Long-Term Chinese Herbs Decoction Administration for Management of Hot Flashes Associated with Endocrine Therapy in Breast Cancer Patients

Objective：To evaluate the effect of Chinese herbs decoction Shu-Gan-Liang-Xue on endocrine therapy-associated hot flashes symptom in breast cancer patients.Methods：Sixty-six patients with breast cancer receiving adjuvant endocrine therapy were categorized to two groups,the control group received endocrine therapy alone,the other group is administered with Chinese herbs decoction Shu-Gan-Liang-Xue besides the endocrine therapy：Shu-Gan-Liang-Xue decoction was administered above 6 months per year for more than 2 years.Frequency of hot flashes per day was recorded,and the effect of Shu-Gan-Liang-Xue decoction on hot flashes symptom being assessed with Kupperman Scoring Index.Results：Sixty cases were analyzed,32 cases in endocrine therapy combining Chinese herbs decoction group,28 cases in mere endocrine therapy group.For hot flashes symptom,in Chinese herbs decoction administration group,7 cases（21.9%） reported symptom disappeared,22 cases（68.7%） reported symptom alleviated,3 cases（9.4%） reported symptom not changed;in endocrine therapy alone group,5 cases（17.9%） reported symptom disappeared,13 cases（46.4%） reported symptom alleviated,10 cases（10/28,35.7%） reported symptom not changed.The difference between two groups was statistically significant（P=0.013）.For sleeping disorder,in Chinese herbs decoction administration group,27 cases（84.4%） reported symptom improved,5 cases（15.6%） reported no change;in endocrine therapy alone group,16 cases（57.1%） symptom improved,12 cases（42.9%） reported no change in sleeping disorder（P=0.019）,the difference was also of significance statistically.Conclusion：Long-term Chinese herbs decoction administration remarkably improved hot flashes symptom and sleeping disorder associated with endocrine therapy,meanwhile without definite toxicity and influence on the risk of recurrence of tumor.

Effect of Traditional Chinese Medicine inImproving Hot Flashes Symptom ofBreast Cancer

Breast cancer (BC) is the most common malignant tumor in women. Around 50% of BC receptor-positive patients are hormone-dependent cases, and it is necessary for them to use endocrine after operation. Through inhibition of estrogen level

Talking about Hot Flashes (潮热)

Women worldwide are dealing with hot flashes (潮热), a perimenopausal feature that is often tiring,embarrassing, and energeticallydraining. Conventionally, Chinese medicine defines hot flashes as Kidney-yin deficiency and its clinical manifestations include red face,sweating, hot sensations in the palms and soles, mouth and nose dryness, constipation, insomnia, lumbar soreness, knee weakness, redtongue, etc. To obtain a broader perspective and understand the dynamics of hot flashes, we examined the mechanisms behind hot flashesbased on both the knowledge from ancient Chinese medicinal texts, as well as novel research findings of Chinese and Western medicine.This perspective was the foundation for the acupuncture study of our traditional Chinese medicine conducted in 2018-2019 in Shanghai.This study, designed as a pragmatic randomized control trial with two parallel groups, focused on regulating and unblocking conceptionand governor vessels. The results confirmed that our acupuncture method could effectively reduce both the frequency and severity of hotflashes and improve life quality of middle-aged women.

Effect of daily supplementation of soy isoflavones on hot flashes and night sweats in African menopausal women

The aim of this study was to evaluate the effectiveness of a pharmaceutical grade isoflavone supplement (Inoclim?) 40 mg per capsule of soy extract rich in daidzin and genistin) on the number of hot flashes and night sweats in menopausal African women. This open, prospective, multicenter study involved 140 menopausal women with climacteric symptoms (i.e., a minimum of five hot flashes and/or moderate to severe night sweats per day). These patients received a daily 40-mg supplement of soy isoflavone contained in an Inoclim? capsule (Laboratoire Innotech International, France). The dose was increased to two capsules per day when there were more than five hot flashes or when the women could not sleep because of night sweats. The patients were followed up over a 4-month period and data were analyzed using EPI-InfoTM version 3.5.1. The outcome measure was fewer hot flashes and night sweats. The mean daily number of episodes of hot flashes was 5.7 at baseline and 1.8 at week 16, corresponding to a decrease of 68.4% (n = 93 patients at baseline and n = 66 at 16 weeks). The mean number of daily episodes of night sweats was 3.7 at baseline and 0.8 at week 16, corresponding to a decrease of 78.4% (n = 127 patients in the first week and n = 73 at 16 weeks). Over 80% of patients took a single one 40 mg capsule per day. The percentage of patients who adhered to the prescription was more than 95% during the 4-month follow-up period. These results confirm the effectiveness of a pharmaceutical grade isoflavone supplement (40 mg, rich in genistin and daidzin) on vasomotor symptoms in menopausal women.

