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Article(id=1322927026511950173, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.10.046, 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=1793339981915, onlineDateStr=2026-10-30, pubDate=1760025600000, pubDateStr=2025-10-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339981915, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339981915, creator=13701087609, updateTime=1793339981915, updator=13701087609, issue=Issue{id=1322926740955341011, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='10', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1760025600000', pubDateStr='2025-10-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339913834, creator='13701087609', updateTime=1793340753123, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322930261259846420, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322930261259846421, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=243, endPage=246, ext={EN=ArticleExt(id=1322927026767802718, articleId=1322927026511950173, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect of Yiqi Yangrong Decoction（益气养荣汤）Combined with Acupuncture on T Lymphocyte Subsets and Serum Levels of CGA，slCAM-1 and GDF3 of Patients with Syndrome of both Qi and Blood Deficiency after Breast Cancer Surgery, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the effects of Yiqi Yangrong Decoction（益气养荣汤）combined with acupuncture on T lymphocyte subpopulation and serum levels of granin A（CGA），soluble intercellular adhesion factor-1（slCAM-1）and human growth differentiation factor 3（GDF3）in patients with syndrome of both Qi and blood deficiency after breast cancer surgery.

Methods

Ninety-two patients with syndrome of both Qi and blood deficiency after breast cancer surgery were treated in the hospital from May 2020 to May 2023.They were divided into the control group and the test group，46 cases in each group，using random number table method.The control group was treated with CEF（Cyclophosphamide，Epirubicin，Fluorouracil）chemotherapy，and the test group was treated with Yiqi Yangrong Decoction combined with acupuncture and moxibustion on the basis of CEF chemotherapy，21 days for 1 cycle，a total of 4 cycles.The quality of life，the serum levels of CGA，slCAM-1，GDF3 and T lymphocyte subsets of the two groups before and after 4 cycles of treatment，the efficacy after 4 cycles of treatment，and the occurrence of adverse reactions during treatment were compared.

Results

Compared with those before treatment，after 4 cycles of treatment，the functional dimension and overall quality of life scores of the two groups were increased，and those of the test group were significantly higher（P<0.05）.Compared with those before treatment，the symptom dimension scores/serum levels of CGA，slCAM-1 and GDF3 were decreased after 4 cycles of treatment，and the scores and levels were significantly lower in the test group（P<0.05）.Compared with those before treatment，the levels of CD4+and CD4+/CD8+in whole blood of the test group were increased after 4 cycles of treatment，and those of the control group were decreased.The levels were significantly higher in the test group（P<0.05）.The level of CD8+in whole blood of the test group decreased，and that of the control group increased.The level of CD8+in the test group was significantly lower（P<0.05）.The total effective rate of the test group was 83.33%（35/42），significantly higher than that of the control group（61.36%，27/44）after 4 cycles of treatment（P<0.05）.During the treatment period，no obvious adverse reactions occurred in the test group and the incidence of adverse reactions in the test group was significantly lower（P<0.05）.

Conclusion

Yiqi Yanggrong Decoction combined with acupuncture can regulate the levels of T lymphocyte subsets in patients with syndrome of both Qi and blood deficiency after breast cancer surgery，inhibit the serum levles of CGA，slCAM-1 and GDF3，control the abnormal proliferation of cancer cells，improve the quality of life，and reduce the risk of postoperative chemotherapy complications.

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目的

研究益气养荣汤联合针灸对乳腺癌术后气血两虚证患者T淋巴细胞亚群及血清嗜铬粒蛋白A（granin A，CGA）、可溶性细胞间黏附因子-1（soluble intercellular adhesion factor-1，slCAM-1）、人生长分化因子3（human growth differentiation factor 3，GDF3）水平的影响。

方法

乳腺癌术后气血两虚证患者92例均由2020年5月—2023年5月于医院接受治疗，采用随机数字表法分为对照组与试验组，各46例。对照组予以CEF方案化疗治疗，试验组在CEF方案化疗的基础上予以益气养荣汤联合针灸治疗，21 d为1个周期，共治疗4个周期。比较两组治疗前、治疗4个周期后生命质量、血清CGA、slCAM-1、GDF3水平、T淋巴细胞亚群及治疗4个周期后疗效，治疗期间不良反应发生情况。

