本文選題：乳腺癌 + 來(lái)曲唑　； 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察滋水培土方防治來(lái)曲唑治療乳腺癌致相關(guān)骨丟失的臨床療效,以中醫(yī)中藥獨(dú)特的整體觀念、辯證論治優(yōu)勢(shì),發(fā)揮中醫(yī)中藥在防治來(lái)曲唑治療乳腺癌致相關(guān)骨丟失的作用,提高乳腺癌患者內(nèi)分泌治療的依從性。方法:采集符合納入標(biāo)準(zhǔn)的60例患者,采用隨機(jī)數(shù)字表法分組為治療組30例和對(duì)照組30例,對(duì)照組和治療組均服用內(nèi)分泌藥物來(lái)曲唑,每次2.5mg,每天一次,對(duì)照組配合使用維生素D鈣咀嚼片,每次600mg,每天一次。治療組配合使用維生素D鈣咀嚼片,每次600mg,每天一次,同時(shí)加用口服滋水培土方(膏方)治療,每次10g,每天早、晚飯后各一次。觀察兩組治療前后臨床療效、X線骨密度(b one mineral density,BMD)評(píng)分、血清Ca2+、血堿性磷酸酶(Alkal in phosphatase,AKP)濃度、中醫(yī)證候積分、血清雌二醇(Estradiol,E2)等相關(guān)指標(biāo),采用SPSS22.0進(jìn)行統(tǒng)計(jì)分析,評(píng)價(jià)滋水培土方防治來(lái)曲唑治療乳腺癌致相關(guān)骨丟失的臨床療效。結(jié)果:1、臨床綜合療效比較:治療組在治療后3個(gè)月、治療后6個(gè)月的臨床綜合療效總有效率分別為46.67%、70.00%。對(duì)照組在治療后3個(gè)月、治療后6個(gè)月的臨床綜合療效總有效率分別為36.67%、46.67%。組間比較分析,治療后6個(gè)月,治療組與對(duì)照組比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。2、血清Ca2+指標(biāo)比較:(1)療效比較:對(duì)照組治療后3個(gè)月、治療后6個(gè)月血清Ca2+值總有效率分別為43.33%、46.67%。治療組治療后3個(gè)月、治療后6個(gè)月血清Ca2+值總有效率分別為50.00%、73.33%。治療后6個(gè)月,治療組與對(duì)照組比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)比值變化比較:對(duì)照組血清Ca2+在治療后3個(gè)月與治療前對(duì)比,差異沒(méi)有統(tǒng)計(jì)學(xué)意義(P0.05);在治療后6個(gè)月與治療前比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。治療組血清Ca2+在治療后與治療前比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05、P=0.0006)。治療后6個(gè)月,治療組與對(duì)照組比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。3、血清AKP指標(biāo)比較:(1)療效比較:對(duì)照組治療后3個(gè)月、治療后6個(gè)月血清AKP總有效率分別為36.67%、40.00%。治療組治療后3個(gè)月、治療后6個(gè)月血清AKP總有效率分別為40.00%、63.33%。治療后6個(gè)月,治療組與對(duì)照組比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)比值變化比較:對(duì)照組血清AKP在治療后與治療前比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療組在治療后3個(gè)月對(duì)比治療前,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);在治療后6個(gè)月與治療前比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后6個(gè)月,治療組與對(duì)照組比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。4、BMD指標(biāo)比較:(1)療效比較:對(duì)照組在治療后3個(gè)月、治療后6個(gè)月的總有效率分別為26.67%、36.33%。治療組在治療后3個(gè)月、治療后6個(gè)月的總有效率分別為30.00%、63.33%。治療后6個(gè)月,治療組對(duì)比對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)比值變化比較:對(duì)照組經(jīng)治療后與治療前相比,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療組治療后3個(gè)月L2-4BMD與治療前相比,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);在治療后6月與治療前相比,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后6個(gè)月,治療組與對(duì)照組比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。5、中醫(yī)癥候比較:治療組在治療后3個(gè)月、治療后6個(gè)月的中醫(yī)癥候積分總有效率分別為50.00%、73.33%。對(duì)照組在治療后3個(gè)月、治療后6個(gè)月的中醫(yī)癥候積分總有效率分別為30.00%、43.33%。治療后6個(gè)月,治療組與對(duì)照組比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)比值變化比較:對(duì)照組經(jīng)治療后對(duì)比治療前,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療組經(jīng)治療后對(duì)比治療前,差異均有統(tǒng)計(jì)學(xué)意義(P0.05,P0.001)。6、血清E2指標(biāo)比較:治療組與對(duì)照組血清E2經(jīng)治療后分別與治療前比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。7、安全性檢測(cè):患者治療前后進(jìn)行安全性指標(biāo)檢測(cè),均未發(fā)現(xiàn)異常;兩組患者未發(fā)現(xiàn)不良事件和不良反應(yīng)。結(jié)論:1、滋水培土方防治來(lái)曲唑治療乳腺癌致相關(guān)骨丟失具有確切的臨床療效,可明顯改善患者的臨床癥狀,增加BMD,防治骨質(zhì)丟失,改善患者生存質(zhì)量。2、滋水培土方不會(huì)引起乳腺癌病情復(fù)發(fā)轉(zhuǎn)移風(fēng)險(xiǎn),療程長(zhǎng),療效更好。3、滋水培土方防治來(lái)曲唑治療乳腺癌致相關(guān)骨丟失患者安全,未發(fā)現(xiàn)藥物不良反應(yīng),未發(fā)現(xiàn)不適癥狀。
[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.

【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R273

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