目的 觀察小金片聯(lián)合NX化療方案（長春瑞濱聯(lián)合卡培他濱）治療紫杉類及蒽環(huán)類耐藥晚期乳腺癌的臨床效果。方法 選取2019年1月-2020年1月南陽市第二人民醫(yī)院收治的100例紫杉類及蒽環(huán)類耐藥晚期乳腺癌患者，根據(jù)信封抽簽法分為對(duì)照組和治療組，每組各50例。對(duì)照組給予NX化療方案治療，第1、8天靜脈滴注酒石酸長春瑞濱注射液，25 mg/m²；第1~14天口服卡培他濱片，1 000 mg/m²，2次/d。治療組在對(duì)照組基礎(chǔ)上口服小金片，2片/次，2次/d。以21 d為1個(gè)周期，兩組患者共治療4個(gè)周期。觀察兩組療效，比較兩組的KPS評(píng)分、細(xì)胞免疫功能指標(biāo)、血清腫瘤標(biāo)志物。結(jié)果 治療后，治療組的客觀緩解率為64.00%，較對(duì)照組的44.00%更高（P<0.05）。治療后，兩組KPS評(píng)分升高（P<0.05），且治療組KPS評(píng)分高于對(duì)照組（P<0.05）。治療后，兩組患者CD8⁺升高，CD3⁺、CD4⁺、CD4⁺/CD8⁺下降（P<0.05），治療后治療組CD8⁺比對(duì)照組高，CD3⁺、CD4⁺、CD4⁺/CD8⁺比對(duì)照組更低（P<0.05）。治療后，兩組癌胚抗原（CEA）、糖類抗原125（CA125）、糖類抗原199（CA199）水平下降（P<0.05），且治療組CEA、CA125和CA199水平比對(duì)照組更低（P<0.05）。結(jié)論 小金片聯(lián)合NX化療方案治療紫杉類及蒽環(huán)類耐藥晚期乳腺癌具有較好的療效，可有效阻止疾病進(jìn)展，提高生活質(zhì)量，減輕免疫抑制，降低患者血清腫瘤標(biāo)志物水平，安全較好。

Objective To observe the clinical effect of Xiaojin Tablets combined with NX chemotherapy regimen (vinorelbine combined with capecitabine) in treatment of taxane and anthracycline resistant advanced breast cancer. Methods Patients (100 cases) with taxane and anthracycline resistant advanced breast cancer in Nanyang Second General Hospital from January 2019 to February 2020 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were given NX chemotherapy regimen. Patients in the control group were iv administered with Vinorelbine Tartrate Injection on the first and eighth day, 25 mg/m², and patients were also po administered with Capecitabine Tablets from first to fourteenth day, 1 000 mg/m², twice daily. Patients in the treatment group were po administered with Xiaojin Tablets on the basis of the control group, 2 tablets/time, twice daily. A course had 21 d, and patients in two groups were treated for 4 courses. After treatment, the clinical efficacies were evaluated, and KPS scores, cellular immune function indexes, and serum tumor markers in two groups were compared. Results After treatment, the objective remission rate of the treatment group was 64.00%, which was higher than objective remission rate (44.00%) of the control group (P<0.05). After treatment, the KPS score of two groups was increased (P<0.05), and the KPS score of the treatment group was higher than that of the control group (P<0.05). After treatment, the CD8⁺ in two groups were increased, but the CD3⁺, CD4⁺ and CD4⁺/CD8⁺ were decreased (P<0.05). After treatment, the CD8⁺ in treatment group was higher than that in control group, but the CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in two groups were lower than those in control group (P<0.05). After treatment, the levels of CEA, CA125, and CA199 in two groups were decreased (P<0.05), and the levels of CEA, CA125, and CA199 in the treatment group were lower than those in the control group (P<0.05). Conclusion Xiaojin Tablets combined with NX chemotherapy regimen has clinical curative effect in treatment of taxane and anthracycline resistant advanced breast cancer, can effectively prevent disease progression, improve the quality of life, reduce immunosuppression, and reduce the serum level of tumor markers, with good safety.

R984;R979.1

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃（聯(lián)合共建）項(xiàng)目（LHGJ20191463）