结果

较治疗前，治疗4个周期后两组功能维度、总体生命质量评分升高，且试验组更高（P<0.05）。与治疗前比较，治疗4个周期后症状维度评分及血清CGA、slCAM-1、GDF3水平降低，且试验组更低（P<0.05）。与治疗前比较，治疗4个周期后两组均降低，且试验组更低（P<0.05）。与治疗前比较，治疗4个周期后试验组全血CD4+、CD4+/CD8+水平升高，对照组全血CD4+、CD4+/CD8+水平降低，试验组更高（P<0.05）；试验组全血CD8+水平降低，对照组全血CD8+水平升高，试验组更低（P<0.05）。与对照组治疗4个周期后的总有效率（61.36%，27/44）比较，试验组总有效率（83.33%，35/42）更高（P<0.05）。治疗期间，两组均未因治疗出现明显不良反应而终止治疗，试验组不良反应发生率更低（P<0.05）。

结论

益气养荣汤联合针灸可调节乳腺癌术后气血两虚证患者T淋巴细胞亚群水平，抑制血清CGA、slCAM-1、GDF3表达，控制癌细胞异常增殖，提高生命质量，疗效确切，降低术后化疗并发症发生风险。

, authors=闫明1, 任璐璐1, 任士珂2, authorsList=闫明, 任璐璐, 任士珂, authorCompany=null, correspAuthors=null, authorNote=

闫明（1987-），男，河南方城人，主治医师，硕士，研究方向：乳腺癌术后中西医结合诊治。

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闫明（1987-），男，河南方城人，主治医师，硕士，研究方向：乳腺癌术后中西医结合诊治。

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闫明（1987-），男，河南方城人，主治医师，硕士，研究方向：乳腺癌术后中西医结合诊治。

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Release Hospital，Xinxiang 453000，Henan，China), AuthorCompanyExt(id=1322927028097397101, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927026511950173, companyId=1322927028059648363, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.新乡牧野经络收放医院，河南 新乡 453000)])], figs=[ArticleFig(id=1322927030014194061, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927026511950173, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
时间组别例数功能维度症状维度总体生命质量
治疗前试验组4254.29±6.4554.02±5.5242.18±5.22
对照组4454.34±7.4853.90±4.4641.63±5.20
治疗4个周期后试验组4275.06±5.26*#25.82±3.25*#60.53±6.15*#
对照组4461.85±6.32*31.14±4.31*52.70±5.21*
), ArticleFig(id=1322927030081302926, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927026511950173, language=CN, label=表1, caption=

两组乳腺癌术后气血两虚证患者生活质量比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
时间组别例数功能维度症状维度总体生命质量
治疗前试验组4254.29±6.4554.02±5.5242.18±5.22
对照组4454.34±7.4853.90±4.4641.63±5.20
治疗4个周期后试验组4275.06±5.26*#25.82±3.25*#60.53±6.15*#
对照组4461.85±6.32*31.14±4.31*52.70±5.21*
), ArticleFig(id=1322927030148411791, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927026511950173, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
时间组别例数CGA/
（ng·mL-1）		slCAM-1/
（ng·mL-1）		GDF3/
（ng·L-1）
治疗前试验组42216.71±24.14 1 328.97±131.26 140.87±23.86
对照组44214.59±22.171 329.12±134.59141.22±21.59
治疗4个周期后试验组42128.91±13.11*#1 174.86±121.41*#78.53±8.62*#
对照组44173.05±14.27*1 240.15±124.72*110.65±17.36*
), ArticleFig(id=1322927030219714960, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927026511950173, language=CN, label=表2, caption=

