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Article(id=1322923438561702505, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923268038078806, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.04.035, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339126482, onlineDateStr=2026-10-30, pubDate=1744214400000, pubDateStr=2025-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339126482, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339126482, creator=13701087609, updateTime=1793339126482, updator=13701087609, issue=Issue{id=1322923268038078806, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='4', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1744214400000', pubDateStr='2025-04-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339085826, creator='13701087609', updateTime=1793340586453, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929562572686061, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923268038078806, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929562572686062, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923268038078806, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=209, endPage=212, ext={EN=ArticleExt(id=1322923438888858218, articleId=1322923438561702505, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Influence of Jianpi Fuzheng Runzao Decoction（健脾扶正润燥汤）on Effects of Chemotherapy Patients with Advanced Breast Cancer, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

The aim was to investigate the effects of Jianpi Fuzheng Runzao Decoction（健脾扶正润燥汤）on the survival and toxic side effects of chemotherapy patients with advanced breast cancer.

Methods

A hundred and twenty cases of breast cancer patients in the hospital were included and randomly divided into observation group and control group according to the random number table method，with 60 cases in each group. The control group was given conventional treatment with western medicines，and the observation group was given Jianpi Fuzheng Runzao Decoction on the basis of the control group. The clinical benefit rate，immune function，median survival，median progression-free survival and the occurrence of toxic side effects were observed before and after treatment in both groups.

Results

After treatment，the clinical benefit rate of the observation group was 73.33%（44/60），which was significantly higher than that（53.33%，32/60）of the control group（P<0.05）. After 2 cycles of treatment，the blood routine indexes of the two groups were lower than those before treatment（P<0.05）. After 4 cycles of treatment，the blood routine indexes of the two groups increased，and the improvement of the observation group was significantly better than that of the control group（P<0.05）. After treatment，the levels of immunoglobulin（Ig）G，IgA and IgM of both groups were significantly higher than those before treatment（P<0.05），and the improvement of the indicators of the observation group was significantly better than that of the control group（P<0.05）. The toxic side effects of both groups were classⅠ～Ⅱ，and the incidence rate of toxic side effects was 23.33%（14/60）in the observation group，which was significantly lower than that（45.00%，27/60）in the control group（P<0.05）. After treatment，the median survival（OS）time of the observation group and the control group was 14.2 months and 11.6 months，respectively，and the time of the observation group was better than that of the control group（P<0.05）. The median progression-free survival（PFS）time of the observation group and the control group was7 months and 5.3 months，respectively，and the time of the observation group was better than that of the control group（P<0.05）.

Conclusion

Jianpi Fuzheng Runzao Decoction has significant efficacy in patients with advanced breast cancer chemotherapy，which can effectively improve the survival and immune function，and reduce the incidence of toxic side effects in patients.

, authors=Jinfeng WANG, Wenguang SONG, Wei LIU, authorsList=Jinfeng WANG, Wenguang SONG, Wei LIU, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322923440700797556, articleId=1322923438561702505, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=健脾扶正润燥汤对晚期乳腺癌化疗临床疗效的影响, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

旨在探究健脾扶正润燥汤对晚期乳腺癌化疗患者临床疗效的影响。

方法

纳入医院120例乳腺癌患者，按随机数字表法将患者随机分为观察组及对照组，两组各60例。对照组给予西药常规治疗，观察组在对照组基础上给予健脾扶正润燥汤。观察两组治疗前后临床获益率、免疫功能、中位生存期、中位无进展生存期及不良反应发生情况。

