目的 探究參附注射液聯(lián)合表柔比星和紫杉醇治療三陰性乳腺癌的臨床療效。方法 選擇2011年5月—2014年5月在海南省人民醫(yī)院接受治療的三陰性乳腺癌患者150例,隨機(jī)分為對(duì)照組和治療組,每組各75例。對(duì)照組在每個(gè)化療周期的第1天靜脈滴注注射用鹽酸表柔比星60 mg/m²,1次/d,同時(shí)靜脈滴注紫杉醇注射液120 mg/m²,1次/d,滴注時(shí)間大于3 h。治療組在每個(gè)化療周期的1～10 d靜脈滴注參附注射液50 mL/次,注射用鹽酸表柔比星和紫杉醇注射液的用法用量同對(duì)照組。21 d為一個(gè)化療療程,兩組均連續(xù)治療2個(gè)療程。治療后,評(píng)價(jià)兩組的臨床療效,同時(shí)比較兩組患者治療前后腫瘤直徑、癌細(xì)胞的叉頭框蛋白A1(fork box protein A1,FOXA1)、乳腺癌易感基因(breast cancer susceptibility gene 1,BRCA1)蛋白水平的變化。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為82.67%、64.00%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P <0.05)。治療后,兩組患者的腫瘤直徑、FOXA1、BRCA1蛋白均較治療前顯著降低,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P <0.05);且治療組的降低程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P <0.05)。對(duì)照組和治療組的不良反應(yīng)發(fā)生率分別為18.67%、13.33%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P <0.05)。結(jié)論 參附注射液聯(lián)合表柔比星和紫杉醇治療三陰性乳腺癌效果較好,可顯著降低患者腫瘤直徑,還可降低FOXAl和BRCAl蛋白水平,且不良反應(yīng)較低,在臨床具有一定的推廣應(yīng)用價(jià)值。

Objective To explore the clinical curative effect of Shenfu Injection combined with epirubicin and paclitaxel in treatment of triple negative breast cancer. Methods Patients (150 cases) with triple negative breast cancer in Hainan General Hospital from May 2011 to May 2014 were randomly divided into control and treatment groups, and each group had 75 cases. The patients in the control group were iv administered with Epirubicin Hydrochloride for injection 60 mg/m² on the first day of each cycle of chemotherapy, once daily. At the same time, they were iv administered with Paclitaxel Injection 120 mg/m², once daily, and the drip time was greater than 3 h. The patients in the treatment group were iv administered with Shenfu Injection 50 mL/time on 1 — 10 d in each cycle of chemotherapy, the usage and dosage of Epirubicin Hydrochloride for injection and Paclitaxel Injection in the treatment group was the same with the control group. A course of treatment included 21 d, and two groups were continuous treated for two courses. After treatment, the treatment efficacy were evaluated, and the changes of tumor diameter, fork box protein A1 (FOXA1) and protein of breast cancer susceptibility gene 1 (BRCA1) in two groups before and after treatment were compared. Results After treatment, the efficacies in the control and treatment groups were 82.67% and 64.00%, respectively, and there was difference between two groups (P < 0.05). After treatment, tumor diameter, FOXA1 and BRCA1 protein in two groups were significantly reduced, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). The incidence of adverse reactions in the control and treatment groups were 18.67% and 13.33%, respectively, and there was difference between two groups (P < 0.05). Conclusion Shenfu Injection combined with epirubicin and paclitaxel has good clinical efficacy in treatment of triple negative breast cancer with less adverse reaction, and can significantly reduce the tumor diameter, also can reduce FOXA1 and BRCA1 protein, which has certain application value in clinical.