两组乳腺癌术后气血两虚证患者血清CGA、slCAM-1、GDF3水平比较（）

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时间组别例数CGA/
（ng·mL-1）		slCAM-1/
（ng·mL-1）		GDF3/
（ng·L-1）
治疗前试验组42216.71±24.14 1 328.97±131.26 140.87±23.86
对照组44214.59±22.171 329.12±134.59141.22±21.59
治疗4个周期后试验组42128.91±13.11*#1 174.86±121.41*#78.53±8.62*#
对照组44173.05±14.27*1 240.15±124.72*110.65±17.36*
), ArticleFig(id=1322927030286823825, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927026511950173, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
时间组别例数CD4+/（%）CD8+/（%）CD4+/CD8+
治疗前试验组4234.89±3.2629.89±4.831.17±0.23
对照组4433.26±3.0429.73±4.681.12±0.24
治疗4个周期后试验组4242.01±3.41*#26.93±2.41*#1.56±0.25*#
对照组4430.95±3.17*33.19±3.56*0.93±0.22*
), ArticleFig(id=1322927030362321298, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927026511950173, language=CN, label=表3, caption=

两组乳腺癌术后气血两虚证患者T淋巴细胞亚群比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
时间组别例数CD4+/（%）CD8+/（%）CD4+/CD8+
治疗前试验组4234.89±3.2629.89±4.831.17±0.23
对照组4433.26±3.0429.73±4.681.12±0.24
治疗4个周期后试验组4242.01±3.41*#26.93±2.41*#1.56±0.25*#
对照组4430.95±3.17*33.19±3.56*0.93±0.22*
), ArticleFig(id=1322927030425235859, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927026511950173, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数痊愈显效有效无效总有效
试验组428（19.05）13（30.95）14（33.33）7（16.67）35（83.33）#
对照组444（9.09）12（27.27）11（25.00）17（38.64）27（61.36）
), ArticleFig(id=1322927030504927636, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927026511950173, language=CN, label=表4, caption=

两组乳腺癌术后气血两虚证患者疗效比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数痊愈显效有效无效总有效
试验组428（19.05）13（30.95）14（33.33）7（16.67）35（83.33）#
对照组444（9.09）12（27.27）11（25.00）17（38.64）27（61.36）
), ArticleFig(id=1322927030572036501, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927026511950173, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数白细胞减少恶心呕吐血小板减少腹泻总不良反应
试验组422（4.76）5（11.90）2（4.76）4（9.52）13（30.95）#
对照组446（13.64）11（25.00）4（9.09）3（6.82）24（54.55）
), ArticleFig(id=1322927030655922582, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927026511950173, language=CN, label=表5, caption=

两组乳腺癌术后气血两虚证患者治疗期间安全性比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数白细胞减少恶心呕吐血小板减少腹泻总不良反应
试验组422（4.76）5（11.90）2（4.76）4（9.52）13（30.95）#
对照组446（13.64）11（25.00）4（9.09）3（6.82）24（54.55）
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益气养荣汤联合针灸对乳腺癌术后气血两虚证T淋巴细胞亚群及血清CGA、slCAM-1、GDF3水平的影响
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闫明 1 , 任璐璐 1 , 任士珂 2
中华中医药学刊 | 省级项目平台 2025,43(10): 243-246
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中华中医药学刊 |省级项目平台 2025 , 43 (10) : 243 -246
益气养荣汤联合针灸对乳腺癌术后气血两虚证T淋巴细胞亚群及血清CGA、slCAM-1、GDF3水平的影响
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闫明（1987-），男，河南方城人，主治医师，硕士，研究方向：乳腺癌术后中西医结合诊治。

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闫明（1987-），男，河南方城人，主治医师，硕士，研究方向：乳腺癌术后中西医结合诊治。

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闫明1, 任璐璐1, 任士珂2
作者信息
  • 1.新乡市中心医院，新乡医学院第四临床学院，河南 新乡 453000
  • 2.新乡牧野经络收放医院，河南 新乡 453000
作者简介:

闫明（1987-），男，河南方城人，主治医师，硕士，研究方向：乳腺癌术后中西医结合诊治。

Effect of Yiqi Yangrong Decoction（益气养荣汤）Combined with Acupuncture on T Lymphocyte Subsets and Serum Levels of CGA，slCAM-1 and GDF3 of Patients with Syndrome of both Qi and Blood Deficiency after Breast Cancer Surgery
Ming YAN1, Lulu REN1, Shike REN2
Affiliations
  • 1.Xinxiang Central Hospital，The Fourth Clinical College of Xinxiang Medical University，Xinxiang 453000，Henan，China
  • 2.Xinxiang Muye Meridian Collection and Release Hospital，Xinxiang 453000，Henan，China
出版时间: 2025-10-10 doi: 10.13193/j.issn.1673-7717.2025.10.046
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摘要
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目的