结果

治疗后观察组临床获益率为73.33%（44/60），对照组临床获益率为53.33%（32/60），观察组显著高于对照组（P<0.05）；治疗2个周期后两组血常规指标均较治疗前降低（P<0.05）；治疗4个周期后，两组血常规指标有所升高，观察组改善情况均显著优于对照组（P<0.05）；治疗后两组IgG、IgA、IgM水平均较治疗前显著升高（P<0.05），观察组各项指标改善显著优于对照组（P<0.05）；两组不良反应均为Ⅰ～Ⅱ级，观察组不良反应发生率为23.33%（14/60），对照组不良反应发生率为45.00%（27/60），观察组明显低于对照组（P<0.05）；治疗后，观察组与对照组中位生存期（OS）分别为：14.2个月、11.6个月，观察组优于对照组（P<0.05）；观察组与对照组中位无进展生存期（PFS）分别为：7个月、5.3个月，观察组优于对照组（P<0.05）。

结论

健脾扶正润燥汤对晚期乳腺癌化疗患者有显著的疗效，能有效提高患者生存期、改善患者免疫功能、降低患者不良反应发生率。

, authors=王金凤, 宋文广, 刘伟, authorsList=王金凤, 宋文广, 刘伟, authorCompany=null, correspAuthors=null, authorNote=

王金凤（1977-），女，河北唐山人，主治医师，硕士，研究方向：中医临床。

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王金凤（1977-），女，河北唐山人，主治医师，硕士，研究方向：中医临床。

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王金凤（1977-），女，河北唐山人，主治医师，硕士，研究方向：中医临床。

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Tangshan 063000, Hebei, China), AuthorCompanyExt(id=1322923440981815927, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923438561702505, companyId=1322923440965038709, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=唐山市工人医院，河北　唐山　063000)])], figs=[ArticleFig(id=1322923442684703377, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923438561702505, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数年龄/（岁，±s）BMI（±s）病理类型/［例（%）］TNM分期/［例（%）］T分期/［例（%）］
浸润型导管癌黏液癌其他ⅡⅢcT2cT3-4
对照组6048.93±10.3620.69±5.1842（70.00）8（13.33）10（16.67）28（46.67）32（53.33）38（63.33）22（36.77）
观察组6049.02±10.3220.54±5.2744（73.33）7（11.67）9（15.00）27（45.00）33（55.00）39（65.00）21（35.00）
t/χ20.047 70.157 20.164 20.076 20.062 50.033 60.033 60.036 20.036 2
P值0.962 10.875 30.685 40.782 50.802 50.854 60.854 60.849 00.849 0
), ArticleFig(id=1322923442747617938, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923438561702505, language=CN, label=表1, caption=

两组晚期乳腺癌患者一般资料对比

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数年龄/（岁，±s）BMI（±s）病理类型/［例（%）］TNM分期/［例（%）］T分期/［例（%）］
浸润型导管癌黏液癌其他ⅡⅢcT2cT3-4
对照组6048.93±10.3620.69±5.1842（70.00）8（13.33）10（16.67）28（46.67）32（53.33）38（63.33）22（36.77）
观察组6049.02±10.3220.54±5.2744（73.33）7（11.67）9（15.00）27（45.00）33（55.00）39（65.00）21（35.00）
t/χ20.047 70.157 20.164 20.076 20.062 50.033 60.033 60.036 20.036 2
P值0.962 10.875 30.685 40.782 50.802 50.854 60.854 60.849 00.849 0
), ArticleFig(id=1322923442823115411, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923438561702505, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数CRPRSDPD临床获益
对照组60010（16.67）22（36.67）28（46.67）32（53.33）
观察组60013（21.67）31（51.66）16（26.67）44（73.33）
χ2值5.167 5
P值0.023 0
), ArticleFig(id=1322923442902807188, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923438561702505, language=CN, label=表2, caption=