Acupuncture for the Treatment of Hot Flashes in Men with Advanced Prostate Cancer

PURPOSE: To test the safety and efficacy of acupuncture in reducing hot flashes in men with advanced prostate cancer (CaP) undergoing androgen deprivation therapy. METHODS: A single-arm, pilot study was undertaken to evaluate acupuncture treatment for hot flashes experienced by CaP patients undergoing hormonal therapy. Sixteen advanced CaP patients undergoing androgen deprivation therapy (ADT) received standardized full body and auricular acupunc-ture 1x/week for 14 weeks. Patients were evaluated at 0, 7, 14, and an additional 14-wk follow-up (F/U) (28-wks). Safety was measured by monitoring for adverse events over the treatment period. Serum testosterone was measured at 0 and 14-wks. Quality of life (QOL) was measured by the hormone domain of the Expanded Prostate Index Composite (EPIC), at the 0, 7, 14, and 28-wks and patient reported hot flash frequency was assessed weekly. Safety endpoints were serum testosterone and analysis of adverse events. Efficacy endpoints were scores on the EPIC and the number of pa-tient reported hot flashes. RESULTS: 17 patients were enrolled and 15 completed the trial. Of 15 evaluable patients the median age was 68 ± 8.19. Serum analysis demonstrated no change in testosterone at baseline 9.5 ng/ml ± 8.9 vs. end-point 14 ± 8.78 (p = 0.101). No adverse events were reported. Data analysis of the EPIC demonstrated a trend toward improvement after 7 wks and a significant improvement following 14 wks of acupuncture (p = 0.01). Analysis of patient reported frequency showed a significant reduction in the number of hot flashes at 7-wk (6, p = 0.04), 14-wk (2.6, p = 0.001), and 28-wk F/U (3.2, p = 0.01) as compared to baseline 9.57 ± 3.98. CONCLUSIONS: The administration of acupuncture in men with advanced CaP appears to significantly decrease the frequency of hot flashes. No serious ad-verse events were noted and serum testosterone levels were unchanged from baseline suggesting that the mechanism of action of acupuncture for hot flash amelioration is not via increase in testosterone.

An exploratory study on perceived relationship of alcohol, caffeine, and physical activity on hot flashes in menopausal women

This study examined the effects of caffeine, alcohol, and physical activity (PA) on the perceived frequency and severity of hot flashes in menopausal women. Female employees at a Mid-Western university were invited to participate in an on-line survey. The 26-itemized Wo- men’s Health Survey (WHS) included questions regarding demographics, menopausal stage, experience of hot flashes, consumption of caffeinated beverages and alcohol, and participation in PA. One-hundred and ninety-six women completed the study. Ordinary Least Squares regressions revealed PA, caffeine, and alcohol intake were significant in predicting the severity of hot flashes (R2 = 0.068, F(6,180) = 2.195, p = 0.046), though they did not predict frequency of hot flashes (R2 = 0.043, F(6,184) = 1.39, p = 0.221). Participation in aerobic PA increased frequency of hot flashes (p = 0.031);while higher intensity of aerobic PA had an inverse relationship on both frequency and severity of hot flashes (p = 0.011, p = 0.003, respectively). Spearman correlations demonstrated a positive relationship between caffeinated soda intake and frequency (r = 0.17, p = 0.06) and severity (r = 0.19, p = 0.04) of hot flashes. Beverage consumption and PA may predict severity of hot flashes in women. Less frequent, higher intensity aerobic PA may lead to fewer, less severe hot flashes.