研究益气养荣汤联合针灸对乳腺癌术后气血两虚证患者T淋巴细胞亚群及血清嗜铬粒蛋白A（granin A，CGA）、可溶性细胞间黏附因子-1（soluble intercellular adhesion factor-1，slCAM-1）、人生长分化因子3（human growth differentiation factor 3，GDF3）水平的影响。

方法

乳腺癌术后气血两虚证患者92例均由2020年5月—2023年5月于医院接受治疗，采用随机数字表法分为对照组与试验组，各46例。对照组予以CEF方案化疗治疗，试验组在CEF方案化疗的基础上予以益气养荣汤联合针灸治疗，21 d为1个周期，共治疗4个周期。比较两组治疗前、治疗4个周期后生命质量、血清CGA、slCAM-1、GDF3水平、T淋巴细胞亚群及治疗4个周期后疗效，治疗期间不良反应发生情况。

结果

较治疗前，治疗4个周期后两组功能维度、总体生命质量评分升高，且试验组更高（P<0.05）。与治疗前比较，治疗4个周期后症状维度评分及血清CGA、slCAM-1、GDF3水平降低，且试验组更低（P<0.05）。与治疗前比较，治疗4个周期后两组均降低，且试验组更低（P<0.05）。与治疗前比较，治疗4个周期后试验组全血CD4+、CD4+/CD8+水平升高，对照组全血CD4+、CD4+/CD8+水平降低，试验组更高（P<0.05）；试验组全血CD8+水平降低，对照组全血CD8+水平升高，试验组更低（P<0.05）。与对照组治疗4个周期后的总有效率（61.36%，27/44）比较，试验组总有效率（83.33%，35/42）更高（P<0.05）。治疗期间，两组均未因治疗出现明显不良反应而终止治疗，试验组不良反应发生率更低（P<0.05）。

结论

益气养荣汤联合针灸可调节乳腺癌术后气血两虚证患者T淋巴细胞亚群水平，抑制血清CGA、slCAM-1、GDF3表达，控制癌细胞异常增殖，提高生命质量，疗效确切，降低术后化疗并发症发生风险。

乳腺癌  /  气血两虚证  /  益气养荣汤  /  针灸  /  T淋巴细胞亚群  /  嗜铬粒蛋白A  /  可溶性细胞间黏附因子-1  /  人生长分化因子3
Objective

To investigate the effects of Yiqi Yangrong Decoction（益气养荣汤）combined with acupuncture on T lymphocyte subpopulation and serum levels of granin A（CGA），soluble intercellular adhesion factor-1（slCAM-1）and human growth differentiation factor 3（GDF3）in patients with syndrome of both Qi and blood deficiency after breast cancer surgery.

Methods

Ninety-two patients with syndrome of both Qi and blood deficiency after breast cancer surgery were treated in the hospital from May 2020 to May 2023.They were divided into the control group and the test group，46 cases in each group，using random number table method.The control group was treated with CEF（Cyclophosphamide，Epirubicin，Fluorouracil）chemotherapy，and the test group was treated with Yiqi Yangrong Decoction combined with acupuncture and moxibustion on the basis of CEF chemotherapy，21 days for 1 cycle，a total of 4 cycles.The quality of life，the serum levels of CGA，slCAM-1，GDF3 and T lymphocyte subsets of the two groups before and after 4 cycles of treatment，the efficacy after 4 cycles of treatment，and the occurrence of adverse reactions during treatment were compared.