两组晚期乳腺癌患者治疗后临床获益率对比

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数CRPRSDPD临床获益
对照组60010（16.67）22（36.67）28（46.67）32（53.33）
观察组60013（21.67）31（51.66）16（26.67）44（73.33）
χ2值5.167 5
P值0.023 0
), ArticleFig(id=1322923442965721749, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923438561702505, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间白细胞血小板中性粒细胞
对照组60治疗前6.35±2.68207.49±34.624.84±1.58
治疗2个周期2.01±1.37a72.93±10.81a1.12±0.23a
治疗4个周期3.24±1.26ac85.35±12.40ac1.50±0.48ac
观察组60治疗前6.32±2.51208.74±34.224.86±1.57
治疗2个周期2.69±1.10ab81.82±12.36ab1.40±0.64ab
治疗4个周期3.74±1.85abc96.79±13.04abc1.93±0.81abc
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两组晚期乳腺癌患者血常规指标对比（±s）

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组别例数时间白细胞血小板中性粒细胞
对照组60治疗前6.35±2.68207.49±34.624.84±1.58
治疗2个周期2.01±1.37a72.93±10.81a1.12±0.23a
治疗4个周期3.24±1.26ac85.35±12.40ac1.50±0.48ac
观察组60治疗前6.32±2.51208.74±34.224.86±1.57
治疗2个周期2.69±1.10ab81.82±12.36ab1.40±0.64ab
治疗4个周期3.74±1.85abc96.79±13.04abc1.93±0.81abc
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组别例数时间IgGIgAIgM
对照组60治疗前5.62±1.831.07±0.220.90±0.16
治疗后7.71±1.90a1.39±0.45a1.41±0.43a
观察组60治疗前5.67±1.861.05±0.200.88±0.18
治疗后9.96±2.15ab1.95±0.56ab1.90±0.82ab
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两组晚期乳腺癌患者免疫功能的对比（±s）

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组别例数时间IgGIgAIgM
对照组60治疗前5.62±1.831.07±0.220.90±0.16
治疗后7.71±1.90a1.39±0.45a1.41±0.43a
观察组60治疗前5.67±1.861.05±0.200.88±0.18
治疗后9.96±2.15ab1.95±0.56ab1.90±0.82ab
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组别例数肝功能异常低蛋白血症血小板减少消化道症状合计
对照组607（11.67）3（5.00）9（15.00）8（13.33）27（45.00）
观察组603（5.00）2（3.33）5（8.33）4（6.67）14（23.33）
χ2值6.261 2
P值0.012 3
), ArticleFig(id=1322923443418706586, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923438561702505, language=CN, label=表5, caption=

两组晚期乳腺癌患者不良反应对比

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组别例数肝功能异常低蛋白血症血小板减少消化道症状合计
对照组607（11.67）3（5.00）9（15.00）8（13.33）27（45.00）
观察组603（5.00）2（3.33）5（8.33）4（6.67）14（23.33）
χ2值6.261 2
P值0.012 3
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健脾扶正润燥汤对晚期乳腺癌化疗临床疗效的影响
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王金凤 , 宋文广 , 刘伟
中华中医药学刊 | 省级项目平台 2025,43(4): 209-212
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中华中医药学刊 |省级项目平台 2025 , 43 (4) : 209 -212
健脾扶正润燥汤对晚期乳腺癌化疗临床疗效的影响
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王金凤, 宋文广, 刘伟
作者信息
  • 唐山市工人医院，河北　唐山　063000
作者简介:

王金凤（1977-），女，河北唐山人，主治医师，硕士，研究方向：中医临床。

Influence of Jianpi Fuzheng Runzao Decoction（健脾扶正润燥汤）on Effects of Chemotherapy Patients with Advanced Breast Cancer
Jinfeng WANG, Wenguang SONG, Wei LIU
Affiliations
  • Tangshan Workers＇Hospital, Tangshan 063000, Hebei, China
出版时间: 2025-04-10 doi: 10.13193/j.issn.1673-7717.2025.04.035
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摘要
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目的

旨在探究健脾扶正润燥汤对晚期乳腺癌化疗患者临床疗效的影响。

方法

纳入医院120例乳腺癌患者，按随机数字表法将患者随机分为观察组及对照组，两组各60例。对照组给予西药常规治疗，观察组在对照组基础上给予健脾扶正润燥汤。观察两组治疗前后临床获益率、免疫功能、中位生存期、中位无进展生存期及不良反应发生情况。

