柴胡加龙骨牡蛎汤加减治疗雌激素受体阳性乳腺癌他莫昔芬相关类围绝经期综合征临床观察

Clinical observation of Chaihu plus modified Longgu Muli Decoction on perimenopausal syndrome of estrogen receptor-positive breast cancer caused by Tamoxifen

目的观察柴胡加龙骨牡蛎汤加减治疗雌激素受体阳性乳腺癌他莫昔芬相关类围绝经期综合征的临床疗效。方法将60例雌激素受体(ER)阳性乳腺癌经他莫昔芬治疗后出现类围绝经期综合征患者按照随机数字表法分为2组。对照组30例予谷维素片口服治疗,治疗组30例在对照组治疗基础上加柴胡加龙骨牡蛎汤加减治疗。治疗3个月后比较2组临床疗效,比较2组治疗前后国内改良Kupperman评分量表评分、中医证候评分。结果治疗组治疗后国内改良Kupperman评分量表潮热汗出、感觉异常、失眠、焦躁、疲倦乏力、心悸评分及总评分均较本组治疗前降低(P<0.05),对照组治疗后潮热汗出、感觉异常评分均较本组治疗前降低(P<0.05);治疗后治疗组潮热汗出、失眠、焦躁、抑郁、疲倦乏力、心悸、头痛、眩晕评分及总评分均低于对照组(P<0.05)。治疗组治疗后中医证候烘热汗出、胸闷叹息、烦躁易怒、腰膝痠软、睡眠不安评分及总评分均较本组治疗前降低(P<0.05),且均低于对照组治疗后(P<0.05);对照组治疗后烘热汗出评分较本组治疗前降低(P<0.05)。治疗组总有效率73.33%(22/30),对照组总有效率40.00%(12/30),治疗组总有效率高于对照组(P<0.05)。结论柴胡加龙骨牡蛎汤加减能有效减轻ER阳性乳腺癌患者经他莫昔芬治疗导致的类围绝经期综合征症状,提高生活质量,改善预后。

Objective To observe the clinical effect of Chaihu plus modified Longgu Muli Decoction on perimenopausal syndrome(PMS)of breast cancer patients caused by Tamoxifen.Methods Totally 60 estrogen receptor(ER)-positive breast cancer patients,who complicated by perimenopausal syndrome after tamoxifen treatment,were randomly divided into two equal groups,patients in treatment group received Chaihu plus modified Longgu Muli Decoction on the basis of oryzanol.By 3-month of treatment,clinical efficacy were compared,in addition,modified Kupperman Index(KI)score of Chinese version and traditional Chinese medicine(TCM)syndrome score.Results After the intervention,decreased scores of hot flashes and sweating,sensation abnormality,insomnia,agitation,fatigue,palpitation in the modified KI rating scale in treatment group were found as compared with before the intervention(P<0.05);patients of control group had decreased score of hot flashes and sweating and sensation abnormality compared with before the intervention(P<0.05),scores of hot flashes and sweating,insomnia,agitation,melancholy,fatigue,palpitation,headache,vertigo were lower in treatment group than in control group(P<0.05).After the intervention,TCM syndrome(reheating sweating,chest sighs,irritable,soreness and weakness of waist and knees,uneasy sleep)scores in treatment group were decreased(P<0.05),which were lower when compared with control group(P<0.05);reheating sweating score in cortrol group was decreased as comparison to before the intervention(P<0.05).The total effective rates were better in treatment group than in control group[73.33%(22/30)vs 40.00%(12/30),(P<0.05),respectively].Conclusion For ER-positive breast cancer patients,Chaihu plus modified Longgu Muli Decoction is capable effectively relieving PMS symptoms caused by tamoxifen treatment,improving quality-of-life and prognosis.