Results

Compared with those before treatment，after 4 cycles of treatment，the functional dimension and overall quality of life scores of the two groups were increased，and those of the test group were significantly higher（P<0.05）.Compared with those before treatment，the symptom dimension scores/serum levels of CGA，slCAM-1 and GDF3 were decreased after 4 cycles of treatment，and the scores and levels were significantly lower in the test group（P<0.05）.Compared with those before treatment，the levels of CD4+and CD4+/CD8+in whole blood of the test group were increased after 4 cycles of treatment，and those of the control group were decreased.The levels were significantly higher in the test group（P<0.05）.The level of CD8+in whole blood of the test group decreased，and that of the control group increased.The level of CD8+in the test group was significantly lower（P<0.05）.The total effective rate of the test group was 83.33%（35/42），significantly higher than that of the control group（61.36%，27/44）after 4 cycles of treatment（P<0.05）.During the treatment period，no obvious adverse reactions occurred in the test group and the incidence of adverse reactions in the test group was significantly lower（P<0.05）.

Conclusion

Yiqi Yanggrong Decoction combined with acupuncture can regulate the levels of T lymphocyte subsets in patients with syndrome of both Qi and blood deficiency after breast cancer surgery，inhibit the serum levles of CGA，slCAM-1 and GDF3，control the abnormal proliferation of cancer cells，improve the quality of life，and reduce the risk of postoperative chemotherapy complications.