结果

治疗后观察组临床获益率为73.33%（44/60），对照组临床获益率为53.33%（32/60），观察组显著高于对照组（P<0.05）；治疗2个周期后两组血常规指标均较治疗前降低（P<0.05）；治疗4个周期后，两组血常规指标有所升高，观察组改善情况均显著优于对照组（P<0.05）；治疗后两组IgG、IgA、IgM水平均较治疗前显著升高（P<0.05），观察组各项指标改善显著优于对照组（P<0.05）；两组不良反应均为Ⅰ～Ⅱ级，观察组不良反应发生率为23.33%（14/60），对照组不良反应发生率为45.00%（27/60），观察组明显低于对照组（P<0.05）；治疗后，观察组与对照组中位生存期（OS）分别为：14.2个月、11.6个月，观察组优于对照组（P<0.05）；观察组与对照组中位无进展生存期（PFS）分别为：7个月、5.3个月，观察组优于对照组（P<0.05）。

结论

健脾扶正润燥汤对晚期乳腺癌化疗患者有显著的疗效，能有效提高患者生存期、改善患者免疫功能、降低患者不良反应发生率。

健脾扶正润燥汤  /  晚期乳腺癌  /  生存期  /  免疫功能  /  不良反应
Objective

The aim was to investigate the effects of Jianpi Fuzheng Runzao Decoction（健脾扶正润燥汤）on the survival and toxic side effects of chemotherapy patients with advanced breast cancer.

Methods

A hundred and twenty cases of breast cancer patients in the hospital were included and randomly divided into observation group and control group according to the random number table method，with 60 cases in each group. The control group was given conventional treatment with western medicines，and the observation group was given Jianpi Fuzheng Runzao Decoction on the basis of the control group. The clinical benefit rate，immune function，median survival，median progression-free survival and the occurrence of toxic side effects were observed before and after treatment in both groups.

Results

After treatment，the clinical benefit rate of the observation group was 73.33%（44/60），which was significantly higher than that（53.33%，32/60）of the control group（P<0.05）. After 2 cycles of treatment，the blood routine indexes of the two groups were lower than those before treatment（P<0.05）. After 4 cycles of treatment，the blood routine indexes of the two groups increased，and the improvement of the observation group was significantly better than that of the control group（P<0.05）. After treatment，the levels of immunoglobulin（Ig）G，IgA and IgM of both groups were significantly higher than those before treatment（P<0.05），and the improvement of the indicators of the observation group was significantly better than that of the control group（P<0.05）. The toxic side effects of both groups were classⅠ～Ⅱ，and the incidence rate of toxic side effects was 23.33%（14/60）in the observation group，which was significantly lower than that（45.00%，27/60）in the control group（P<0.05）. After treatment，the median survival（OS）time of the observation group and the control group was 14.2 months and 11.6 months，respectively，and the time of the observation group was better than that of the control group（P<0.05）. The median progression-free survival（PFS）time of the observation group and the control group was7 months and 5.3 months，respectively，and the time of the observation group was better than that of the control group（P<0.05）.

Conclusion

Jianpi Fuzheng Runzao Decoction has significant efficacy in patients with advanced breast cancer chemotherapy，which can effectively improve the survival and immune function，and reduce the incidence of toxic side effects in patients.