Relief of hot flashes with escitalopram in non-depressed menopausal women in Japan: Results of a retrospective analysis

Purpose: Hormone therapy (estrogen with or without progestin) remains the gold standard treatment for hot flashes in menopausal women, but concerns for the risk of hormone therapy have resulted in its decline and a demand for nonhormonal treatments with demonstrated efficacy for hot flashes. Aim of this study was to examine the efficacy of selective serotonin reuptake inhibitor escitalopram on hot flashes in a healthy sample of non-depressant menopausal women in Japan. Methods: We retrospectively analyzed the medical records of 11 menopausal patients with hot flashes, who received escitalopram (10 mg daily) for 2 weeks between March and August 2012. Hot flashes severities and scores were recorded on a scale of 0 to 10 points, at beginning and end of 2 weeks treatment. Results: At 2 weeks of therapy, 9 of 11 patients reported significant decreases in hot flash frequency and severity, but the remission of the symptom was not observed in 2 patients. Speed of relief from hot flashes was rapid (within one week). Conclusions: Escitalopram 10 mg/day may be a prompt and effective option for treating hot flashes in menopausal women who do not want to use hormone replacement therapy.

Acupuncture for Hot Flashes:A Literature Review of Randomized Controlled Trials Conducted in the Last 10 Years

Objective:To conduct a literature review of randomized controlled trials(RCTs)on the use of acupuncture for hot flashes to analyze the characteristics of each study,draw a conclusion on the advantages and disadvantages of previous studies and provide the suggestions for future studies on the same topic.Methods:We searched English and Chinese databases for the literature published from 2009 to 2019 restricted in the English and Chinese language,and we included RCT using acupuncture as the main observational intervention for hot flashes by the criteria.Results:Twenty studies met our eligibility criteria.All the studies were of high quality and confirmed the clinical efficacy of acupuncture for hot flashes,although they used different controlled interventions.The acupuncture treatment and theory of acupoints selection were relatively consistent among the studies,and they had close trial designs.Conclusions:These RCTs on acupuncture were nonuniform,which made the studies on this topic lack coherence,leading to unsatisfactory research outcomes.Therefore,more professional research teams are needed to perform studies on a definite topic and draw a specific conclusion to previous studies before the next step is taken.

Comparative research between acupuncture and Climen in treatment of menopausal hot flashes:A randomized controlled trial

Objective:To compare the therapeutic effect on menopausal hot flashes between acupuncture and Climen so as to provide a new approach to the treatment of this disease.Methods:A total of 80 cases in line with inclusion criteria were randomized into a treatment group(treated with acupuncture) and a control group(oral administration with climen),40 cases in each one.The treatment for 1 month was as 1 course and lasted consecutively for 2 courses.Before and after treatment,the contents of serum estrogen(estradiol,E_(2)) and 5-hydroxytryptamine(HT) and the scores of the attack frequency and severity scale of hot flashes and sweating,domestic modified Kupperman scale and traditional Chinese medicine(TCM) symptom scale were observed,and the clinical therapeutic effect was evaluated in the two groups separately.Results:Before treatment,there was no difference in the content of E_(2) and 5-HT,the score of hot flashes and sweating,Kupperman score and TCM symptom score in the patients between two groups,indicating the comparability(all P>0.05).Compared with the data before treatment,the contents of serum E_(2)(treatment group vs control group:22.24±11.02 vs 33.12±1.01;22.11±10.19 vs 25.29±2.23) and5-HT(treatment group vs control group:96.12±8.21 vs 131.21±30.21;96.98±7.99 vs 108.29±22.08),the score of hot flashes and sweating(treatment group vs control group:8.24±1.02 vs 3.12±1.01;8.11±1.19 vs 5.29±2.23),Kupperman score(treatment group vs control group:26.12±2.21 vs11.21±0.21;26.98±1.99 vs 18.29±2.08) and TCM symptom score(treatment group vs control group:18.97±3.87 vs 10.12±0.16;19.01±2.29 vs 15.61±2.89) were statistically different after treatment in the two groups(all P<0.05).After treatment,the contents of serum E_(2) and 5-HT,the score of hot flashes and sweating,Kupperman score and TCM symptom score in the treatment group were all different statistically compared with the control group(all P<0.05).There was statistical difference in clinical therapeutic effect in the patients between two group,in which,the therapeutic effect in the treatment group was better than that in the control group(90% vs 77.5%,P<0.05).Conclusion:Acupuncture effectively reduces Kupperman score and TCM symptom score in the patients and its therapeutic effect is better than climen.Regarding relieving hot flashes symptoms in menopausal patients of kidney yin deficiency and improving in attack frequency and severity of hot flashes and sweating,the effects of acupuncture are superior to Climen.Acupuncture obviously increases the contents of serum E_(2) and 5-HT.

