调肝理肾解毒汤治疗乳腺癌术后骨转移临床研究

Curative effect of Tiaogan Lishen Jiedu decoction on bone metastasis after breast cancer surgery

目的:探讨调肝理肾解毒汤对乳腺癌术后骨转移的临床疗效。方法:选取110例乳腺癌术后骨转移患者作为研究对象,随机数字表法分为两组,各55例。对照组用唑来膦酸治疗,观察组在对照组基础上加用调肝理肾解毒汤治疗,4周为1个疗程,均治疗4个疗程,比较两组治疗有效率,两组治疗前后中医症候评分、治疗后骨痛例数、骨代谢指标以及生活质量。结果:观察组治疗有效率66.67%高于对照组47.17%,差异有统计学意义(P<0.05)。治疗后两组中医症候评分无显著差异(P>0.05)。治疗后观察组骨痛缓解率72.22%高于对照组的52.83%,差异有统计学意义(P<0.05)。治疗后观察组骨钙素(N-MID)、人总I型前胶原氨基端延长肽(TP1NP)及β胶联降解产物(β-CTx)水平变化低于对照组,差异有统计学意义(P<0.05)。治疗后观察组生活质量评分高于对照组,差异有统计学意义(P<0.05)。结论:自拟调肝理肾解毒汤用于乳腺癌术后骨转移患者有助于提高疗效和骨痛缓解率,改善骨代谢指标,进一步提升患者生活质量。

Objective:To explore clinical curative effect of Tiaogan Lishen Jiedu decoction on bone metastasis after breast cancer surgery.Methods:110 patients with bone metastases after breast cancer surgery were enrolled.They were divided into two groups by random number table method,55 cases in each group.The control group was treated with zoledronic acid.On the basis of control group,experimental group was treated with self-made Tiaogan Lishen Jiedu decoction.4 weeks was defined as a course of treatment.All were treated for 4 courses.The response rate of treatment,TCM symptoms scores before and after treatment,number of cases with bone pain after treatment,bone metabolism indexes and quality of life were compared between the two groups.Results:In this study,there were 54 cases and 53 cases completing test in experimental group and control group,respectively.The response rate of treatment in experimental group was higher than that in control group(66.67%vs 47.17%)(P<0.05).After treatment,there was no significant difference in TCM symptom scores between the two groups(P>0.05).After treatment,remission rate of bone pain in experimental group was higher than that in control group(72.22%vs 52.83%)(P<0.05).After treatment,changes in levels of osteocalcin(N-MID),total procollagen type 1 amino-terminal propeptide(TP1NP)andβ-C-terminal telopeptide of type I collagen(β-CTx)in experimental group were lower than those in control group(P<0.05).After treatment,scores of quality of life in experimental group were higher than those in control group(P<0.05).Conclusion:The application of self-made Tiaogan Lishen Jiedu decoction in patients with bone metastases after breast cancer surgery is conducive to improving curative effect and remission rate of bone pain,improving bone metabolism indexes,further promoting their quality of life.