Jianpi Fuzheng Runzao Decoction（健脾扶正润燥汤）  /  advanced breast cancer  /  survival  /  immune function  /  toxic side effects
王金凤, 宋文广, 刘伟. 健脾扶正润燥汤对晚期乳腺癌化疗临床疗效的影响. 中华中医药学刊, 2025 , 43 (4) : 209 -212 . DOI: 10.13193/j.issn.1673-7717.2025.04.035
Jinfeng WANG, Wenguang SONG, Wei LIU. Influence of Jianpi Fuzheng Runzao Decoction（健脾扶正润燥汤）on Effects of Chemotherapy Patients with Advanced Breast Cancer[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (4) : 209 -212 . DOI: 10.13193/j.issn.1673-7717.2025.04.035
正文
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乳腺癌是威胁女性健康的首位恶性肿瘤，乳腺癌发病率在全球多数国家癌症发病率中排名前列，占所有癌症病例的10%～12%[1]。化疗作为目前治疗晚期乳腺癌的首选方案，能有效缓解患者临床症状，延缓疾病进展，延长患者生存期；但化疗同样可破坏机体免疫功能，引起诸多不良反应，如消化道症状、肝肾功能损伤、骨髓抑制等[2-3]。随着乳腺癌治疗的研究进展，中西医结合治疗模式在乳腺癌治疗中发挥稳定的优势，中医药协同现代医学手段可提高患者临床疗效、增强免疫力，减轻不良反应，充分发挥扶正祛邪的中医治疗原则[4]。大量证据表明中医药具有多靶点、多通路、低毒性、经济性等优势，已成为目前治疗乳腺癌的主要方式之一[5-6]。健脾扶正润燥汤主要由多种扶正补益中药材组成，具有健脾扶正、补血益气之效，可提高患者对化疗的耐受性和依从性。本研究在常规化疗的基础上加用健脾扶正润燥汤，探索健脾扶正润燥汤对晚期乳腺癌化疗患者生存期和不良反应的综合影响及患者获益情况，现报道如下。
1　资料与方法
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1.1　一般资料
选取本院2018年3月—2021年3月收治的120例乳腺癌患者，按照随机数表法将患者分为对照组及观察组各60例。其中对照组年龄25～75岁，平均（49.02±10.32）岁；观察组年龄26～74岁，平均（48.93±10.36）岁。两组患者的年龄、BMI、病理类型、临床分期等一般资料相比，差异均无统计学意义（P>0.05）。见表1。
1.2　诊断标准
西医诊断标准参照《乳腺癌诊疗指南（2022版）》[7]，乳房肿块边界不清、活动性差、表面不光滑，乳头有浆血性液体流出，皮肤凹陷等，且经乳腺超声、病理活检等检查结果确诊。中医诊断标准参考《中药新药临床研究指导原则》[8]：胃脘胀痛、纳呆腹胀、乳房结块疼痛、情志抑郁、泄泻、舌紫黯苔白、脉细等。
1.3　纳入及排除标准
1.3.1　纳入标准
①符合本研究中西医诊断标准；②根据实体瘤疗效评价标准至少有1个可测量病灶；③预计生存期≥6个月；④自愿参加本研究并签署知情同意书。
1.3.2　排除标准
①合并其他恶性肿瘤者；②近期接受过其他抗肿瘤药物治疗；③手术治疗者；④伴有白细胞减少、血小板下降等血液系统疾病的患者；⑤化疗前卡氏功能状态（KPS）评分低于60分。
1.4　方法
两组患者均行表柔比星（法玛新，辉瑞制药有限公司生产，规格10 mg/支，国药准字H20000496，规格50 mg/支，国药准字H20000497）100 mg/m2联合注射用环磷酰胺（山西普德药业股份有限公司生产，规格0.2g/支，国药准字H14023686 80 mg/m2。每次化疗时间为1 d，每21 d化疗1次，为1个周期，共观察4个化疗周期。
