开心散治疗乳腺癌失眠症患者的临床疗效及对血清5-羟色胺水平的影响

目的 观察开心散治疗乳腺癌失眠症患者的临床疗效及对血清5-羟色胺（5-hydroxytryptamine，5-HT）水平的影响。方法 将63例乳腺癌失眠症患者随机分为对照组33例和治疗组30例。对照组患者采用艾司唑仑治疗，治疗组患者采用开心散联合艾司唑仑治疗。比较两组治疗前后匹兹堡睡眠质量指数量表（Pittsburgh sleep quality index,PSQI）、抑郁自评量表（self-rating depression scale,SDS）、焦虑自评量表（self-rating anxiety scale,SAS）、欧洲癌症研究和治疗协作组编制的癌症患者生活质量评分（European organization for research and treatment of cancer quality of life questionnaire-core 30，EORTC QLQ-C30）以及血清5-HT水平；在连续治疗4周后，比较两组临床疗效及不良反应发生率。结果 治疗4周后，两组PSQI、SDS、SAS评分均较治疗前显著降低（P＜0.05），且治疗组PSQI评分显著低于对照组（P＜0.05）；治疗组EORTC QLQ-C30躯体功能、情绪功能、认知功能以及社会功能评分均显著高于对照组（P＜0.05）；两组患者治疗后血清5-HT水平较治疗前显著升高（P＜0.05）,且治疗组血清5-HT水平高于对照组（P＜0.05）；治疗组疗效优于对照组（P＜0.05）；治疗组总不良反应发生率低于对照组，差异有统计学意义（P＜0.05）。结论 相较于单纯艾司唑仑治疗，开心散联合艾司唑仑能更好地改善乳腺癌患者睡眠，升高血清5-HT水平，提高乳腺癌患者生活质量，降低不良反应发生率。

Clinical Effect of Kaixin Powder in Treatment of Breast Cancer Patients with Insomnia and Its Effect on the Serum Level of 5-Hydroxytryptamine

Objective To investigate the clinical effect of Kaixin Powder in the treatment of breast cancer patients with insomnia and its effect on the serum level of 5-hydroxytryptamine (5-HT). Methods A total of 63 breast cancer patients with insomnia were randomly divided into treatment group with 30 patients and control group with 33 patients.The patients in the control group were given oral administration of estazolam, and those in the treatment group were given Kaixin Powder combined with estazolam.The two groups were compared in terms of Pittsburgh sleep quality index (PSQI),Self-rating Depression Scale (SDS),Self-rating Anxiety Scale (SAS), European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), and serum 5-HT level before and after treatment, and after treatment for 4 consecutive weeks, the two groups were compared in terms of clinical outcome and the incidence rate of adverse reactions.Results After 4 weeks of treatment,both groups had significant reductions in PSQI, SDS, and SAS scores (P<0.05),and the treatment group had a significantly lower PSQI score than the control group (P<0.05);compared with the control group,the treatment group had significantly higher scores of physical function,emotional function,cognitive function,and social function in EORTC QLQ-C30 (P<0.05);after treatment, both groups had a significant increase in the serum level of 5-HT (P<0.05),and the treatment group had a significantly higher serum level of 5-HT than the control group (P<0.05).Compared with the control group, the treatment group had a significantly better clinical outcome(P<0.05) and a significantly lower incidence rate of adverse reactions (P<0.05). Conclusion Compared with estazolam alone for patients with breast cancer, Kaixin Powder combined with estazolam can better alleviate insomnia, increase the serum level of 5-HT,improve quality of life,and reduce the incidence rate of adverse reactions.