The Regulation Of TNBC Syndromes And The Decoction Of Qi And Activating Blood Circulation Decoction

Objective:To observe the difference of immune cells in different TCM type of TNBC patients, and analyze the influence of herb medicine to TNBC patients’ immune cells and quality of life, so as to explore the relationship between TCM and the immunity of TNBC patients. And get the personalized treatment planning.Methods:It’s a before and after self control study. We collected 138 TNBC patients from 2012-12 to 2014-12 at Guang’ anmen Hospital. They have clearly diagnosed pathological disease which has been reassured by distinguished hospitals after the surgery. We get syndrome differentiation according to diagnostic criteria of TCM Syndromes. All the patients take herb medicine called yiqi-huoxue-jiedu formular. Qi stagnation and blood stasis patients add bupleuri Radix and Melia toosendan, deficiency of liver-yin and kidney-yin patients add asparagus cochinchinensis and radix glehniae, spleen-deficiency and phlegm-turbid stagnation patients add Pinellia ternata and pericarpium citri reticulatae, qi-blood deficiency get more Astragalus membranaceus. All the medicine provide by Guang’ anmen Hospital’s pharmacy. Patients take the medicine 400ml twice daily. And the medicine be taken in the morning and before bedtime. Those patients take it 6 months at least,or to progress.All the patients combined western medicine treatment. According to the NCCN breast cancer treatment guidelines they get TAC or AC-weekly T chemotherapy regimens 6 to 8 weeks. Patients get radiotherapy according to the NCCN breast cancer treatment guidelines when their lymph nodes metastasis attain three or more. Used streaming blood instrument to measure patients’ CD4+/CD25+/CD127-, CD8+/CD28-, CD8+/CD28+ and NK cells.All patients filled in FACT-B life quality scale when they saw the doctor and take the medicine 2 months later. The subjects were followed for up to 3 years after their operation.Results:1.We used MANOVA to analysis the diffirence among the patients’ immune cells who divided to 4 types of TCM. (F=8.485, P=0.000< 0.05). And then made a comparison between each of them. Compared to the other 3 types qi-stagnation and blood stasis P value are 0.040 0.000 0.000 respectively.Compared with spleen-deficiency and phlegm-turbid stagnation type and qi-blood deficiency type,the P value of deficien-cy of liver-yin and kidney-yin are 0.049 0.047 respectively. Compared spleen-deficiency and phlegm-turbid stagnation type to qi-blood deficiency type the P value is 0.920.2. After 2 month TCM treatment 138 patients’total score change of physiological status, social/family status, emotional state, functional status, additional attention in FACT-B all had statistical significance. The results were applied comparative t-test to perform statistical analysis.3.30 patient’s cell value of CD4+/CD25+/CD127-、CD8+/CD28-declined, CD8+/CD28+、NK ascended after taking herb medicine for 2 months. The paired t test was used to analyze the experimental data of CD4+/CD25+/CD127-, (t=3.718 p=0.001) CD8+/CD28-(t=5.128 p-0.000), CD8+/CD28+((t=-5.458 p-0.000), NK(t=-5.949 p-0.000) we got the result that they all had statistical significance.4. The value of CD4+/CD25+/CD127-(F=0.908 P-0.450)、CD8+/CD28-(F=1.825 P=0.167)、CD8+/CD28+(F=0.908 P=0.451)、NK (F=1.077 P=0.367) all had no statistical difference.We got it from repeated variable variance analysis5. We got the result of clinical stage (HR=2.248(1.350-5.623) P=0.001), the stage of SBR(HR=4.576(1.852-7.239)P=0.000), CD4+/CD25+/CD127-(HR=3.813 (1.627-5.420) P=0.001). NK (HR=3.206(1.410-5.097) P=0.000) by cox regression analysis.Conclusion:1.Diffirent types according to TCM of TNBC patients have diffirent cell immunity level.The same as below deficiency of liver-yin and kidney-yin> spleen-deficiency and phlegm-turbid stagnation> qi-blood deficiencys> qi-stagnation and blood stasis.2. TCM types have effect ion on the level of CD8+/CD28-、CD8+/CD28+、 NK.CD4+/CD25+/CD127-had no business with TCM types.3. The herb medicine called yiqi-huoxue-jiedu formular can evaluated TNBC patients’immunity level,and improve the quality of theri life.4. Different TCM type can effect the yiqi-huoxue-jiedu formular’s influence to the immune cells.5. We can learn from cox analysis that clinical stage and grade of SBR, CD4+CD25+/CD127-cells, NK cells were related to PFS prognostic factors.