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目的观察乳癌术后化裁方对绝经后乳腺癌患者内分泌治疗使用芳香化酶抑制剂(AIs)引起骨丢失的干预作用,以及对患者10年内骨质疏松性骨折和髋骨骨折率的控制作用。方法将73例患者,分为中药组(乳癌术后化裁方组)、唑来膦酸组、空白对照组。所有患者每年进行骨密度(BMD)检测,并运用骨折风险因子评估工具(FRAX)进行骨折风险因子评估。结果空白对照组患者骨密度较初始下降(P<0.05),中药组未见明显变化,唑来膦酸组较初始骨密度上升(P<0.05);中药组较空白对照组能提高患者骨密度(P<0.05);唑来膦酸组可降低10年内主要部位发生骨质疏松性骨折和髋骨骨折概率(P<0.05),中药组骨折风险较初始无明显变化,空白对照组骨折风险有所增加(P<0.05);中药组与空白对照组比较,能降低患者10年内髋骨骨折发生率(P<0.05)。结论乳癌术后化裁方可减缓绝经后使用芳香化酶抑制剂的乳腺癌患者骨密度下降趋势,降低骨折风险,对骨质起保护作用。
Objective To observe the intervention effect of postoperative chemotherapy for breast cancer on the bone loss induced by aromatase inhibitor (AIs) in endocrine therapy of postmenopausal women and the control effect on osteoporotic fracture and hip fracture rate within 10 years . Methods Seventy-three patients were divided into two groups: Chinese medicine group (post-operative breast-cancer group), zoledronic acid group and blank control group. All patients underwent bone mineral density (BMD) testing each year and fracture risk factor assessment using the Fracture Risk Factor Assessment Tool (FRAX). Results Compared with the control group, the BMD in the blank control group decreased significantly (P <0.05), and no significant change was observed in the TCM group. The BMD in the zoledronic acid group was significantly higher than that in the control group (P <0.05) (P <0.05). In the zoledronic acid group, the incidence of osteoporotic fractures and hip fractures in the major sites within 10 years was significantly reduced (P <0.05). There was no significant difference in fracture risk between the traditional Chinese medicine group and the control group (P <0.05). Compared with the blank control group, the TCM group can reduce the incidence of hip fracture within 10 years (P <0.05). Conclusions The postoperative chemotherapy for breast cancer can reduce the decline of BMD in breast cancer patients using aromatase inhibitors after menopause, reduce the risk of fractures and protect the bone.