Effect of acupuncture on menopausal hot flashes:Study protocol for a randomized controlled clinical trial

Background:Hot flashes are one of the most common symptoms in menopause and significantly affect the quality of life of 67% of menopausal women.Acupuncture is found to be a low risk treatment in treating hot flashes but the evidence for its effectiveness is inconclusive.We developed an optimized acupuncture treatment protocol and designed a randomized controlled trial(RCT) to assess the efficacy of acupuncture for reducing hot flashes in menopausal women.Methods:This is a single-site,single-blind,randomized sham-controlled trial with two parallel arms.A total of 60 eligible patients will be recruited and randomly assigned to either the acupuncture group(n=30) or the sham acupuncture group(n=30).Treatment will be given twice a week,for 30 min,for six consecutive weeks.The primary outcome is the hot flashes scores,assessed using the validated hot flashes diary at baseline,week 3,week 6 and week 10.The secondary outcome will be measured by menopause-specific quality of life(MENQOL) at baseline,week 6,and week 10.Meanwhile,any adverse events will be recorded.Discussion:If the outcome of this study confirms acupuncture to be an effective therapy to reduce hot flashes in menopausal women,we expect this study to inspire further investigations and provide useful information in forming an optimal acupuncture treatment protocol for clinic.Trial registration:Chinese Clinical Trial Registry identifier:ChiCTR1800018638,Date of registration:30 th September 2018.URL:http://www.chictr.org.cn/showproj.aspx?proj=31462.

Efficacy evaluation of standardized Rheum rhaponticum root extract(ERr 731®)on symptoms of menopause:A systematic review and meta-analysis study

Menopause is characterized by various physical,mental and emotional symptoms.ERr 731®is a standardized extract from Rheum rhaponticum root and has been clinically studied for its role in reducing menopausal symptoms.The current systematic review and meta-analysis aimed to evaluate the efficacy of ERr 731®supplementation in alleviating the severity of menopausal symptoms.In this review,we searched across three online databases up to March 2023,evaluated the quality of the included studies by the Physiotherapy Evidence Database scale,and assessed the risk of bias by the Cochrane Risk of Bias tool.We then performed a metaanalysis using RevMan software to estimate the pooled mean difference(MD).The study protocol was registered in the Prospective Register of Systematic Reviews(CRD42023416808).After screening and evaluation,we included four high-quality studies(a total of 390 participants;the ERr 731®group:193 participants;the control group:197 participants)in the meta-analysis.The results showed that ERr 731®supplementation significantly reduced the Menopause Rating Scale score(MD:–15.12;P<0.001),compared with control therapy.Sensitivity analysis revealed no effect of individual studies on the overall pooled estimate or overall observed heterogeneity.The current review provides evidence that ERr 731®supplementation is effective in reducing menopause symptoms.Potential bias and high heterogeneity in the results warrant further clinical studies.

前列腺癌病人内分泌治疗相关潮热症状管理研究进展

对前列腺癌内分泌治疗相关潮热症状的定义、发生率、评估工具和相关非药物干预进行综述,多种非药物干预已被用于治疗潮热,但其临床证据有限,需要更多的循证支持。临床工作人员应对病人进行关于潮热的健康教育,建议将电子潮热日记用于未来潮热的动态研究,作为潮热症状的一种前瞻性测量。

