| Objective:To analyze the efficacy and safety of arthroscopic debridement combined with intercondylar fossa plasty for elderly patients with knee osteoarthritis,and to find the most reasonable and effective treatment for such patients,and observe safety.Methods :96 patients with metastatic breast cancer treated in our hospital from August 2013 to December 2014 were randomly divided into experimental group and control group,with 48 cases in each group,of which the control group was treated with apatinib,and the experimental group was treated with alapatinib.28 d is the 1 course of treatment,continuous treatment until the progress of the disease,if the patient is indeed intolerant,it is necessary to discontinue the medication.After treatment,the clinical efficacy of the two groups was compared,and the scores of TCM syndrome,VEGFR2,CD4+,CD8+,CD4+/CD8+,NK,IgG and IgA were compared before and after treatment to observe the occurrence of adverse reactions.Results:The effective rate of the experimental group was 37.5%,which was significantly higher than that of the control group(18.8%),and the difference was statistically significant(?2=4.174,P < 0.05).After treatment,the score of TCM syndrome in two groups was significantly lower than that before treatment(P < 0.05).The score of TCM syndrome in the experimental group was(6.65 ±1.58)scores after treatment,which was significantly lower than that of the control group(9.23 ±1.85),and the difference was statistically significant(t=7.347,P< 0.05).Before treatment,there was no significant difference in serum IGF-I,CA153,IL-8 and VEGFR2 levels between the two groups(P > 0.05).After treatment,the levels of serum IGF-I,CA153,IL-8 and VEGFR2 were significantly lower than those before treatment(P < 0.05),and the serum levels of IGF-I,CA153,IL-8 and VEGFR2 in the treatment group were significantly lower than those in the control group(t=3.911,4.637,3.189,5.567,P < 0.05).There was no significant difference in immune function related indexes between the two groups before treatment(P > 0.05).After treatment,the serum CD4+,CD4+/CD8+ and NK in the test group were significantly higher than those before the treatment(P < 0.05),and the serum CD8+ was significantly lower than that before the treatment(P < 0.05),and the IgG and IgA before and after treatment in the control group were significantly lower than that before treatment(P < 0.05).After treatment,the CD4+,CD4+/CD8+,NK,IgG and IgA in the experimental group were significantly higher than those in the control group,while those in the CD8+ group were significantly lower than those in the control group(P <0.05).In the experimental group,28 cases(58.3%)had adverse reactions,including 8 cases of anemia,14 cases of thrombocytopenia,6 cardiac toxicity,26 cases in the control group(54.2%)had adverse reactions,including 6 anemia,12 thrombocytopenia and 8 cardio toxicity.There was no statistical difference in the total incidence of adverse reactions among the two groups.Meaning(P > 0.05).The results of follow-up showed that the PFS and OS in the test group were(7.32 ±1.35)months and(28.63± 2.57)months respectively,which were significantly longer than those of the control group(5.21 + 1.25)months and(23.58 ± 2.25)months,and the difference was statistically significant(t=10.534,8.462,P < 0.05).Conclusion:The combination of Shen Bai Fu Zheng granule and apatinib is effective in the treatment of metastatic breast cancer with multiple line treatment.It can effectively reduce the level of IGF-I,CA153,IL-8 and VEGFR2,at the same time,improve the immune function,high safety and Prolong the survival time of the Patients.It is worth Popularizing. |
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