青娥丸联合钙剂对乳腺癌内分泌治疗后骨质疏松患者骨代谢的影响

目的 探讨青娥丸联合钙剂对乳腺癌内分泌治疗后骨质疏松患者骨代谢的影响.方法 前瞻性收集乳腺癌内分泌治疗后骨质疏松患者100例,按完全随机原则分为研究组和对照组,每组各50例,研究组给予青娥丸联合钙剂治疗,对照组仅给予钙剂治疗.主要观察指标包括降钙素、骨钙素、碱性磷酸酶、抗酒石酸酸性磷酸酶5b、转化生长因子β1、I型胶原羧基末端肽和骨密度.结果 两组患者治疗前骨密度差异无统计学意义[(0.52±0.06)vs(0.54±0.05)g·cm-2,P＞0.05].与对照组比较,研究组患者治疗后6个月时骨密度显著增加[(0.66±0.09) vs (0.58±0.08) g·cm-2,P＜0.05];治疗12个月后骨密度显著增加[(0.71 ±0.11)vs(0.63±0.10)g·cm-2,P＜0.05].两组患者治疗前降钙素、骨钙素、碱性磷酸酶和抗酒石酸酸性磷酸酶5b水平差异无统计学意义(P＞0.05).治疗后12个月与对照组比较,研究组患者降钙素水平显著升高[(262.39 ±72.59)vs(231.53 ±62.39) ng·L-1,P＜0.05];骨钙素水平显著升高[(11.53 ±2.69)vs(9.35 ±2.27)μg·L-1,P＜0.05];碱性磷酸酶水平显著升高[(111.59 ±35.35)vs(97.93 ±31.56) IU·L-1,P＜0.05];抗酒石酸酸性磷酸酶5b显著降低[(3.57 ±0.91)vs(4.49 ±1.50) mIU·mL-1,P＜0.05)].两组患者治疗前后转化生长因子β1和Ⅰ型胶原羧基末端肽等均差异无统计学意义(P＞0.05).结论 青娥丸联合钙剂有助于改善乳腺癌内分泌治疗后骨质疏松患者骨密度和骨代谢.

Effect of Qing'e Pill combined with calcium on bone metabolism in patients with osteoporosis after endocrine therapy of breast cancer

Objective To investigate the effect of Qing'e Pill combined with calcium on bone metabolism in patients with osteoporosis after endocrine therapy of breast cancer.Methods A hundred cases of osteoporosis patients after endocrine treatment of breast cancer were prospectively collected,and randomly assigned into a study group and a control group,50 cases in each group.The study group received the treatment of Qing'e Pill combined with calcium,while the control group was given calcium treatment only.The main observation indexes included calcitonin,osteocalcin,alkaline phosphatase,tartrate resistant acid phosphatase 5b,transforming growth factor beta-1,collagen carboxy terminal peptide of type I and bone mineral density.Results There was no significant difference in bone mineral density between the two groups before treatment [(0.52 ± 0.06) vs (0.54 ± 0.05) g · cm-2,P ＞ 0.05].When compared with the control group,the bone mineral density of the study group was significantly increased 6 months after treatment [(0.66 ± 0.09) vs (0.58±0.08) g· cm-2,P＜0.05],and 12 months after the treatment [(0.71 ±0.11) vs (0.63 ±0.10) g · cm-2,P＜0.05].There were no significant differences between the two groups in calcitonin,osteocalcin,alkaline phosphatase and tartrate resistant acid phosphatase 5b before treatment (P ＞0.05).Compared with the control group,the patients in the study group got a significantly higher level of calcitonin 12 months after the treatment [(262.39 ± 72.59) vs (231.53 ± 62.39) ng· L-1,P ＜ 0.05],an elevated level of osteocalcin [(11.53 ± 2.69) vs (9.35 ± 2.27) μg · L-1,P ＜ 0.05],an elevated level of alkaline phosphatase [(111.59 ± 35.35)vs (97.93 ±31.56) IU · L-1,P ＜ 0.05],and a lower level of tartrate resistant acid phosphatase 5b [(3.57 ± 0.91) vs (4.49 ± 1.50) mIU · mL-1,P ＜ 0.05)].There was no significant difference in the two groups of patients before and after treatment in transforming growth factor beta-1 and collagen carboxy terminal peptide of type Ⅰ (P ＞ 0.05).Conclusions Qing'e Pill combined with calcium helps to improve bone mineral density and bone metabolism in breast cancer patients with osteoporosis after endocrine therapy.