滋水培土方防治来曲唑治疗乳腺癌致相关骨丢失的临床研究

发布时间：2018-05-16 02:25

本文选题：乳腺癌 + 来曲唑　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:观察滋水培土方防治来曲唑治疗乳腺癌致相关骨丢失的临床疗效,以中医中药独特的整体观念、辩证论治优势,发挥中医中药在防治来曲唑治疗乳腺癌致相关骨丢失的作用,提高乳腺癌患者内分泌治疗的依从性。方法:采集符合纳入标准的60例患者,采用随机数字表法分组为治疗组30例和对照组30例,对照组和治疗组均服用内分泌药物来曲唑,每次2.5mg,每天一次,对照组配合使用维生素D钙咀嚼片,每次600mg,每天一次。治疗组配合使用维生素D钙咀嚼片,每次600mg,每天一次,同时加用口服滋水培土方(膏方)治疗,每次10g,每天早、晚饭后各一次。观察两组治疗前后临床疗效、X线骨密度(b one mineral density,BMD)评分、血清Ca2+、血碱性磷酸酶(Alkal in phosphatase,AKP)浓度、中医证候积分、血清雌二醇(Estradiol,E2)等相关指标,采用SPSS22.0进行统计分析,评价滋水培土方防治来曲唑治疗乳腺癌致相关骨丢失的临床疗效。结果:1、临床综合疗效比较:治疗组在治疗后3个月、治疗后6个月的临床综合疗效总有效率分别为46.67%、70.00%。对照组在治疗后3个月、治疗后6个月的临床综合疗效总有效率分别为36.67%、46.67%。组间比较分析,治疗后6个月,治疗组与对照组比较,差异具有统计学意义(P0.05)。2、血清Ca2+指标比较:(1)疗效比较:对照组治疗后3个月、治疗后6个月血清Ca2+值总有效率分别为43.33%、46.67%。治疗组治疗后3个月、治疗后6个月血清Ca2+值总有效率分别为50.00%、73.33%。治疗后6个月,治疗组与对照组比较,差异具有统计学意义(P0.05)。(2)比值变化比较:对照组血清Ca2+在治疗后3个月与治疗前对比,差异没有统计学意义(P0.05);在治疗后6个月与治疗前比较,差异具有统计学意义(P0.05)。治疗组血清Ca2+在治疗后与治疗前比较,差异具有统计学意义(P0.05、P=0.0006)。治疗后6个月,治疗组与对照组比较,差异具有统计学意义(P0.05)。3、血清AKP指标比较:(1)疗效比较:对照组治疗后3个月、治疗后6个月血清AKP总有效率分别为36.67%、40.00%。治疗组治疗后3个月、治疗后6个月血清AKP总有效率分别为40.00%、63.33%。治疗后6个月,治疗组与对照组比较,差异具有统计学意义(P0.05)。(2)比值变化比较:对照组血清AKP在治疗后与治疗前比较,差异均无统计学意义(P0.05)。治疗组在治疗后3个月对比治疗前,差异无统计学意义(P0.05);在治疗后6个月与治疗前比较,差异具有统计学意义(P0.05)。治疗后6个月,治疗组与对照组比较,差异具有统计学意义(P0.05)。4、BMD指标比较:(1)疗效比较:对照组在治疗后3个月、治疗后6个月的总有效率分别为26.67%、36.33%。治疗组在治疗后3个月、治疗后6个月的总有效率分别为30.00%、63.33%。治疗后6个月,治疗组对比对照组,差异具有统计学意义(P0.05)。(2)比值变化比较:对照组经治疗后与治疗前相比,差异均无统计学意义(P0.05)。治疗组治疗后3个月L2-4BMD与治疗前相比,差异无统计学意义(P0.05);在治疗后6月与治疗前相比,差异具有统计学意义(P0.05)。治疗后6个月,治疗组与对照组比较,差异具有统计学意义(P0.05)。5、中医症候比较:治疗组在治疗后3个月、治疗后6个月的中医症候积分总有效率分别为50.00%、73.33%。对照组在治疗后3个月、治疗后6个月的中医症候积分总有效率分别为30.00%、43.33%。治疗后6个月,治疗组与对照组比较,差异具有统计学意义(P0.05)。(2)比值变化比较:对照组经治疗后对比治疗前,差异均无统计学意义(P0.05)。治疗组经治疗后对比治疗前,差异均有统计学意义(P0.05,P0.001)。6、血清E2指标比较:治疗组与对照组血清E2经治疗后分别与治疗前比较,差异均有统计学意义(P0.05)。7、安全性检测:患者治疗前后进行安全性指标检测,均未发现异常;两组患者未发现不良事件和不良反应。结论:1、滋水培土方防治来曲唑治疗乳腺癌致相关骨丢失具有确切的临床疗效,可明显改善患者的临床症状,增加BMD,防治骨质丢失,改善患者生存质量。2、滋水培土方不会引起乳腺癌病情复发转移风险,疗程长,疗效更好。3、滋水培土方防治来曲唑治疗乳腺癌致相关骨丢失患者安全,未发现药物不良反应,未发现不适症状。
[Abstract]:Objective: To observe the clinical efficacy of zigzai in the treatment of bone loss associated with breast cancer in the treatment of letrozole, with the unique overall concept of traditional Chinese medicine, dialectical treatment advantage, the role of traditional Chinese medicine in the prevention and treatment of breast cancer related bone loss in the treatment of letrozole, and to improve the compliance of breast cancer patients with endocrine therapy. The 60 patients who entered the standard were divided into 30 cases in the treatment group and 30 cases in the control group. The control group and the treatment group all took the endocrine drug letrozole, each time 2.5mg, once a day, the control group was combined with vitamin D calcium chewing tablets, each time 600mg, once a day. The treatment group was combined with vitamin D calcium chewing tablets, each time 600mg, each time. At the same time, it was treated with oral hydroponic soil (anointment), each time 10g, morning and after dinner. Observe the clinical effect of two groups before and after treatment, X-ray bone density (b one mineral density, BMD), serum Ca2+, serum alkaline phosphatase (Alkal in phosphatase, AKP), TCM syndrome score, serum estradiol (Estradiol, etc.). The clinical efficacy of tazigzole in the treatment of breast cancer associated bone loss was evaluated by SPSS22.0. Results: 1, the clinical comprehensive curative effect was compared: 3 months after treatment in the treatment group, the total effective rate of clinical curative effect was 46.67% after 6 months after treatment, and the treatment group in the control group of 70.00%. was treated 3 months after treatment. The total effective rate of clinical comprehensive efficacy was 36.67% in the last 6 months, compared with the 46.67%. group and 6 months after treatment. The difference between the treatment group and the control group was statistically significant (P0.05).2, and the serum Ca2+ index was compared: (1) the curative effect was compared: the control group was 3 months after treatment, and the total effective rate of serum Ca2+ in the 6 months after treatment was 43.33%, 46.67%. treatment, respectively. 