中国中西医结合外科杂志2018，Vol.24Issue(1)：15-20,6.DOI:10.3969/j.issn.1007-6948.2018.01.004
强骨止痛方治疗芳香化酶抑制剂所致乳腺癌骨丢失性疼痛
Clinical Study of Qianggu Zhitong Decoction for Treating Aromatase Inhibitors-induced Bone Loss Related Pain in Breast Cancer Patients
赵炜 1关念波 1周壅明 1张美英1
作者信息
- 1. 中国中医科学院广安门医院肿瘤科 北京100053
- 折叠
摘要
Abstract
Objectives To observe the effect of Qianggu Zhitong Decoction (QZD) on aromatase inhibitors-induced bone loss (CTIBL) pain in post-menopausal breast cancer patients.Methods Total 54 patients treated by aromatase inhibitors and suffering from lower back and/or leg pain were selected as research sbujects.The patients were randomly divided into treatment group and control group.The patients in treatment group were treated by QZD,while the patients in control group were treated by Caltrate for 3 months.Before and after treatment,the patients' pain was evaluated by visual analogue scale (VAS).Bone metabolism was monitored by VITD-T,bone gla-protein (BGP),immunoreactive parathyroid hormone (iPTH),calcitonin and cross-linked N-telopeptide of type I collagen (CTx).Bone density was monitored by dual-energy X-ray absorptiometry (DEXA).The effect of the tumor and hormone was monitored by serum CEA,CA 153,CA125 and E2.And the drug-safety was monitored by blood routine and biochemistry Results The VAS of reatment group and control group decreased significantly (4.0 ± 0.8 vs 2.0 ± 0.8,3.9 ± 0.9 vs 2.8 ± 0.8).The differences of total effective rate and marked effective rate between treatment group and control group were quite remarkable (92.3 ％ vs 81.0％,69.2 ％ vs 33.3 ％).After treatment,the VITD-T of two groups increased [(12.96 ± 4.97)vs (15.47 ± 5.79)] in treatment group,(12.38 ± 3.87) vs (14.36 ± 3.78) in control group] and increased significantly in perimenopausal group,marked effective group and low bone mass (LBMD) group on the basis of Stratified analysis.The CTx of two groups decreased in two groups,and decreased obviously in LBMD group [(0.78 ± 0.29) vs (0.71 ± 0.30)] on the basis of Stratified analysis.Compared with the liver and kidney deficiency group,the femoral BMD of the spleen and kidney deficiency group was lower [(0.83 ± 0.21) vs (1.03 ± 0.15)] and the BGP was higher [(35.99 ± 13.38) vs (23.20 ± 8.030)].The VITD-T increased more sharply [(16.86 ± 5.76) vs (14.99 ± 5.09)] and the BGP decreased obviously [(21.11 ± 7.93) vs (31.11 ± 13.76)] in the liver and kidney deficiency group.Conclusion QZD could relieve the pain caused by osteopenia,further effectively than Caltrate.It had no obvious effect on estrogen.QZD was effective related to increasing VITD-T and decreasing BGP and CTx.Perimenopausal patients and LBMD patients were more sensitive to QZD than old age patients and osteoporosis patients.The intervention in patients with liver and kidney deficiency was better in early stage.关键词
强骨止痛方/芳香化酶抑制剂/乳腺癌/骨丢失性疼痛Key words
Qianggu Zhitong Decoction/aromatase inhibitors/breast cancer/bone loss pain分类
医药卫生引用本文复制引用
赵炜,关念波,周壅明,张美英..强骨止痛方治疗芳香化酶抑制剂所致乳腺癌骨丢失性疼痛[J].中国中西医结合外科杂志,2018,24(1):15-20,6.
