昝玲玲　蔡兴隆　李晓娜　缪元秀

[摘要]目的：觀察马应龙麝香痔疮膏在乳腺癌化疗（卡培他滨或多柔比星）所致手足综合征（Hand-foot syndrome，HFS）中的应用效果。方法：收集2018年1月-2020年6月临沂市肿瘤医院因化疗导致HFS的92例乳腺癌患者临床资料，采用随机数字表法分为对照组和观察组，各46例，两组均给予维生素B6口服，对照组同时给予湿润烧伤膏外涂，观察组则同时给予马应龙麝香痔疮膏外涂，两组均于治疗两周后评价临床疗效。比较两组干预前后HFS临床症状评分、HFS分级情况、欧洲癌症研究和治疗组织生存质量核心量表（the european organzation for research and treatment of cancer QLQ-C30，EORTC QLQ-C30）评分变化及HFS干预临床疗效。结果：治疗后，两组HFS各临床症状评分及总分均较治疗前下降，差异有统计学意义（P<0.05）;治疗后组间比较，除色素沉着评分外，观察组HFS其余临床症状及总分均显著低于对照组，差异有统计学意义（P<0.05）。治疗后两组HFS分级均有改善，且组间比较差异有统计学意义（P<0.05）。观察组治疗总有效率高于对照组（89.13% vs 71.74%），差异有统计学意义（P<0.05）。治疗后两组EORTC QLQ-C30量表五项功能评分均显著提升，且观察组显著高于对照组，差异有统计学意义（P<0.05）。结论：马应龙麝香痔疮膏与湿润烧伤膏均能改善化疗所致的HFS症状，提高患者生活质量水平，相较而言马应龙麝香痔疮膏临床效果更优。

[关键词]乳腺癌;化疗;手足综合征;马应龙麝香痔疮膏;湿润烧伤膏

[中图分类号]R737.9    [文献标志码]A    [文章编号]1008-6455（2021）09-0022-04

Effect of Ma Yinglong Musk Hemorrhoid Ointment on Hand-foot Syndrome Caused by Chemotherapy in Breast Cancer Patients

ZAN Ling-ling1，CAI Xing-long1，LI Xiao-na1，MIAO Yuan-xiu2

（1.Department of Breast;2.Office of Drug Clinical Trial Institution，Linyi Tumor Hospital，Linyi 276000，Shandong，China）

Abstract： Objective  To observe the application effect of Ma Yinglong musk hemorrhoid ointment in hand-foot syndrome （HFS） induced by breast cancer chemotherapy （capecitabine or doxorubicin）. Methods  During the period from January 2018 to June 2020， 92 breast cancer patients with chemotherapy-induced HFS in Linyi Tumor Hospital were collected. They were divided into the control group and the observation group by random number table method， 46 cases in each group. Both groups were given oral vitamin B6. On this basis， the control group was given external application of moisture exposed burn ointment （MEBO）， while the observation group was additionally given external application of Ma Yinglong musk hemorrhoid ointment. The clinical curative effect in both groups was evaluated after two weeks of treatment. The changes in scores of HFS clinical symptoms， HFS grading and scores of European organization for research and treatment of cancer quality of life core questionnaire （EORTC QLQ-C30） before and after intervention， and clinical curative effect of HFS intervention were compared between the two groups. Results  After treatment， the clinical symptom scores and total scores of HFS in the two groups decreased compared with those before treatment， the differences were statistically significant （P<0.05）. After treatment， the clinical symptoms and total scores of HFS in the observation group were significantly lower than those in the control group except pigmentation score （P<0.05）. After treatment， the HFS grades of the two groups were improved， and the difference between the two groups was statistically significant （P<0.05）. The total effective rate of the observation group was higher than that of the control group （89.13% vs 71.74%， P<0.05）. After treatment， the five functional scores of EORTC QLQ-C30 scale in the two groups were significantly improved， and the observation group were significantly higher than those in the control group （P<0.05）. Conclusion  Both Ma Yinglong musk hemorrhoid ointment and MEBO can improve chemotherapy-induced HFS symptoms， and improve quality of life in patients. Compared with MEBO， the clinical effect of Ma Yinglong musk hemorrhoid ointment is better.

Key words： breast cancer; chemotherapy; hand-foot syndrome; Ma Yinglong musk hemorrhoid ointment; moisture exposed burn ointment （MEBO）

化疗是乳腺癌治疗的重要手段，无论是术前新辅助化疗、术后辅助化疗或是晚期乳腺癌的姑息性治疗中，均具有重要地位[1-2]。然而化疗在杀灭肿瘤细胞的同时，会产生一些严重的副反应，如手足综合征（Hand-foot syndrome，HFS）等[3]。卡培他滨和多柔比星脂质体是乳腺癌化疗的常用药物，文献[4-5]报道，与卡培他滨和多柔比星脂质体相关的HFS具有高发生率。严重的HFS明显影响患者的生活质量，并可能导致患者无法耐受化疗疗程甚至停药，因此寻找安全、有效、经济的治疗HFS方法具有重要的临床意义。马应龙麝香痔疮膏具有清热燥湿，活血消肿，去腐生肌之功效，治疗痔疮具有良好的疗效和安全性，目前将其应用于HFS的相关报道较少。……