黄芪加味汤防治乳腺癌术后芳香化酶抑制剂相关骨丢失

目的本课题旨在从骨密度、骨质疏松症发生率、骨疼痛等级、生活质量评分、服药依从性评分,评估黄芪加味汤对乳腺癌术后芳香化酶抑制剂相关骨丢失的预防作用。方法本课题采用前瞻性、随机、对照的临床研究方法,纳入125例早期乳腺癌患者,并分为治疗组62例和对照组63例。所有患者每日均口服来曲唑2.5 mg加钙尔奇D 1片,治疗组在此基础上加服黄芪加味汤(黄芪、熟地黄、山药、山茱萸、泽泻),每日1剂,早晚饭后0.5 h温服。结果 1)骨密度:在治疗6个月和12个月,对照组患者的腰椎、股骨颈、全髋骨密度的下降较治疗组明显,但组间比较差异无统计学意义(P>0.05)。2)骨质疏松症发生率:治疗组治疗6个月和12个月骨质疏松症发生率为3.39%、1.76%,对照组为4.91%、3.45%,组间比较差异无统计学意义(P>0.05)。3)骨疼痛等级:治疗6个月和12个月,治疗组疼痛等级较对照组低(P<0.05)。4)生活质量评分:治疗6个月和12个月,治疗组生活质量评分明显高于对照组(P<0.05)。5)服药依从性评分:治疗12个月,治疗组患者的服药依从性评分明显高于对照组(P<0.05)。结论黄芪加味汤可通过"益气健脾、滋补肝肾"的治法有效预防及缓解芳香化酶抑制剂引起的骨疼痛、关节酸痛等临床症状,明显优化患者的生活质量,提高患者的服药依从性,并有降低骨密度下降的趋势。

Prevention of Aromatase Inhibitor-Associated Bone Loss in Postoperative Breast Cancer with Huangqi Jiawei Decoction

Objective The aim of this study was to evaluate the preventive and therapeutic effect of the modifi ed astragalus membranaceus decoction on Aromatase Inhibitor,which is considered in connection to the bone loss after breast cancer surgery.The evaluation was conducted from following perspectives:bone mineral density,incidence of osteoporosis,bone pain grade,quality of life score and medication compliance score.Methods This subject adopts a prospective,randomized and controlled clinical research method.We included 125 patients who were at the early phase of breast cancer.62 patients were allocated to a treatment group while the other 63 were put in a control group.All patients were treated with letrozole 2.5 mg and caltrate orally.Based on this,the treatment group was treated with modified Huangqi Jiewei decoction(milkvetch root,prepared rehmannia root,common yam rhizome,asiatic cornelian cherry fruit,oriental waterplantain rhizome),1 dose daily,0.5 h after meal in the morning and evening.Results First,bone mineral density:the comparison between the results of 6 months after treatment and those of 12 months after treatment showed that the bone mineral density of lumbar spine,femoral neck and total hip in the control group was significantly lower than that in the treatment group,but there was no statistical signifi cance in the difference between the two groups (P>0.05).Second,incidence of osteoporosis:in the treatment group,the incidence of osteoporos was 3.39% (6 months) and 1.76% (12 months) while those in the control group was 4.91% (6 months),3.45% (12 months) respectively.There was no significant difference in the incidence of osteoporosis between the two groups (P>0.05).Third,bone pain grade:the difference of incidence between 6 months and 12 months was P<0.05,which showed the bone pain grade in the treatment group was significantly lower than the control group.Fourth,quality of life score:the quality of life score in the treatment group was higher than that in the control group,and there wa s a significant difference between the two groups (P<0.05).Fifth,medication compliance score:12 months after treatment,the medication adherence score of the treatment group was significantly higher than that of the control group,and the difference between the groups was statistically significant (P<0.05).Conclusion Huangqi Jiawei decoction was provedable to reduce the trend of bone mineral density decline,effectively preventing and alleviating clinical symptoms such as bone pain and joint soreness.It gave a convincing effect of optimizing patents’quality of life,improving their compliance with medication benefiting from qi,invigorating sleen,nourishing liver and kidney.