breast cancer  /  syndrome of both Qi and blood deficiency  /  Yiqi Yangrong Decoction（益气养荣汤）  /  acupuncture  /  T lymphocyte subsets  /  chromogranin A  /  soluble intercellular adhesion factor-1  /  human growth differentiation factor 3
闫明, 任璐璐, 任士珂. 益气养荣汤联合针灸对乳腺癌术后气血两虚证T淋巴细胞亚群及血清CGA、slCAM-1、GDF3水平的影响. 中华中医药学刊, 2025 , 43 (10) : 243 -246 . DOI: 10.13193/j.issn.1673-7717.2025.10.046
Ming YAN, Lulu REN, Shike REN. Effect of Yiqi Yangrong Decoction（益气养荣汤）Combined with Acupuncture on T Lymphocyte Subsets and Serum Levels of CGA，slCAM-1 and GDF3 of Patients with Syndrome of both Qi and Blood Deficiency after Breast Cancer Surgery[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (10) : 243 -246 . DOI: 10.13193/j.issn.1673-7717.2025.10.046
正文
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相关研究[1-2]指出，随着女性社会角色的改变、生活压力的增加，乳腺癌的发病率在逐步升高，且年轻人群发生乳腺癌的风险也在增加，其临床诊治为临床研究的热点。根治性手术治疗为具备手术治疗指征的乳腺癌患者首选治疗手段，可有效切除肿瘤组织，改善患者预后。患者术后多需配合CEF方案化疗治疗，术后治疗也是临床治疗重要组成[3]。中医理论认为乳腺癌术后患者痰邪、毒邪瘀积体内，脏腑功能受损，加之受金刃之创，气血损耗，正气不足，多具有气血两虚证，治疗应以调和气血阴阳为主[4-5]。中医疗法多样，益气养荣汤出自《外科理例》，是一种补益剂，针灸则可通过刺激经络腧穴，调畅血运与气机，但目前益气养荣汤联合针灸在乳腺癌术后患者中应用效果及机制尚未明确。本研究纳入乳腺癌术后气血两虚证患者92例进行研究，旨在分析益气养荣汤联合针灸对乳腺癌术后气血两虚证患者T淋巴细胞亚群及血清嗜铬粒蛋白A（granin A，CGA）、可溶性细胞间黏附因子-1（soluble intercellular adhesion factor-1，slCAM-1）、人生长分化因子3（human growth differentiation factor 3，GDF3）水平的影响的临床疗效。
1　资料与方法
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1.1　一般资料
92例乳腺癌术后气血两虚证患者均于2020年5月—2023年5月由我院接受治疗，患者本人签署知情同意书后，纳入对照组与试验组，各46例，方法为随机数字表法。临床试验经医院伦理委员会审核批准。
1.2　诊断标准
1.2.1　西医诊断标准
西医诊断符合《中国抗癌协会乳腺癌诊治指南与规范（2019年版）》[6]中乳腺癌相关诊断标准，经影像学、细胞学检查、病理检测确诊。
1.2.2　中医辨证分型标准
符合《中药新药临床研究指导原则试行》[7]气血两虚证诊断标准，主证包括神疲乏力，气短懒言，面白无华或萎黄，舌淡，脉细弱无力；次证包括自汗，手足发麻，头昏眼花，心悸、失眠，月经量少、色淡，苔薄，具备3项主证及2项次证即可诊断。
1.3　纳入标准
①年龄18岁及以上者；②语言、听力正常，能配合治疗者；③具备根治性手术治疗指征，并成功完成手术治疗者；④既往无乳腺癌及其他恶性肿瘤史者等。
1.4　排除标准
①存在严重感染者；②合并胃肠功能障碍性疾病，影响服药吸收者；③妊娠及哺乳期妇女者；④肝肾等重要脏器功能存在障碍者；⑤合并出血性倾向者；⑥对益气养荣汤联合针灸、CEF方案化疗不耐受等。
1.5　剔除标准
①同期接受其他治疗方案治疗，影响结果观察者；②治疗过程中出现新的疾病或意外事件者；③依从性不足，未完成全程治疗者；④失访，随访资料不完善者等。
1.6　治疗方法
1.6.1　对照组
注射用环磷酰胺（国药准字H14023686，山西普德药业有限公司，0.2 g/支）500 mg/m2静脉滴注，d1；注射用盐酸表柔比星（国药准字H20233195，注射用盐酸表柔比星，四川汇宇制药股份有限公司）70 mg/m2静脉滴注，于30 min内滴注完毕，d1；氟尿嘧啶注射液（国药准字H20057995，亚宝药业集团股份有限公司，10 mL∶0.25 g）500 mg/m2静脉滴注，维持滴注24 h，d1。21 d为1个治疗周期，共治疗4个周期。
1.6.2　试验组
