Clinical Study On Treating Chemotherapy-associated Leukopenia With Traditional Chinese Medicine And Moxibustion In Breast Cancer

Purpose:Breast cancer has now become the first place in the incidence of malignant tumors in our country,and the incidence has been increasing year by year.Chemotherapy plays a crucial role in the treatment of breast cancer.However,it is of great importance in improving the overall survival and disease-free survival of breast cancer patients,Delay the progress of the disease at the same time,but also inevitably bring a series of toxic and side effects,According to relevant statistics,80%of patients have bone marrow suppression during chemotherapy,especially the most typical leukopenia.Currently,granulocyte colony stimulating factor is one of the main drugs clinically used to treat chemotherapy-related leukopenia.However,various adverse reactions may occur during clinical use.The most common such as bone pain,fever,flu-like symptoms and the like.In addition,studies have shown that it may also stimulate the growth of certain malignant cells,bone marrow reserve shortages may also make it more difficult post-chemotherapy.Traditional Chinese medicine has been dedicated to the study of the treatment of leukopenia.It has been confirmed by clinical literature that whether it is a single drug or a combination of drugs,the efficacy of leukopenia after chemotherapy is significant.However,it was observed that its evaluation criteria for efficacy and the lack of uniform standards,the results of the assessment of the credibility is not high,the clinical application also found no advantage compared to literature research.Moxibustion therapy has the effect of invigorating the spleen and invigorating the kidney,and its clinical application has found that it can improve the body immunity and enhance the white blood cells.Therefore,to carry out traditional Chinese medicine combined with moxibustion in the treatment of breast cancer chemotherapy-related leukopenia research to expand the chemotherapy-related leukopenia research ideas and fields,has important clinical significance and social value.method:A prospective randomized controlled design was included.Sixty-four breast cancer patients treated with anthracycline in our hospital from December 2016to November 2017 were randomly divided into two groups:treatment group（32cases）,control group（32 cases）,the treatment group in the 1-14 days after chemotherapy taking the treatment of moxibustion and Bu shen jian pi Fang,the control group is in the 1-14 days after chemotherapy,taking only Bu shen jian pi Fang.The observation time and index:（1）The change of Neutrophils level on the 7th day,the 9th day,the 11th day and the 20th day after chemotherapy;（2）The symptom score of TCM on day 1 and day 20 after chemotherapy;（3）On the 20^th day after chemotherapy,the usage of granulocyte colony stimulating factor was recorded.（4）Adverse reactions to treatment.result:1.baseline:The study included 64 cases of patients,the treatment group and control group of 32 cases.There was no difference in the age,tumor type,pathological type,TNM stage,pathological differentiation,molecular typing,chemotherapy regimens and chemotherapy treatment（P>0.05）;There was no difference in neutrophil level before chemotherapy and scores of symptoms of spleen and kidney deficiency on the 1st day after chemotherapy（P>0.05）.2.There was no significant difference in the degree of neutropenia between the two groups after chemotherapy（P>0.05）.During the entire course of chemotherapy,there was no significant difference between grade I and II neutrophil gradients（P=0.063>0.05）.Compared with grade III and IV neutrophil gradients,the incidence of grade III and IV neutropenia in the treatment group was approximately 22%,and that of the control group was approximately 41%,which was significantly higher than that of the treatment group.Significance（P=0.42>0.05）.3.In the case of granulocytes reduced to normal times,On the 7th day after chemotherapy,the treatment group showed only grade I and II neutropenia.Compared with the control group,the normal time of recovery was faster than that of the control group,and the difference was significant（P=0.034<0.05）.On the eleventh day after chemotherapy,one patient in both groups developed grade IV neutropenia,but the neutrophils returned to normal use in the treated group was shorter than the control group,with a statistically significant difference（P=0.002<0.05）.On the 9th day after chemotherapy,the treatment group was faster than the control group in terms of recovery time,and the difference was not statistically significant（P=0.31>0.05）.4.The use of granulocyte colony stimulating factor:Five patients in the treatment group used granulocyte colony-stimulating factor,thirteen patients in the control group used granulocyte colony-stimulating factor,Compared with the total amount of granulocytes,the treatment group was also less than the control group,indicating that the treatment group significantly reduced the rate of using granulocyte colony-stimulating factor compared with the control group,the difference was statistically significant（P=0.025<0.05）.5.In terms of TCM symptom scores,The effective rate of the treatment group was higher than that of the control group,and the difference was s tatistically significant（P=0.037<0.05）.The comparison of moxibustion plu s Bu shen jian pi fang can significantly improve the patient’s clinical d iscomfort,in particular,significantly improve fatigue,less lazy,less ap petite poor,weak waist（P<0.05）.Conclusions:1.Bu shen jian pi fang combined with moxibustion compared to simple take Bu shen jian pi fang,can reduce the occurrence of neutropenia at III degree and IV degree,but has no significant effect on the degree of neutropenia at degree I and II.2.For the early grade I and II neutropenia,Bushen Jianpi Fang combined with moxibustion compared with single,can significantly reduce the time to return to normal granulocytes;There is a certain effect for neutropenia in III degree and IV degree after chemotherapy,but the advantage is not obvious.3.The rate using of granulocyte colony-stimulating factor in patient s with Bushen Jianpifang combined with moxibustion was significantly lowe r than that in the control group,and can significantly improve the clini cal symptoms of discomfort.This shows that Bushen Jianpifang combined wi th moxibustion treatment,the patient’s condition is stable and feel reli eved.4.The combination of Jianpi Bushen decoction and moxibustion did not increase the incidence of adverse reactions and was worthy of clinical a pplication.