对照组于每次化疗前30 min予静推盐酸格拉司琼氯化钠注射液50 mL止呕（成都倍特药业股份有限公司生产，规格50 mL/支，格拉司琼3 mg与氧化钠0.45 g，国药准字H20030370），若白细胞计数低于2.0×10 VL时，予皮下注射重组人粒细胞集落刺激因子300 μg升白治疗（商品名：津恤力，石药集团百克山东生物制药有限公司生产，规格300 μg/支，国药准字S2000011），若合并感染者予抗生素治疗。
观察组在对照组治疗方案上给予健脾滋阴汤：麦门冬20 g，炙黄芪20 g，白术20 g，党参20 g，茯苓15 g，生姜10 g，半夏10 g，葛根15 g，吴茱萸10 g，木香10 g，神曲10 g，谷芽10 g，麦芽10 g，甘草6 g。随症加减：若有较多清水呕出，并觉腔冷肢凉明显者，可加附子温中止呕；若呕吐吞酸，嗳气频发，可加香附、郁金、柴胡疏肝解郁；若发热恶寒，头身疼痛，可加藿香、白芷芳香化浊，散寒解表。化疗当天在化疗用药前1 h服用中药，以后每天早晚两次分服，用药21 d。
1.5　观察指标
1.5.1　临床疗效评价
参照RECIST 1.1评价标准[9]：完全缓解（CR），所有靶病灶消失，全部病理性淋巴结短直径减少至10 mm以下；部分缓解（PR），靶病灶直径之和比基线水平减少30%以上；疾病稳定（SD），靶病灶减小的程度未达到PR水平，增加的程度未达到PD水平；疾病进展（PD），靶病灶直径之和比基线增加20%以上，直径之和的绝对值增加至少5 mm，或出现1个或多个新发病灶。当实体瘤的直径之和评定为PD时，暂停用药。临床获益率＝（CR ＋PR ＋SD）/总例数×100%。
1.5.2　血常规
分别于治疗前、治疗2个周期、治疗4个周期后采集两组患者空腹静脉血3 mL，离心机1500 r/min离心5 min，取上清液待检。应用全自动血液分析仪检测两组患者白细胞、中性粒细胞及血小板计数。
1.5.3　免疫功能
分别于治疗前后采集两组患者静脉血，离心处理后采用酶联免疫吸附法测定血清免疫球蛋白IgA、IgM、IgG。
1.5.4　生存期
通过门诊或电话随访2年观察两组中位生存期（OS）、中位无进展生存期（PFS）。
1.5.5　不良反应
参照WHO肿瘤治疗不良反应评估标准[10]，观察两组患者发生肝功能异常、低蛋白血症、血小板减少、消化道症状等情况；不良反应程度为0～Ⅳ级。
1.6　统计学分析
使用SPSS 22.0统计软件对研究数据进行处理，计数资料行χ2检验，计量资料行t检验，P<0.05表明差异具有统计学意义。
2　结果
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2.1　临床获益率对比
治疗后观察组临床获益率为73.33%，显著高于对照组53.33%（P<0.05）。见表2。
2.2　血常规指标对比
治疗2个周期后两组血常规指标均较治疗前降低（P<0.05）；治疗4个周期后，两组血常规指标有所升高，观察组改善情况均显著优于对照组（P<0.05）。见表3。
2.3　免疫功能对比
治疗后两组IgG、IgA、IgM水平均较治疗前显著升高（P<0.05），观察组各项指标改善显著优于对照组（P<0.05）。见表4。
2.4　不良反应对比
两组不良反应均为Ⅰ～Ⅱ级，观察组不良反应发生率为23.33%，对照组不良反应发生率为45.00%，观察组明显低于对照组（P<0.05）。见表5。
2.5　生存期对比
治疗后，观察组与对照组中位生存期（OS）分别为：14.2个月、11.6个月，观察组优于对照组（P<0.05）；观察组与对照组中位无进展生存期（PFS）分别为：7个月、5.3个月，观察组优于对照组（P<0.05）。
3　讨论