CEF方案化疗应用方法同对照组，并予以益气养荣汤联合针灸治疗。益气养荣汤药用：人参30 g，炙黄芪20 g，柴胡20 g，白芍12 g，白花蛇舌草12 g，莪术12 g，白茯苓12 g，熟地黄12 g，白术12 g，当归15 g，川芎15 g，桔梗10 g，橘皮10 g，贝母10 g，枳壳10 g，香附10 g，甘草8 g。水煎服，1剂/d，早晚服用。针灸治疗取穴：百会、关元、气海、风池、足三里以及三阴交。指导患者仰卧，对需针灸的部位进行消毒，然后采用0.25 mm×40 mm的一次性针灸针（泰兴市天和医疗器械有限公司）进行治疗，进针后患者局部有酸麻胀得气感后，行平补平泻手法，风池穴针尖微向下，向鼻尖方向斜刺15～20 mm；百会穴向后平刺15～20 mm；关元、气海、足三里及三阴交穴均直刺25～30 mm，观察患者对针刺的耐受度，单个穴位行针时间为15 s，留针时间为15 min。1次/d，治疗5 d后间隔2 d。以21 d为1个治疗周期，共治疗4个周期。
1.7　疗效评价标准和观察指标
1.7.1　生命质量
治疗前、治疗4个周期后，根据癌症患者生命质量测定量表核心量表（European Organization for Reasearch and Treatment of Cancer of Quality of Life Questionnare Core 30，EORTCQLQ-30）[8]评价两组生活质量，EORTC QLQ-30包括功能维度15条，症状维度13条和总体生命质量维度2条，3个维度得分0～100分，得分越高患者该维度表现越明显。
1.7.2　血清CGA、slCAM-1、GDF3水平
治疗前、治疗4个周期后，采集两组空腹血液标本3 mL，转速3300 r/min离心10 min，分离出血清，检测血清CGA、slCAM-1、GDF3水平，酶联免疫吸附试验试剂盒来自美国西门子医学诊断股份有限公司。
1.7.3　T淋巴细胞亚群
同1.7.2采集血液标本，采用Cy-Flow® Counter型流式细胞仪（希森美康帕泰科有限责任公司）及配套试剂检测全血CD4+、CD8+、CD4+/CD8+水平。
1.7.4　疗效判定标准
在治疗前、治疗4个周期后根据《中药新药临床研究指导原则（试行）》评估中医证候积分变化分析疗效，总有效率（%）＝（1-无效例数/总例数）×100%。疗效指数（%）＝（治疗前-治疗4个周期后）中医证候积分/治疗前中医证候积分×100%。痊愈：疗效指数大于95%；显效：疗效指数70%～95%；有效：疗效指数30%～<70%；无效：未达到以上标准，甚至加重。
1.7.5　不良反应
记录两组治疗期间出现的白细胞减少、恶心呕吐、血小板减少以及腹泻等情况。
1.8　统计学方法
使用SPSS 26.0统计软件进行分析。计数资料以例（%）表示，χ2检验比较。计量资料符合正态分布，使用表示，两组组内及组间比较采用配对、独立样本t检验。P<0.05，表示差异具有统计学意义。
2　结果
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2.1　基线资料比较
治疗期间，试验组剔除4例（失访1例，未按要求服药3例），对照组剔除2例（失访1例，未按要求服药1例）。试验组年龄22～74岁，平均（53.76±5.39）岁；体质量指数（body mass index，BMI）18～26 kg/m2，平均（22.01±0.63）kg/m2；TNM分期[9]：Ⅱ期25例，Ⅲ期17例。对照组年龄23～76岁，平均（54.18±5.35）岁；BMI 18～25 kg/m2，平均（21.92±0.78）kg/m2；TNM分期：Ⅱ期27例，Ⅲ期17例。两组一般资料均衡（P>0.05），可比。
2.2　生活质量比较
较治疗前，治疗4个周期后两组功能维度、总体生命质量评分升高，且试验组更高（P<0.05）；症状维度评分降低，且试验组更低（P<0.05）。见表1。
2.3　血清CGA、slCAM-1、GDF3水平比较
与治疗前比较，治疗4个周期后两组血清CGA、slCAM-1、GDF3水平均降低，且试验组更低（P<0.05）。见表2。
2.4　T淋巴细胞亚群比较
与治疗前比较，治疗4个周期后试验组全血CD4+、CD4+/CD8+水平升高，对照组全血CD4+、CD4+/CD8+水平降低，试验组更高（P<0.05）；试验组全血CD8+水平降低，对照组全血CD8+水平升高，试验组更低（P<0.05）。见表3。
2.5　疗效比较
与对照组治疗4个周期后的总有效率比较，试验组总有效率更高（P<0.05）。见表4。
2.6　治疗期间安全性比较
治疗期间，两组均未因治疗出现明显不良反应而终止治疗，试验组不良反应发生率更低（P<0.05）。见表5。
3　讨论
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乳腺癌已成为我国女性的头号杀手，发病及病死率均居于首位，防治形势越来越严峻，根治性手术为乳腺癌首要治疗方案，CEF方案化疗可进一步杀灭肿瘤细胞，为手术治疗的重要补充部分[10-11]。而随着精准化治疗理念的发展，中医药具有多成分、多靶点、多通路的特征，也成为乳腺癌术后综合诊治中不可忽视的组成部分[12-13]。因此，本研究通过传统中医疗法来为乳腺癌术后气血两虚证患者的治疗提供新的思路，探讨益气养荣汤联合针灸治疗乳腺癌术后气血两虚证患者的效果，为乳腺癌术后气血两虚证患者的临床治疗提供新的依据。
