中药治疗乳腺癌他莫昔芬相关类围绝经期综合征的临床研究  

Traditional Chinese medicine in the treatment of perimenopausal syndrome of breast cancer caused by Tamoxifen

作　　者：李丛珊 李哲元 靳利利 安云博 LI Congshan;LI Zheyuan;JIN Lili(The First Department of TCM,Zhangjiakou Maternal and Child Health Hospital,Hebei,Zhangjiakou 074000,China;不详)

机构地区：[1]河北省张家口市妇幼保健院中医一科,074000 [2]河北省张家口市妇幼保健院妇科,074000 [3]河北省张家口市第一医院

出　　处：《河北医药》2023年第1期75-77,81,共4页Hebei Medical Journal

基　　金：河北省中医药管理局科研计划项目(编号:2021438)。

摘　　要：目的探讨中药治疗乳腺癌他莫昔芬相关类围绝经期综合征的效果及对Greene更年期量表、内分泌激素含量变化的影响。方法收集2021年1~6月收治的经他莫昔芬治疗后出现类围绝经期综合征的绝经前激素依赖型乳腺癌患者60例临床资料,辨证属中医肾虚肝郁证者,随机分为对照组和治疗组,每组30例。2组患者均保持原有他莫昔芬治疗。对照组给予对症治疗,治疗组在对照组基础上给予柴胡加龙骨牡蛎汤合肾四味化裁汤剂口服治疗。观察2组治疗前后症状积分、中医证候疗效、生活质量评分、Greene更年期量表、血清内分泌激素[(雌二醇E2)、孕酮(P)]含量变化情况、血清肿瘤标志物[糖类抗原15-3(CA15-3)、糖类抗原125(CA125)]和安全性。结果治疗组总有效率为73.33%高于对照组的40.00%(χ^(2)=6.787,P=0.009)。治疗后,2组患者E2、FSH、CA15-3、CA125较治疗前无明显变化(P>0.05),组间对比无明显差异(P>0.05)。治疗后,2组患者Greene更年期量表、中医证候积分较治疗前下降,KPS评分较治疗前提高(t=2.986、3.711、3.039,P=0.004、0.000、0.004)。结论中药治疗能提高患者生活质量,控制中医证候积分,值得推广。Objective To explore the effect of traditional Chinese medicine(TCM) in the treatment of perimenopausal syndrome of breast cancer caused by Tamoxifen, and its influence on Greene menopause scale and endocrine hormone levels.Methods From January 2021 to June 2021,totally 60 estrogen receptor(ER)-positive breast cancer patients with perimenopausal syndrome after tamoxifen treatment(kidney deficiency syndrome) were randomized assigned into control group and the treatment group, the control group received conventional therapy, while the treatment group received TCM on the basis of Tamoxifen. The key observation was TCM symptom score, curative effect, quality-of-life score, Greene Climacteric Scale(GCS),serum endocrine hormone changes [estradiol(E2),progesterone(P)],serum tumor markers [carbohydrate antigen 15-3(CA15-3)],as well as safety.Results The total effective rate in the treatment group was significantly higher than that in the control group(73.33% vs 40.00%,χ^(2)=6.787,P=0.009<0.05,respectively). There were no significant in E2,FSH,CA15-3 and CA125 between groups before and after treatment(P>0.05). GCS and TCM syndrome scores decreased KPS score increased in the two groups compared with before treatment(t=2.986,3.711,3.039;P=0.004,0.000,0.004,respectively).Conclusion TCM treatment can improve the quality of life of these patients, control the TCM syndrome score, and it is worth popularizing.

关 键 词：中药 乳腺癌 他莫昔芬 围绝经期 Greene更年期量表 内分泌激素含量 

分 类 号：R737.9[医药卫生—肿瘤]