乳腺癌患者芳香化酶抑制剂诱导的骨关节症状预防和管理的证据总结

目的 系统检索、评价并总结国内外关于乳腺癌患者芳香化酶抑制剂诱导的骨关节症状预防和管理的最佳证据。方法 系统检索国内外相关指南网站及专业协会网站、Cochrane Library、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、PubMed、Web of Science核心集、Embase、CINAHL、中国知网、维普数据库、万方数据库、中国生物医学文献数据库中所有关于乳腺癌患者芳香化酶抑制剂诱导的骨关节症状预防及管理的指南、专家共识、系统评价、Meta分析、最佳实践、推荐实践，检索时限为建库至2022年7月12日。由2名研究者独立进行文献质量评价和资料提取。结果 共纳入21篇文献，其中循证指南1篇、共识指南3篇、系统评价或Meta分析17篇，从骨关节症状的发病率、临床表现、症状评估、风险评估、预防措施、药物干预、非药物干预、管理策略8个方面总结出37条最佳证据，其中有17条1级证据。结论 乳腺癌患者芳香化酶抑制剂诱导的骨关节症状预防和管理的最佳证据可以为临床医护人员制订相关症状管理方案和开展临床实践提供参考，但仍需结合临床情境和患者意愿选择适宜的证据应用于临床实践。

Evidence summary of the prevention and management in breast cancer patients for aromatase inhibitors-induced musculoskeletal symptoms

Objective To retrieve，evaluate and summarize domestic and foreign latest evidence on the prevention and management in breast cancer patients for aromatase inhibitors-induced musculoskeletal symptoms. Methods We systematically searched relevant guideline networks and association websites，as well as Cochrane Library，JBI，PubMed，Web of Science Core Collection，Embase，CINAH，CNKI，VIP，Wanfang，and CBM to collect guidelines，expert consensuses，systematic reviews，and meta-analyses，best practices and recommended practices related to preventions and management about breast cancer patients for aromatase inhibitors-induced musculoskeletal symptoms. The retrieval period was from the inception of databases to July 12，2022. There were 2 researchers who independently evaluated the quality of included literature，and extracted and summarized the evidence. Results A total of 21 articles were incorporated，including 1 guideline，3 expert consensuses，and 17 systematic reviews or meta-analyses. Finally，37 pieces of best evidence including 8 aspects were summarized，namely incidence，clinical features，symptom assessment，risk assessment，prevention，pharmacotherapy，non-pharmacotherapy，and management strategy. There were 17 pieces of Level-1 evidence. Conclusion The best evidence for prevention and management in breast cancer patients for aromatase inhibitors-induced musculoskeletal symptoms could provide references to develop the plan of symptom management and conduct the best clinical practice of clinicians and nurses，but the best evidence should be selected according to the clinical situations and patients’ preferences.