新乡市中心医院,河南省新乡市卫滨区金穗大道56号,453000
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收稿:2025-10-27,
修回:2026-05-30,
录用:2026-04-22,
网络首发:2026-08-03,
纸质出版:2026-08-02
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王泽凤,齐路霞,郭占非等.参苓白术散加减辅助治疗对乳腺癌化疗所致骨髓抑制脾肾不足证患者外周血象及免疫功能的影响——一项随机、双盲、安慰剂对照试验[J].中医杂志,2026,67(15):1627-1633.
WANG Zefeng,QI Luxia,GUO Zhanfei,et al.Effect of Modified Shenling Baizhu Powder (参苓白术散) as an Adjuvant Therapy on Peripheral Blood Counts and Immune Function in Breast Cancer Patients with Chemotherapy-Induced Myelosuppression and Spleen-Kidney Insufficiency Syndrome:A Randomized,Double-Blind,Placebo-Controlled Trial[J].Journal of Traditional Chinese Medicine,2026,67(15):1627-1633.
王泽凤,齐路霞,郭占非等.参苓白术散加减辅助治疗对乳腺癌化疗所致骨髓抑制脾肾不足证患者外周血象及免疫功能的影响——一项随机、双盲、安慰剂对照试验[J].中医杂志,2026,67(15):1627-1633. DOI: 10.13288/j.11-2166/r.2026.15.009.
WANG Zefeng,QI Luxia,GUO Zhanfei,et al.Effect of Modified Shenling Baizhu Powder (参苓白术散) as an Adjuvant Therapy on Peripheral Blood Counts and Immune Function in Breast Cancer Patients with Chemotherapy-Induced Myelosuppression and Spleen-Kidney Insufficiency Syndrome:A Randomized,Double-Blind,Placebo-Controlled Trial[J].Journal of Traditional Chinese Medicine,2026,67(15):1627-1633. DOI: 10.13288/j.11-2166/r.2026.15.009.
目的
2
观察参苓白术散加减对乳腺癌化疗所致骨髓抑制脾肾不足证患者外周血象及免疫功能影响。
方法
2
采用随机、双盲、安慰剂对照研究方法,将102例乳腺癌化疗所致骨髓抑制脾肾不足证患者随机分为治疗组和对照组各51例。两组均在化疗后给予粒细胞刺激因子支持治疗及血液成分输注治疗,治疗组同时口服参苓白术散加减,每日1剂,对照组同时口服安慰剂,每日1剂。两组均以1个化疗周期21天为1个疗程,共治疗4个疗程,每个疗程内服中药/安慰剂3周。主要结局指标为外周血白细胞计数(WBC)、红细胞计数(RBC)、血小板计数(PLT)、血红蛋白(Hb)水平。次要结局指标包括免疫功能指标[CD3
+
淋巴细胞比例、CD4
+
淋巴细胞比例、CD8
+
淋巴细胞比例、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)]、中医证候积分、化疗完成率,并记录不良反应发生情况。
结果
2
研究过程中治疗组脱落2例、对照组脱落3例,最终纳入治疗组49例、对照组48例。与本组治疗前比较,两组患者WBC、RBC、PLT、Hb、CD3
+
、CD4
+
、IgA、IgG、IgM水平均升高,CD8
+
、中医证候积分均降低(
P
<0.05)。与对照组治疗后比较,治疗组WBC、PLT、Hb、CD3
+
、CD4
+
、IgA、IgG、IgM升高,CD8
+
、中医证候积分降低(
P
<0.05)。治疗组化疗完成率91.84%(45/49)高于对照组77.08%(37/48,
P
<0.05)。治疗组不良反应总发生率30.61%(15/49)低于对照组56.25%(26/48,
P
<0.05)。
结论
2
参苓白术散加减辅助治疗可有效改善乳腺癌化疗所致骨髓抑制脾肾不足证患者的外周血象,改善免疫功能且安全性较高。
Objective
2
To observe the effect of modified
Shenling Baizhu Powder
(参苓白术散, SBP) on peripheral blood counts and immune function in breast cancer patients with chemotherapy-induced myelosuppression and spleen-kidney insufficiency syndrome.
Methods
2
A randomized, double-blind, placebo-controlled trial was conducted. A total of 102 breast cancer patients with chemotherapy-induced myelosuppression and spleen-kidney insufficiency syndrome were randomly divided into a treatment group and a control group, with 51 cases in each group. Both groups rece
ived granulocyte colony-stimulating factor (G-CSF) support therapy and blood component transfusion therapy after chemotherapy. The treatment group additionally took modified SBP orally at one dose per day, while the control group was administered with placebo orally at the same dosage. Each chemotherapy cycle lasted 21 days and was defined as one treatment course. A total of four treatment courses were administered, with either herbal medicine or placebo taken orally for three weeks during each course. The primary outcome measures were peripheral blood para-meters including white blood cell count (WBC), red blood cell count (RBC), platelet count (PLT), and hemoglobin (Hb) levels; secondary outcome measures were comprised of immune function parameters including CD3
+
lymphocyte percentage, CD4
+
lymphocyte percentage, CD8
+
lymphocyte percentage, immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM), traditional Chinese medicine (TCM) syndrome scores, chemotherapy completion rate, and incidence of adverse reactions.
Results
2
During the study, 2 cases in the treatment group and 3 cases in the control group were lost, resulting in a final analysis of 49 cases in the treatment group and 48 cases in the control group. Compared with baseline values, WBC, RBC, PLT, Hb, CD3
+
, CD4
+
, CD4
+
/CD8
+
ratio, IgA, IgG and IgM levels increased in both groups, while CD8
+
lymphocyte percentage and TCM syndrome scores decreased (
P
<0.05). Compared to the control group after treatment, the treatment group had higher levels of WBC, PLT, Hb, CD3
+
, CD4
+
, IgA, IgG and IgM, and lower levels of CD8
+
lymphocyte percentage and TCM syndrome scores (
P
<0.05). The chemotherapy completion rate in the treatment group was 91.84% (45/49), which was higher than 77.08% (37/48) in the control group (
P
<0.05). The overall incidence of adverse
reactions in the treatment group was 30.61% (15/49), significantly lower than 56.25% (26/48) in the control group (
P
<0.05).
Conclusion
2
Modified SBP as an adjuvant therapy can effectively improve the peripheral blood counts, enhance the body's immune function, and demonstrate favorable safety in breast cancer patients with myelosuppression and spleen-kidney insufficiency syndrome during chemotherapy.
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