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目的:观察三黄抗氧化方改善乳腺癌患者术后使用蒽环类药物化疗心脏毒性的效果。方法:67例患者均来自江苏省中医院2014年1月—2014年11月收治的乳腺科住院患者,经手术病理确诊为乳腺癌。67例乳腺癌患者被随机分为2组,即治疗组与对照组,治疗组34例,对照组33例。治疗组加服三黄抗氧化方。观察化疗前后心电图、心脏彩超(左室射血分数LVEF)、心肌肌钙蛋白(c Tn I)、血清一氧化氮(NO)与超氧化歧化酶(SOD)、临床症状改善等情况。结果:(1)治疗组发生窦性心动过速、室性或房性期前收缩、ST-T段改变以及室性心动过速的比率显著低于对照组(P<0.05)。(2)治疗组患者心脏彩超中LVEF值在化疗后下降不明显,与化疗前相比,差异无统计学意义(P>0.05),而对照组LVEF值较化疗前明显降低(P<0.05)。化疗后两组相比,治疗组LVEF明显优于对照组(P<0.05)。(3)心肌肌钙蛋白(c Tn I)无论是治疗组还是对照组患者,化疗前后的肌钙蛋白I均无显著性差异(P>0.05),且两组差异无统计学意义(P>0.05)。(4)治疗组血清NO明显低于对照组,SOD含量明显高于对照组,差异有统计学意义(P<0.05)。(5)三黄抗氧化方明显改善患者化疗期出现的不适症状包括胸闷、心悸、乏力等症状(P<0.05)。结论:三黄抗氧化方通过抗氧化应激机制,有效清除体内自由基和氧化物,保护心肌细胞,从而缓解乳腺癌术后蒽环类药物化疗所致的心脏毒性。
Objective: To observe the effect of Sanhuang Anti-Oxidant on improving the cardiotoxicity of anthracycline chemotherapy in patients with breast cancer after operation. Methods: All the 67 patients were from inpatients of breast department admitted from January 2014 to November 2014 in Jiangsu Provincial Hospital of Traditional Chinese Medicine. The pathological diagnosis was breast cancer. Sixty-seven breast cancer patients were randomly divided into two groups: the treatment group and the control group, with 34 cases in the treatment group and 33 cases in the control group. Treatment group plus serving three yellow antioxidant side. Electrocardiogram, left ventricular ejection fraction (LVEF), cardiac troponin (cTn I), serum nitric oxide (NO) and superoxide dismutase (SOD) were observed before and after chemotherapy. Results: (1) The rate of sinus tachycardia, ventricular or atrial contraction, ST-T segment change and ventricular tachycardia in treatment group were significantly lower than those in control group (P <0.05). (2) There was no significant difference in the value of LVEF between the two groups (P> 0.05), while the value of LVEF in the control group was significantly lower than that before chemotherapy (P <0.05) . Compared with the two groups after chemotherapy, the treatment group LVEF was significantly better than the control group (P <0.05). There was no significant difference in troponin I before and after chemotherapy (P> 0.05), and there was no significant difference between the two groups (P> 0.05). (4) The serum NO in the treatment group was significantly lower than that in the control group, the SOD content was significantly higher than that in the control group, the difference was statistically significant (P <0.05). (5) Sanhuang Anti-Oxidant significantly improved the symptoms of patients during chemotherapy, including chest tightness, palpitations, fatigue and other symptoms (P <0.05). Conclusion: Sanhuang Antioxidant can relieve cardiotoxicity caused by anthracycline chemotherapy after breast cancer surgery through anti-oxidative stress mechanism, effectively clearing free radicals and oxides and protecting cardiomyocytes.