加味二仙汤联合卵巢功能抑制辅助内分泌治疗对绝经前激素受体阳性乳腺癌患者生活质量、中医证候、血脂及性激素的影响

Influence of strengthening endocrine therapy of Jiawei Erxian Decoction joint ovarian function suppression on quality of life,traditional Chinese medicine syndromes,blood lipids and sex hormones of breast cancer patient in pre-menopausal hormones with receptor-positiv

目的观察加味二仙汤联合卵巢功能抑制(OFS)辅助内分泌治疗对绝经前激素受体阳性乳腺癌患者生活质量、中医证候、血脂及性激素的影响。方法将80例绝经前激素受体阳性乳腺癌患者按照随机数字表法分为2组,对照组45例予OFS辅助内分泌治疗,治疗组35例在对照组治疗基础上应用加味二仙汤口服,2组均治疗3个月。观察2组治疗完成情况,比较2组治疗前后卡氏(KPS)评分、中医证候评分变化,比较2组治疗前后血脂[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]、性激素[雌二醇(E 2)、卵泡刺激素(FSH)]水平变化。结果治疗组35例,终止治疗2例(5.71%),完成治疗33例(94.29%),对照组45例,终止治疗12例(26.67%),完成治疗33例(73.33%),治疗组治疗完成率高于对照组(P<0.05);治疗组治疗后KPS评分较本组治疗前升高(P<0.05),且高于对照组治疗后(P<0.05)。治疗组治疗后中医证候各项评分及总评分均较本组治疗前降低(P<0.05),且低于对照组治疗后(P<0.05)。对照组治疗后TC、LDL-C均较本组治疗前升高(P<0.05),且高于治疗组治疗后(P<0.05),治疗组治疗前后无明显变化(P>0.05)。2组治疗前后及2组治疗后E 2、FSH水平比较差异均无统计学意义(P>0.05)。结论加味二仙汤治疗绝经前激素受体阳性乳腺癌,可改善OFS辅助内分泌治疗所带来的类围绝经期综合征、高脂血症等副作用,改善患者生活质量,提高依从性,且不影响患者体内性激素水平,临床疗效安全可靠。

Objective To observe the influence of strengthening endocrine therapy of Jiawei Erxian Decoction joint ovarian function suppression(OFS)on quality of life,traditional Chinese medicine(TMC)syndromes,blood lipids and sex hormones of breast cancer(BC)patient in pre-menopausal hormones with receptor-positiv.Methods A total of 80 BC patient in pre-menopausal hormones with receptor-positiv were randomly divided into treatment group(n=35)and control group(n=45).The control group was treated with strengthening endocrine therapy of OFS after surgery and radiotherapy and chemotherapy,the treatment group was additionally treated with Jiawei Erxian Decoction on the basis of control group,and the both groups were treated for 3 months.The karnofsky(KPS)score,changes of TCM syndrome score,total cholesterol(TC)level,low-density lipoprotein cholesterol(LDL-C)level,estradiol(E 2)level and follicle stimulating hormone(FSH)level were compared between two groups before and after treatment.Results Two cases(5.71%)discontinued treatment and 33 cases(94.29%)completed the treatment in the treatment group,12 cases(26.67%)discontinued treatment and 33 cases(73.33%)completed the treatment in the control group,and the completion rate of treatment in the treatment group is higher than that in the control group(P<0.05).After treatment,the KPS score in the treatment group was increased than that in this group before treatment(P<0.05),and which was higher than the control group(P<0.05);the TCM syndrome score and total scores in the treatment group were decreased than those in this group before treatment(P<0.05),and which were lower than the control group(P<0.05);the levels of TC and LDL-C in the control group was increased than that in this group before treatment(P<0.05),and which was higher than the treatment group(P<0.05),there was no significant change in the treatment group before and after treatment(P<0.05).There was no statistically significant difference in the levels of E 2 and FSH between the two groups before and after treatment(P>0.05).Conclusion Jiawei Erxian Decoction for treating BC patient in pre-menopausal hormones with receptor-positiv can improve the side effects of perimenopausal syndrome and hyperlipidemia caused by the intensive endocrine therapy of OFS,improve the life quality,improve the completion rate of treatment,and does not affect the internal sex hormone levels,the therapeutic effect is safe and reliable.