清心滋肾汤对前列腺癌内分泌治疗后潮热的疗效及初步机制研究

Clinical Efficacy of Qingxin Zishen Decoction on Hot Flashes After Endocrine Therapy for Prostate Cancer and Its Preliminary Mechanism

目的:观察清心滋肾汤对前列腺癌内分泌治疗后潮热症状的临床疗效,初步探讨其疗效机制。方法:收集2021年12月至2022年12月就诊于江苏省中医院符合标准的患者共60例,随机分为观察组与对照组各30例,观察组予清心滋肾汤治疗,对照组予常规护理,观察周期为8周。观察两组患者治疗前后潮热频率、潮热程度、潮热评分、中老年男性睾酮缺乏症状自我测量表(ISS量表)评分和中医证候积分的改善情况,对比治疗前后血清内皮素-1(ET-1)、一氧化氮(NO)和降钙素基因相关肽(CGRP)及前列腺特异抗原(PSA)、睾酮的水平变化。结果:在疗效方面,与本组治疗前比较,观察组患者潮热频率下降,潮热程度减轻,潮热评分降低,ISS量表评分降低,中医证候积分下降(P<0.05);与对照组治疗后比较,观察组患者各项指标均优于对照组(P<0.05)。在实验室指标方面,与本组治疗前比较,观察组患者血清NO水平升高,ET-1水平降低,ET-1/NO下降,CGRP水平降低(P<0.05),而睾酮、PSA水平差异无统计学意义;治疗后观察组患者血清NO水平高于对照组,ET-1水平、ET-1/NO、CGRP水平低于对照组(P<0.05),但两组患者睾酮、PSA水平差异无统计学意义。结论:清心滋肾汤能显著改善前列腺癌患者内分泌治疗后潮热症状,其机制可能是通过调节血管舒缩因子的表达水平,改善血管舒缩功能,从而达到治疗潮热的目的。

Objective:To observe the clinical effect of Qingxin Zishen decoction on hot flashes after endocrine therapy for prostate cancer and explore its therapeutic mechanism.Method:A total of 60 patients who met the criteria and were admitted to Jiangsu Province Hospital of Chinese Medicine from December 2021 to December 2022 were collected and randomly divided into a treatment group and a control group,with 30 cases in each group.The treatment group was treated with Qingxin Zishen decoction,while the control group was only given routine nursing.The observation period of this study was eight weeks.The improvement of hot flash frequency,hot flash degree,hot flash score,ISS score,and TCM syndrome score were observed in the two groups before and after treatment.The changes of serum endothelin-1(ET-1),nitric oxide(NO),calcitonin gene-related peptide(CGRP),prostate specific antigen(PSA),and testosterone were detected.Result:In terms of efficacy,after treatment,the frequency,degree,and score of hot flashes,ISS score,and TCM syndrome score decreased in the treatment group(P<0.05).Compared with the control group,all indicators were better in the treatment group(P<0.05).In terms of laboratory indicators,after treatment,the serum NO level in the treatment group was increased.ET-1 level was decreased.The ratio of ET-1/NO was decreased,and the CGRP level was decreased(P<0.05).However,testosterone and PSA levels were not significantly changed.Compared with the control group,after treatment,the serum NO level in the treatment group was higher,and the level of ET-1 was lower.The ratio of ET-1/NO and the CGRP level were lower(P<0.05).There were no significant differences in testosterone and PSA levels between the two groups.Conclusion:Qingxin Zishen decoction can significantly improve hot flashes in patients with prostate cancer after endocrine therapy.The mechanism of Qingxin Zishen decoction may be to improve the vasomotor function by regulating the expression level of vasomotor factors,so as to treat hot flashes.