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 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.

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.

Menopause and cognitive impairment:A narrative review of current knowledge

A severe impairment of cognitive function characterizes dementia.Mild cognitive impairment represents a transition between normal cognition and dementia.The frequency of cognitive changes is higher in women than in men.Based on this fact,hormonal factors likely contribute to cognitive decline.In this sense,cognitive complaints are more common near menopause,a phase marked by a decrease in hormone levels,especially estrogen.Additionally,a tendency toward worsened cognitive performance has been reported in women during menopause.Vasomotor symptoms(hot flashes,sweating,and dizziness),vaginal dryness,irritability and forgetfulness are common and associated with a progressive decrease in ovarian function and a subsequent reduction in the serum estrogen concentration.Hormone therapy(HT),based on estrogen with or without progestogen,is the treatment of choice to relieve menopausal symptoms.The studies conducted to date have reported conflicting results regarding the effects of HT on cognition.This article reviews the main aspects of menopause and cognition,including the neuroprotective role of estrogen and the relationship between menopausal symptoms and cognitive function.We present and discuss the findings of the central observational and interventional studies on HT and cognition.

针灸与克龄蒙治疗更年期潮热比较研究

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.

针刺对围绝经期潮热的影响:一项随机对照临床试验研究方案

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.