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.

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。

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。

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。

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。

中药舒肝凉血方改善乳腺癌患者潮热的临床研究

目的观察中药舒肝凉血方对服用三苯氧胺的乳腺癌患者潮热的改善情况。方法选择2004年10月—2006年11月乳腺癌诊断明确,服用三苯氧胺(他莫西芬tamoxifen,TAM)出现潮热症状的患者73例,随机分为治疗组(37例)和对照组(36例),治疗组予中药舒肝凉血方,对照组予安慰剂。观察潮热及睡眠改善情况。以治疗前1周每日平均潮热次数及睡眠情况作为基线。采用国际认可的Kupperman评分方法,比较治疗前后潮热及睡眠改善情况。结果可评价病例66例,治疗组33例,对照组33例。潮热症状减轻情况:治疗组潮热症状消失5例(15.2%),减轻14例(42.4%),无变化14例(42.4%);对照组无患者症状消失,减轻10例(30.3%),无变化23例(69.7%)。两组比较,差异有统计学意义(P=0.012)。睡眠改善情况:治疗组睡眠改善21例(63.6%),无变化12例(36.4%);对照组睡眠改善13例(39.4%),无变化20例(60.6%)。两组比较,差异有统计学意义(P=0.002)。结论中药舒肝凉血方可减轻服用三苯氧胺乳腺癌患者的潮热症状并改善睡眠情况。

低雌激素引发潮热的外周机制

近年来,潮热已成为困扰因各种原因导致低雌激素状态的妇女工作和生活的主要因素之一,严重影响其生活质量。目前国际公认潮热的发生是中枢体温调节热中性带变窄,体温调节系统紊乱所致。既往主要是研究雌激素降低后,引起体温调节中枢功能异常,从而诱发潮热的机制,而较少关注其中枢整合后传出通路的外周体温调节作用方式的变化情况。我们从外周体温调节的3种基本方式,即交感神经系统调节、躯体神经系统调节和肾上腺激素与甲状腺激素分泌调节,对低雌激素状态下的潮热的外周体温调节机制进行综述。

针刺调节乳腺癌内分泌治疗后潮热的选穴规律分析

目的:探讨针刺调节乳腺癌内分泌治疗后潮热的腧穴选用规律。方法:利用多种数据库检索针刺调节乳腺癌内分泌治疗后潮热的临床研究文献统计腧穴使用频次,运用SPSS Clementine12.0统计软件对腧穴进行聚类分析及关联规则分析。结果:最终纳入15篇国外文献,分析得出三阴交为治疗要穴,太冲、神门、百会、太溪、肾俞、合谷、足三里、内关和关元为常用腧穴;太冲配三阴交是最常用的腧穴配伍,其次为合谷、足三里与三阴交的配伍组合,在特定穴中交会穴使用频次最高。结论:针刺调节乳腺癌内分泌治疗后潮热的选穴可针对肾精不足、冲任亏虚的病机和潮热主症确定主穴,并以心神不宁等主要兼症选择配穴。