疗效(提高患者KPS评分、降低中医症效积分),且中药联合来曲唑治疗疗效优于单纯来曲唑治疗。4.PLR水平变化、患者KPS评分水平变化、中医症效积分水平变化与中医证型无关。
[Abstract]:Objective: to observe the effect of traditional Chinese medicine combined with letrozole on the levels of NLRL PLR and clinical efficacy in patients with steroid-dependent breast cancer before and after treatment. To explore the value of traditional Chinese medicine in the treatment of hormone-dependent breast cancer. Materials and methods: from September 2013 to December 2016, 36 cases of breast cancer in the oncology department of the second affiliated Hospital of Liaoning University of traditional Chinese Medicine were selected, including 16 cases in the treatment group and 20 cases in the control group. To collect relevant clinical data, including age, TCM syndrome differentiation, TCM syndromes score, KPS score before and after treatment (Karoufsky behavior score, neutrophil count, platelet count and lymphocyte count, etc. The control group was treated with oral letrozole 2.5mg once a day, and the treatment group was treated with traditional Chinese medicine decoction for 4 weeks. SPSS19.0 software was used to analyze the changes of SPSS19.0 score and TCM syndromes score before and after treatment. The inspection level is set at P0. 05. The result is 1: 1. After treatment, the mean score of NLR level was 2.10 卤0.78 in the treatment group and 1.61 卤0.55 in the control group. There was significant difference between the two groups in NLR level. The PLR level in the treatment group was significantly lower than that in the control group (P 0.05). The control group had no significant effect on the decrease of PLR level. The difference of PLR level before and after treatment was 26.52 卤43.27 in the treatment group and -8.18 卤35.81 in the control group. The difference between the two groups was statistically significant (P 0.05). Both the treatment group and the control group could increase the KPS score (P 0.05). There was significant difference in KPS score between groups after treatment. The average value of difference in treatment group was 22.41, rank sum was 358.5, and that in control group was 15.38 and 307.5 respectively. The difference between the two groups was statistically significant by rank sum test (P0. 009). Both the treatment group and the control group could decrease the TCM syndrome score, and the effect of the observation group was better than that of the control group. The difference was statistically significant (P 0.05) .5.PLR level, the KPS score level of the patients, and the TCM symptom effect integral level were not related to the TCM syndrome type. Conclusion 1. In reducing the level of NLR in patients, both Chinese medicine combined with letrozole and letrozole alone have no significant curative effect. 2. 2. Chinese medicine combined with letrozole can reduce the level of PLR in patients, and the curative effect of Chinese medicine combined with letrozole is better than that of letrozole alone. 3. Traditional Chinese medicine combined with letrozole and letrozole alone can improve the clinical efficacy of the patients (improve the patients' KPS score and reduce the integral of symptomatic effect of traditional Chinese medicine, and the curative effect of traditional Chinese medicine combined with letrozole is better than that of letrozole alone. 4. The level of PLR is higher than that of letrozole alone. The change of KPS score and TCM symptom effect score were not related to TCM syndrome type.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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