目的 探究参附注射液联合表柔比星和紫杉醇治疗三阴性乳腺癌的临床疗效。方法 选择2011年5月—2014年5月在海南省人民医院接受治疗的三阴性乳腺癌患者150例,随机分为对照组和治疗组,每组各75例。对照组在每个化疗周期的第1天静脉滴注注射用盐酸表柔比星60 mg/m²,1次/d,同时静脉滴注紫杉醇注射液120 mg/m²,1次/d,滴注时间大于3 h。治疗组在每个化疗周期的1～10 d静脉滴注参附注射液50 mL/次,注射用盐酸表柔比星和紫杉醇注射液的用法用量同对照组。21 d为一个化疗疗程,两组均连续治疗2个疗程。治疗后,评价两组的临床疗效,同时比较两组患者治疗前后肿瘤直径、癌细胞的叉头框蛋白A1(fork box protein A1,FOXA1)、乳腺癌易感基因(breast cancer susceptibility gene 1,BRCA1)蛋白水平的变化。结果 治疗后,对照组和治疗组的总有效率分别为82.67%、64.00%,两组比较差异有统计学意义(P <0.05)。治疗后,两组患者的肿瘤直径、FOXA1、BRCA1蛋白均较治疗前显著降低,同组治疗前后差异有统计学意义(P <0.05);且治疗组的降低程度优于对照组,两组比较差异具有统计学意义(P <0.05)。对照组和治疗组的不良反应发生率分别为18.67%、13.33%,两组比较差异有统计学意义(P <0.05)。结论 参附注射液联合表柔比星和紫杉醇治疗三阴性乳腺癌效果较好,可显著降低患者肿瘤直径,还可降低FOXAl和BRCAl蛋白水平,且不良反应较低,在临床具有一定的推广应用价值。

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.