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晚期乳腺癌是一种严重的恶性疾病，其发展受到多种因素的影响包括遗传因素、激素水平的异常、生活方式、环境因素等[11-12]。乳腺癌通常会通过淋巴系统或血管系统扩散到其他部位，形成远处的转移病灶[13]。目前，乳腺癌的常规治疗方案主要包括手术切除、放射疗法、荷尔蒙治疗和化疗[14-15]。手术切除是早期乳腺癌治疗的首选方法，但对于晚期乳腺癌患者，手术可能会受到限制，因为肿瘤可能已经扩散到其他组织或器官[16]。放射疗法常用于减少术后复发风险，而荷尔蒙治疗则主要适用于雌激素受体阳性的乳腺癌[17]。晚期乳腺癌的化疗方案通常是根据患者的具体情况和病理类型来选择。常用的方案有AC方案（多柔比星＋环磷酰胺）、TAC方案（多柔比星＋紫杉醇）或单药方案等[18-19]。总的来说，化疗对晚期乳腺癌患者可以在一定程度上减小肿瘤体积、延长生存期，甚至使肿瘤进入缓解期[20]。然而，化疗通常伴随着不良反应，如恶心、呕吐、脱发、疲劳和免疫抑制。患者的疗效和耐受性因个体差异而异，有些患者可能会对化疗产生耐药性[21]。因此，治疗方案的选择和管理应该由医疗专业人员根据患者的具体情况进行个体化决策。此外，近年来随着中医药被引入肿瘤治疗领域，也在一些患者中显示出了良好的疗效，并减少了一些化疗的不良反应[22]。
中医学对乳腺癌的认识是经过历代医家从各个角度深入研究和治疗中逐渐完善了与此病有关的辨证施治方法。一般认为乳腺癌的发生可能与外界六淫的侵袭、邪气的积聚或情感困扰，对肝脾功能产生不良影响，导致气血瘀滞，这些问题与肝、脾、肾以及冲任之间的相互关系息息相关。外界六淫邪气滞留在乳腺组织，从而引发疾病；此外乳腺癌的发生与情感波动有密切关系，情志不畅可能导致肝气郁结，脾失调节，痰湿滞留，气滞痰凝，经络受阻，最终引发该疾病。冲任是肝肾的附属器官，负责调节气血循环，但如果肝肾功能不足，冲任的调控功能受损，气血流动不畅，气滞血凝，乳腺组织中的气血也因此受到影响，使乳腺癌形成。总而言之，乳腺癌患者的病因主要是情感波动带来的阴阳失衡，这些情感波动会导致体内的生理机制紊乱。治疗时应以健脾理气、滋阴润燥为准则。本研究使用健脾扶正润燥汤，组方为麦门冬、炙黄芪、白术、党参、茯苓、生姜、半夏、葛根、吴茱萸、木香、神曲、谷芽、麦芽、甘草。其中炙黄芪为君药，大量使用健脾益气，升阳托毒；同时组方寓有四君子汤，党参、白术、茯苓、甘草，此4味药甘温益气、健脾燥湿，增强君药益气健脾之效；生姜、半夏、吴茱萸、木香燥湿化痰、消痞散结；麦门冬、神曲、谷芽、麦芽益胃生津、滋阴健脾；上14味药共奏益气健脾、燥湿化痰、滋阴润燥之效。现代药理学研究结果也表明，本方中药物含有黄芪皂苷、黄芪多糖、氨基丁酸、各种微量元素等有效成分，能提高机体免疫功能，还能起到抗氧化、抗炎等作用[23-24]。
对于乳腺癌患者来说，其生存期是一个关键的指标，它反映了患者的综合疗效及预后效果。延长生存期对乳腺癌患者来说至关重要，能有效降低患者家庭和社会的经济负担，减少医疗资源的消耗[25]。本研究使用健脾扶正润燥汤治疗晚期乳腺癌化疗患者，显示出了延长患者生存期及减少不良反应的效果，同时还显示出了对于患者免疫功能的改善，值得临床推广使用。
基金
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  • 河北省中医药类科研计划项目(2022571)
文献
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2025年第43卷第4期
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doi: 10.13193/j.issn.1673-7717.2025.04.035
  • 首发时间：2026-10-30
  • 出版时间：2025-04-10
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河北省中医药类科研计划项目(2022571)
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    唐山市工人医院，河北　唐山　063000
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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