3 months after treatment, the total effective rate of serum Ca2+ in 6 months after treatment was 50% and 6 months after treatment. The difference was statistically significant (P0.05) compared with the control group (P0.05). (2) the ratio of the serum Ca2+ in the control group was compared with that before treatment (P0.05) in the 3 months after treatment (P0.05); and 6 after treatment. Compared with before treatment, the difference was statistically significant (P0.05). The difference of serum Ca2+ in the treatment group was statistically significant (P0.05, P=0.0006) after treatment. After 6 months of treatment, the difference was statistically significant (P0.05).3, and the serum AKP index was compared with that of the control group: (1) the curative effect was compared: 3 months after treatment in the control group, The total effective rate of serum AKP in 6 months after treatment was 36.67%, 3 months after treatment in 40.00%. treatment group. The total effective rate of serum AKP in 6 months after treatment was 40% and 63.33%. was 6 months after treatment. The difference was statistically significant (P0.05) compared with the control group. (2) the ratio of AKP in the control group was compared with that of the control group after treatment. The difference was not statistically significant (P0.05). In the treatment group, the difference was not statistically significant before the treatment 3 months after treatment (P0.05), and the difference was statistically significant (P0.05) after 6 months after treatment. After 6 months of treatment, the difference between the treatment group and the control group was statistically significant (P0.05).4, and the BMD index was compared: (1) the curative effect was compared: In the control group 3 months after treatment, the total effective rate of 6 months after treatment was 26.67%, the 36.33%. treatment group was 3 months after treatment, the total effective rate of 6 months after treatment was 30%, and the treatment group was compared to the control group for 6 months. The difference was statistically significant (P0.05). (2) the ratio changes were compared: the control group was treated with the treatment before and before the treatment. The difference was not statistically significant (P0.05). The difference between the 3 months after treatment and before treatment was not statistically significant (P0.05). The difference was statistically significant (P0.05) compared with before treatment (P0.05) in June after treatment. The difference was statistically significant (P0.05).5, the treatment group was compared with the control group for 6 months after the treatment, and the TCM syndrome was compared with that of the control group: the treatment of TCM syndrome was compared with that of the control group. 3 months after treatment, the total effective rate of TCM syndrome score in the 6 month after treatment was 50%, the 73.33%. control group was 3 months after treatment, and the total effective rate of TCM syndrome score was 30% after 6 months after treatment, and 6 months after 43.33%. treatment. The difference was statistically significant (P0.05). (2) ratio change ratio. Comparison: the control group had no statistical significance (P0.05) before treatment after treatment. The difference was statistically significant (P0.05, P0.001).6 after treatment after treatment (P0.001), and the serum E2 index was compared: the serum E2 of the treatment group and the control group were compared with the treatment before treatment, the difference was statistically significant (P0.05).7, safety detection: The safety indexes of the patients were detected before and after treatment. The two groups did not find adverse events and adverse reactions. Conclusion: 1, the prevention and control of letrozole in the treatment of breast cancer caused by letrozole has a definite clinical effect. It can obviously improve the clinical symptoms, increase BMD, prevent the loss of bone and improve the survival of the patients. Quality.2, nourishing water culture soil does not cause the risk of recurrence and metastasis of breast cancer, long treatment process and better curative effect.3. It is safe to treat patients with bone loss associated with breast cancer in the treatment of letrozole, no adverse drug reaction and undiscomfort symptoms have been found.

【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R273

【参考文献】