CAJ | 학술논문

目的：观察乳腺癌术后高危人群复发转移的影响因素，并应用中医辨证论治方案干预，观察其降低复发转移率的有效性。方法对178例激素受体阳性乳腺癌术后高危人群复发转移影响因素进行分析，比较中西医结合队列(中医辨证论治＋内分泌治疗)与西医队列(内分泌治疗)的复发转移、无病生存情况及中医症状积分。结果淋巴结转移情况、肿瘤分期、是否接受中医辨证治疗3个因素对乳腺癌术后高危患者的无病生存率有影响，是否服用中药是影响无病生存期的独立预后因素。与西医队列比较，中西医结合队列3年复发转移率明显减少，差异有统计学意义(P＝0.03)。两队列的中医临床症状总积分在治疗3个月及6个月时均明显下降，接受中医辨证治疗的队列改善程度更大。中医治疗对于心烦易怒及烘热汗出的疗效显著，自汗及失眠的疗效次之，口干口苦及神疲乏力的改善情况欠佳。结论淋巴结转移情况、肿瘤分期、是否接受中医辨证治疗是影响乳腺癌术后复发转移的主要因素。中医辨证治疗可降低3年复发转移率，明显改善中医症状，尤其对心烦易怒及烘热汗出的疗效更为显著。
목적：관찰유선암술후고위인군복발전이적영향인소，병응용중의변증론치방안간예，관찰기강저복발전이솔적유효성。방법대178례격소수체양성유선암술후고위인군복발전이영향인소진행분석，비교중서의결합대렬(중의변증론치＋내분비치료)여서의대렬(내분비치료)적복발전이、무병생존정황급중의증상적분。결과림파결전이정황、종류분기、시부접수중의변증치료3개인소대유선암술후고위환자적무병생존솔유영향，시부복용중약시영향무병생존기적독립예후인소。여서의대렬비교，중서의결합대렬3년복발전이솔명현감소，차이유통계학의의(P＝0.03)。량대렬적중의림상증상총적분재치료3개월급6개월시균명현하강，접수중의변증치료적대렬개선정도경대。중의치료대우심번역노급홍열한출적료효현저，자한급실면적료효차지，구간구고급신피핍력적개선정황흠가。결론림파결전이정황、종류분기、시부접수중의변증치료시영향유선암술후복발전이적주요인소。중의변증치료가강저3년복발전이솔，명현개선중의증상，우기대심번역노급홍열한출적료효경위현저。
Objective To observe the influencing factors of recurrence and metastasis for postoperative breast cancer high-risk population, and TCM regimen of syndrome differentiation and treatment was used to validate its significance for the prevention of recurrence and metastasis. Methods The influencing factors of recurrence and metastasis of 178 postoperative breast cancer high-risk cases with positive hormone receptor were studied. The recurrence and metastasis, disease-free survival and accumulative points of TCM symptoms of integrated group (with TCM syndrome differentiation and endocrine therapy) and western medicine group (with endocrine therapy) were compared. Results Lymph node metastasis, cancer staging and TCM therapy had influence on the disease-free survival rate of postoperative breast cancer high-risk patients. TCM therapy was the independent prognostic factor for disease-free survival. 3-year recurrence and metastasis rate was lower in integrated group than that in western medicine group, with statistical difference (P=0.03). The total accumulative points of TCM symptoms in both two groups decreased after treated for 3 and 6 months, integrated group showed greater significance. TCM therapy was better for the treatment of irritability, hot flash and perspiration, good for spontaneous perspiration and insomnia, but poor in dry mouth, bitter taste in mouth and fatigue. Conclusion Lymph node metastasis, cancer staging and TCM therapy are main influencing factors for recurrence and metastasis. TCM therapy with regimen of syndrome differentiation and treatment can reduce 3-year recurrence and metastasis rate, improve TCM symptoms, especially is significant for the improvement of irritability, hot flash and perspiration.