补中益气汤联合疲三针对乳腺癌术后癌因性疲乏肝郁脾虚证患者心理状态和Th1/Th2细胞因子的影响

摘要 目的：观察补中益气汤联合疲三针对乳腺癌术后癌因性疲乏（CRF）肝郁脾虚证患者心理状态和辅助性T细胞（Th）1/Th2细胞因子的影响。方法：收集2021年4月至2023年4月期间就诊于我院的148例乳腺癌术后CRF肝郁脾虚证患者的临床资料，按照随机数字表法将患者分为对照组（常规治疗和疲三针治疗，n=74）和研究组（对照组的基础上接受补中益气汤治疗，n=74）。对比两组匹兹堡睡眠质量指数（PSQI）评分、疗效、Piper疲乏量表（PFS）、焦虑自评量表（SAS）、中医证候总分、抑郁自评量表（SDS）、Th1/Th2细胞因子[γ-干扰素（IFN-γ）、白细胞介素-4（IL-4）、IFN-γ/IL-4]。结果：研究组的临床总有效率高于对照组（P<0.05）。研究组治疗后中医证候总分、PFS、PSQI评分低于对照组（P<0.05）。研究组治疗后SDS、SAS评分低于对照组（P<0.05）。研究组治疗后IL-4低于对照组，IFN-γ、IFN-γ/IL-4高于对照组（P<0.05）。结论：补中益气汤联合疲三针可改善乳腺癌术后CRF肝郁脾虚证患者的睡眠质量和免疫功能，减轻疲乏程度和抑郁焦虑心理，进一步提高治疗效果。

Effect of Buzhong Yiqi Decoction Combined with Fatigue Three Needles on Psychological State and Th1/Th2 Cytokines in Patients with Cancer-Related Fatigue after Breast Cancer Surgery with Liver Depression and Spleen Deficiency Syndrome

ABSTRACT Objective: To observe the effect of buzhong yiqi decoction combined with fatigue three needles on psychological state and helper T cell (Th) 1/Th2 cytokines in patients with cancer-related fatigue (CRF) after breast cancer surgery with liver depression and spleen deficiency syndrome. Methods: Clinical data of 148 patients with CRF liver depression and spleen deficiency syndrome after breast cancer surgery who were treated in our hospital from April 2021 to April 2023 were collected, patients were divided into control group (conventional treatment and fatigue three needles treatment, n=74) and study group (buzhong yiqi decoction on the basis of control group, n=74) according to the random number table method. The pittsburgh sleep quality index (PSQI) score, efficacy, piper fatigue scale (PFS), self-rating anxiety scale (SAS), total score of TCM syndromes, self-rating depression scale (SDS), Th1/Th2 cytokines [γ-interferon (IFN-γ), interleukin-4 (IL-4), IFN-γ/IL-4] were compared between two groups. Results: The total clinical effective rate in study group was higher than that in control group (P<0.05). The total score of TCM syndromes, PFS and PSQI scores in study group were lower than those in control group after treatment(P<0.05). The SDS and SAS scores in study group were lower than those in control group after treatment(P<0.05). IL-4 in study group was lower than that in control group, and IFN-γ and IFN-γ/IL-4 were higher than those in control group after treatment(P<0.05). Conclusion: Buzhong yiqi decoction combined with fatigue three needles can improve the sleep quality and immune function of patients with CRF liver depression and spleen deficiency syndrome after breast cancer surgery, reduce the degree of fatigue and depression and anxiety, and further improve the treatment effect.