独活寄生汤对乳腺癌骨转移患者骨相关事件及OPG和RANKL表达的影响

目的:评价独活寄生汤对乳腺癌骨转移的疗效,并观察其对患者外周血OPG和RANKL表达的影响。方法:选取2012年1月至2015年1月广东省中西医结合医院收治的乳腺癌骨转移患者50例纳入研究,随机分为对照组和观察组,每组25例。对照组接受吉西他滨联合唑来膦酸治疗,观察组在对照组治疗基础上加用独活寄生汤,1剂/d。2组均进行3周期治疗,疗程结束后比较2组生命质量评分、血清肿瘤标志物浓度、骨相关事件发生率、外周血OPG和RANKL浓度变化。结果:1)2组患者SF-36评分均较治疗前有所提升(P<0.05),观察组优于对照组(P<0.05);2)治疗后2组患者CA153、CA125、CEA、FER浓度均较治疗前有所下降(P<0.05),观察组下降较对照组明显(P<0.05);3)治疗过程中2组均有SREs发生,观察组发生SREs明显低于对照组(P<0.05);4)经过干预后OPG表达上调,RANKL浓度下降,其中观察组改变的幅度较对照组明显(P<0.05)。结论:独活寄生汤可明显降低乳腺癌骨转移骨相关事件发生的风险,提升患者的生命质量,其作用机制可能与调节OPG-RANKL系统平衡有关。

Effect of Duhuo Jisheng Decoction on Related Events, and Expressions of OPG and RANKL in Breast Cancer Patients with Bone Metastasis

To evaluate the effect of Duhuo Jisheng Decoction on bone metastasis of breast cancer, and to observe its effect on the peripheral blood of patients with the expression of OPG and RANKL. Methods:A total of 50 cases of bone metastasis of breast cancer in our hospital from January 2012 to January 2015 were included. The patients were randomly divided into control group and observation group, with 25 cases in each group. The control group received gemcitabine combined with zoledronic acid treatment, and the observation group was treated with Duhuo Jisheng decoction, 1 dose/day. The two groups were treated for 3 courses. After the end of treatment, the quality of life score, serum tumor markers concentration, incidence of bone related events and peripheral blood OPG and RANKL concentrations in two groups were compared. Results:1) the SF-36 scores of two groups were improved than before treatment (P<0.05), and the observation group was better than the control group (P<0.05); 2) after the treatment of two patients with CA153, CA125, CEA, FER concentrations were decreased after treatment (P<0.05), and the observation group decreased significantly compared with the control group (P<0.05); 3) during the treatment, SREs occurred in both groups. SREs in observation group was significantly lower than the control group (P<0.05); 4) after the intervention of the expression of OPG, RANKL concentration decreased, the amplitude of the observation group changed significantly compared with the control group (P<0.05). Conclusion:Duhuo Jisheng decoction can significantly reduce the risk of bone related events for bone metastasis of breast cancer, improve the quality of life of patients, and its mechanism may be related to regulating the balance of OPG-RANKL system.