《素问·调经论篇》曰：“人之身，气血而已”，气生血、气摄血、气行血，《灵枢·本脏》则指出：“人之血气精神者，所以奉生而周于性命者也”。乳腺癌术后气血两虚证属“虚劳”范畴，气血两虚为其基础病机，治疗应以“虚则补之”为基本原则。益气养荣汤方中人参大补元气、生津止渴，炙黄芪补气固表，柴胡升举阳气，白芍养血敛阴，白花蛇舌草、香附、莪术消肿解毒，白茯苓渗湿利水，熟地黄补血滋润，橘皮、枳壳、白术健脾益气，当归补血养血，川芎活血行气，桔梗、贝母清热散结，甘草补脾益气、调和诸药，全方共奏大补阴阳、理气健脾、养血补虚之效[14-15]。针灸选穴中百会穴为诸阳之会，百脉之宗，刺激可调理脏腑气血；关元与气海皆为任脉之要穴，刺激可调整阴阳平衡、补肾益气、扶正气血；风池是足少阳经、阳维脉的交会穴，可维持气血平衡；足三里为胃经重要穴位，三阴交则为脾经重要穴位，刺激可健脾和胃，诸穴共用能发挥补五脏六腑、益元气之效，改善乳腺癌术后气血两虚证患者气、血、阴、阳的亏耗[16-17]。本研究中，治疗4个周期后试验组功能维度、总体生命质量评分、总有效率更高，症状维度评分更低；治疗期间，两组均未因治疗出现明显不良反应而终止治疗，试验组不良反应发生率更低，提示益气养荣汤联合针灸可调节乳腺癌术后气血两虚证患者，可提高生命质量，疗效确切，降低术后化疗并发症发生风险。戴雅琴等[18]研究亦显示，加用中医疗法可降低恶性肿瘤患者术后并发症发生风险，疗效确切。
乳腺癌为内分泌相关肿瘤，CGA为内分泌肿瘤相关标志物，slCAM-1可参与免疫系统的异常激活，GDF3则可直接介导乳腺癌细胞的异常增殖，均可参与乳腺癌发生及发展；此外，免疫功能降低为乳腺癌的重要表现，T淋巴细胞亚群失衡，还可能导致其抑癌作用难以发挥[19-21]。本研究中，治疗4个周期后试验组血清CGA、slCAM-1、GDF3水平及全血CD8+更低，试验组全血CD4+、CD4+/CD8+水平更高，提示益气养荣汤联合针灸可调节乳腺癌术后气血两虚证患者T淋巴细胞亚群水平，抑制血清CGA、slCAM-1、GDF3表达，控制癌细胞异常增殖。孙音乐等[22]、杨慧芬等[23]研究指出，中医内治、外治疗法在恶性肿瘤的临床治疗中具有辅助作用。分析其治疗机制为，人参不仅含有人参皂苷，可激活造血功能，促进多能干细胞的分化-增殖，而且还含有脂肪、糖类、多种氨基酸以及多种维生素等营养物质，可改善机体营养状态；白术中白术多糖可促进淋巴细胞转化，延长淋巴细胞寿命，纠正T淋巴细胞亚群分布紊乱状态，增强细胞免疫功能，并呈现出抗肿瘤作用，降低肿瘤细胞分泌CGA、slCAM-1、GDF3水平[24-25]。李文涛等[26]研究指出，针灸法可改善中晚期非小细胞肺癌免疫功能，调节淋巴细胞亚群百分率，提高其绝对计数，最终改善患者病情进展，与本研究结果类似。
综上，益气养荣汤联合针灸可调节乳腺癌术后气血两虚证患者T淋巴细胞亚群水平，抑制血清CGA、slCAM-1、GDF3表达，控制癌细胞异常增殖，提高生命质量，疗效确切，降低术后化疗并发症发生风险。但本研究纳入病例均来自单一区域，未进行长期随访，样本量相对有限，可能增加结果的偏倚，临床可行大样本量、多中心、长期随访研究，进一步探讨益气养荣汤联合针灸治疗乳腺癌术后气血两虚证患者的效果。
基金
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  • 河南省医学科技攻关计划联合共建项目(LHGJ20191312)
  • 湖北陈孝平科技发展基金会肿瘤防治研究专项(CXPJJH122002-029)
文献
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2025年第43卷第10期
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doi: 10.13193/j.issn.1673-7717.2025.10.046
  • 首发时间：2026-10-30
  • 出版时间：2025-10-10
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河南省医学科技攻关计划联合共建项目(LHGJ20191312)
湖北陈孝平科技发展基金会肿瘤防治研究专项(CXPJJH122002-029)
作者信息
    1.新乡市中心医院，新乡医学院第四临床学院，河南 新乡 453000
    2.新乡牧野经络收放医院，河南 新乡 453000
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2种不同金属材料的力学参数
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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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