基于《黄帝内经》探讨从肝主疏泄论治女性围绝经期潮热盗汗

潮热盗汗是女性围绝经期综合征的典型临床症状,严重干扰围绝经期女性的健康生活。女性在进入围绝经期后,出现潮热盗汗、情志不舒、月经不调、头晕目眩、眼目干涩等多种症状,而其中潮热盗汗因其多发于夜间,使人难以入眠,对女性造成严重困扰,故该文针对潮热盗汗进行分析探讨。目前西医对于其治疗多采用激素疗法,表现出明显的不良反应,且疗效有限。而从中医角度进行辨证论治,可减少产生不良反应,提高临床疗效。现中医临床多认为女性围绝经期潮热盗汗的发生与阴虚津亏密切相关,却易忽视肝失疏泄也是女性围绝经期发病的重要因素。该文基于《黄帝内经》及其他经典著作从生理、病理方面分析“肝主疏泄”理论,进一步探讨女性围绝经期的生理特点及潮热盗汗产生的病因病机,发现女性围绝经期产生潮热盗汗的重要原因在于肝失疏泄所导致的肝气郁结,气血瘀积化热,引起血热妄行、迫津外泄,以及肝失疏泄所引起的津液输布失常。故以此为依据,从恢复肝之疏泄功能进行论治,以疏肝理气为主要方法,柔肝滋阴、补肝养肾等为辅助手段,致力于为临床治疗女性围绝经期潮热盗汗提供学习和借鉴。

一种多路Flash存储结构的热数据判断方法

在多路Flash存储结构基础上研究多路并行写入时各芯片间的磨损均衡问题。提出用基于数据访问频率的热数据判断方法解决频繁访问数据在各芯片之间的均衡分布问题。实验表明,基于数据访问频率的热数据判断方法,不仅能有效区分频繁和非频繁访问的数据,还能满足多芯片中热数据均衡分布的要求。

基于自适应块分配策略的NAND闪存垃圾回收算法

在NAND闪存垃圾回收算法中,冷热分离可以提高垃圾回收效率。但是,现有算法将数据分为固定数量的类,没有考虑数据写入过程中热度的聚类变化。为了解决这一问题,对基于自适应块分配策略的垃圾回收算法进行研究。通过监督受害块的有效页比例和分配块的写入频率来调节块分配池大小,避免数据热度分类不准确带来的块闲置问题,实现更高效的冷热分离。实验结果表明,该算法在降低垃圾回收开销以及提高磨损均衡程度上均有所提升。

衬底负偏置对FLASH器件耐久性退化的影响

研究了ETOXTM结构FLASHmemory单元器件在VFG≈VD/2的热载流子写入应力条件下,衬底负偏置对单元器件耐久性退化的影响.结果表明:在既定的栅、漏偏置条件下,随着衬底负偏置的增加,器件耐久性退化会出现极小值.综合考虑了器件耐久性退化以及写入效率两方面的要求以后,确定了在VFG≈VD/2热载流子写入应力模式下,FLASHmemory单元器件具有增强写入效率以及最小耐久性退化的最佳衬底负偏置条件.

Yaffs2文件系统中对NAND Flash磨损均衡的改进

针对以NAND Flash为存储介质时Yaffs2文件系统存在磨损均衡的缺陷,通过改进回收块选择机制,并在数据更新中引入冷热数据分离策略,从而改善NAND Flash的磨损均衡性能。实验借助Qemu软件建立Linux嵌入式仿真平台,从总擦除次数、最大最小擦除次数差值和块擦除次数标准差等方面进行对比。实验结果表明,在改进后的Yaffs2文件系统下NAND Flash的磨损均衡效果有明显提升,这有益于延长NAND Flash的使用寿命。

基于大数据挖掘中医治疗围绝经期潮热组方配伍规律的研究

目的通过大数据挖掘,探索中医治疗围绝经期潮热的组方配伍规律。方法检索中国知网、万方、维普、CBM数据库中医治疗围绝经期潮热的临床研究文献,对纳入的有效方剂进行多元统计分析。结果本研究共提取方剂132首,药物182种,其中高频用药23种,以补虚药、清热药为主,性味以寒、平,甘、苦为先,用药多归肝、肾二经;共聚类出5个核心药物组方;结论中医治疗围绝经期潮热以清热滋阴类中药为主,组方滋补肝肾,清相火,再根据临床辩证加以平肝、安神、敛汗、理气、化瘀等药物,彰显中医标本兼治的用药原则。

