阿托伐他汀联合活血降浊汤对绝经后乳腺癌经内分泌治疗患者血脂、心血管事件及骨密度的影响  

Effects of atorvastatin combined with Huoxue Jiangzhuo Decoction on blood lipids, cardiovascular events and bone mineral density in postmenopausal women with breast cancer treated with endocrine therapy

作　　者：王志超[1] 鲍双振[2] 杨进强[2] 赵凤龙 WANG Zhichao;BAO Shuangzhen;YANG Jinqiang;ZHAO Fenglong(The Second People’s Hospital of Hengshui City,Hengshui 053000,Hebei,China;Harrison International Peace Hospital,Hengshui 053000,Hebei,China;Wuyi County People’s Hospital,Hengshui 053400,Hebei,China)

机构地区：[1]河北省衡水市第二人民医院,河北衡水053000 [2]哈励逊国际和平医院,河北衡水053000 [3]河北省武邑县人民医院,河北武邑053400

出　　处：《现代中西医结合杂志》2019年第8期826-829,835,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省卫计委课题(20181571)

摘　　要：目的观察阿托伐他汀联合活血降浊汤对绝经后乳腺癌经内分泌治疗患者血脂、心血管事件及骨密度的影响。方法将183例绝经后乳腺癌术后患者随机分为观察组92例及对照组91例,对照组给予来曲唑治疗,观察组在对照组治疗基础上给予阿托伐他汀联合活血降浊汤治疗,2组疗程均为2年。观察2组治疗前后血脂、骨密度、主要症状积分变化情况,并统计2组主要心血管事件(MACE)与不良反应发生情况。结果治疗6个月、12个月、18个月、24个月后,2组三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平均显著升高(P均<0.05),但观察组升高水平显著低于对照组(P均<0.05);2组总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)水平均无明显变化(P均>0.05)。治疗12个月、24个月后2组腰椎、股骨颈处骨密度均明显降低(P均<0.05),但观察组腰椎、股骨颈处骨密度均显著高于对照组(P均<0.05);2组主要症状积分均显著增加(P均<0.05),但观察组显著低于对照组(P<0.05)。观察组MACE发生率显著低于对照组(P<0.05);2组均未出现明显不良反应。结论阿托伐他汀联合活血降浊汤可显著改善绝经后乳腺癌经内分泌治疗患者临床症状与血脂水平,减轻因雌激素水平下降对骨密度的影响,并可降低主要心血管事件发生率,值得临床推广应用。Objective It is to observe the effects of atorvastatin combined with Huoxue Jiangzhuo Decoction on blood lipids, cardiovascular events and bone mineral density in postmenopausal women with breast cancer treated with endocrine therapy. Methods 183 postmenopausal women with breast cancer were randomly divided into observation group (92 cases) and control group (91 cases). The control group was treated with letrozole. The observation group was given atorvastatin combined with Huoxue Jiangzhuo Decoction on the basis of the control group. Both the treatment course were 2 years. The changes of blood lipids, bone mineral density and main syndrome scores before and after treatment were observed, the main cardiovascular events (MACE) and adverse reactions occurred in the two groups were counted. Results After 6 months, 12 months, 18 months and 24 months, the levels of triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) in the two groups were significantly increased ( P <0.05). However, the levels of the observation group were significantly lower than that of the control group ( P <0.05). There was no significant change in the total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) levels in the two groups ( P >0.05). After 12 months and 24 months of treatment, the bone mineral density of the lumbar vertebrae and femoral neck were significantly decreased ( P <0.05), but the bone density of the lumbar vertebrae and femoral neck was significantly higher in the observation group than that in the control group ( P <0.05). The scores of main syndromes in the group were significantly increased ( P <0.05), but the scores in observation group was significantly lower than that in the control group ( P <0.05). The incidence of MACE in the observation group was significantly lower than that in the control group ( P <0.05);no significant adverse reactions were observed in either group. Conclusion Atorvastatin combined with Huoxue Jiangzhuo Decoction can significantly improve the clinical symptoms and bloo

关 键 词：绝经后乳腺癌 阿托伐他汀 活血降浊汤 内分泌治疗 血脂 主要心血管事件 

分 类 号：R737.9[医药卫生—肿瘤]