2型糖尿病阴虚证小鼠模型生物节律变化及六味地黄汤对其影响

目的探究2型糖尿病阴虚证“潮热”症状的潜在机制。方法将99只空腹血糖≥16.7 mmol·L^(-1)的8周龄db/db小鼠分为2型糖尿病组、2型糖尿病阴虚证组、2型糖尿病六味地黄汤低、中、高剂量组、2型糖尿病阴虚证六味地黄汤低、中、高剂量组,21只同窝野生对照型雄性m/m小鼠分为空白对照组、阴虚证组。采用“热盛伤阴”法造模,4周后评价小鼠阴虚证表现。后予六味地黄汤组对应剂量灌胃,连续4周。实验期间,每周1次于8:30、15:00,20:00测定小鼠肛温、心前区温度、四肢爪心温度。采用Western blot法观察下丘脑、肝脏生物节律相关蛋白表达情况。结果实验研究表明运用热盛伤阴法可建立2型糖尿病阴虚证模型,其肛温、双上肢爪心温度呈8:30“低”、15:00“高”、20:00“低”的节律变化,六味地黄汤以方测证可见高剂量组能够有效恢复体温节律。下丘脑和肝脏共同可见节律因子Clock、Cry2蛋白表达升高;节律调控中枢下丘脑中,Per2和Cry2蛋白升高明显;在外周靶器官肝脏中,Bmal1、Per3和Cry1蛋白表达升高更显著。结论肝脏和下丘脑生物节律蛋白表达异常可能是导致2型糖尿病阴虚证“潮热”证候特征的重要机制之一。

双侧卵巢切除术和他莫昔芬给药诱发的潮热模型大鼠证候评价

目的探索用于妇女潮热现象研究的证候动物模型。方法24只雌性SD大鼠随机分为假手术组、双侧卵巢切除组和他莫昔芬组,每组8只,分别采用双侧卵巢切除术和灌胃10 mg/(kg·d)他莫昔芬模拟两种潮热动物模型。在造模第14和28天,检测大鼠旷场活动、肛温、体表红外热像图等表征信息。第29天处死大鼠,取子宫称重并制作病理切片;ELISA检测血液雌二醇与儿茶酚胺类物质含量;RT-qPCR检测肾上腺性激素合成酶(Star、Cyp11a1、Cyp17a1、Cyp19a1、Por、Hsd3b2、Hsd17b1)基因表达,肾上腺髓质儿茶酚胺物质合成酶(Th、Ddc、Dbh、Pnmt)基因表达。结果与假手术组相比,双侧卵巢切除组大鼠体重增长显著(P<0.01),而他莫昔芬组大鼠体重增长缓慢。双侧卵巢切除组大鼠体表最高温度在第28天显著下降(P<0.01),类似于阳虚表现,而其腹部最高温度与最低温度之差在第14天显著升高(P<0.05)、背部最高温度与最低温度之差在第28天显著升高(P<0.01),类似于内热表象,且大鼠旷场活动度下降(P<0.01),类似于精气不足表现;他莫昔芬组大鼠给药14 d其体表最高温度显著下降(P<0.01),但大鼠旷场活动度上升(P<0.01)。两种造模方式均导致大鼠子宫指数呈明显下降(P<0.01)。与假手术组相比,双侧卵巢切除组和他莫昔芬组E2均显著下降(P<0.01),NE、Epi均呈降低趋势(P<0.05),双侧卵巢切除组β-EP也明显下降(P<0.05);与假手术组相比,双侧卵巢切除大鼠肾上腺Cyp11a1基因表达显著上升(P<0.05),而Cyp17a1与Hsd17b1基因表达显著下降(P<0.05);他莫昔芬组Star与Por基因表达显著上升(P<0.01),而Cyp17a1基因表达量明显下降(P<0.01);双侧卵巢切除组Pnmt基因表达显著下调(P<0.01)。结论双侧卵巢切除SD大鼠可以用于围绝经期潮热的研究,其证候特征类似于中医的肾阳不足兼阴虚内热。