摘要
目的：探讨六味地黄丸预防芳香化酶抑制剂治疗相关骨丢失（AIBL）的可行性和安全性。方法：将72例符合应用芳香化酶抑制剂（AIs）行内分泌治疗的乳腺癌患者按随机化原则分为两组,对照组每日服用标准剂量的AIs＋维生素D钙制剂,研究组在此基础上加用六味地黄丸。分别检测她们在治疗前和治疗后6月及12月的第2~4腰椎（L2-4）和双股骨Ward三角（Ward＇s）平均骨密度值及骨代谢指标血清N端骨钙素（N-MID）和I型胶原C端肽（CTX-I）水平,并监测血清雌二醇（E2）水平。结果：对照组的L2-4和Ward＇s骨密度值在治疗后6月和12月持续显著降低（P〈0.001）,并伴随着N-MID和CTX-I水平的持续显著增加（P〈0.001）。而研究组在治疗后6月虽然血清N-MID和CTX-I水平亦明显增加（P〈0.001）,但骨密度并未出现降低;而治疗12月后血清N-MID和CTX-I水平明显回落,只略高于治疗前水平（P=0.067,P=0.052）,L2-4和Ward＇s骨密度值则较治疗前明显增加（P〈0.001,P=0.005）。两组的E2水平在治疗后6月均出现显著降低（P〈0.001和P=0.003）,并维持于低水平。结论：六味地黄丸是预防AIBL的安全有效的药物。
Objective： To explore the feasibility and safety of Liuwei Dihuang pills in preventing aromatase inhibitor - associated bone loss （A1BL） of breast cancer. Methods： Seventy -two breast cancer patients treated with endoerinotherapy by aromatase inhibitors （Als） were randomly divided into two groups. The patients in control group were treated with standard doses of AIs and compound of vitamin D and calcium, while the patients in study group were treated with Liuwei Dihuang pills based on control group. The mean bone alineral den- sity （BMD） values of lumbar vertebra （L2-4 ） and bilateral femoral triangle of ward （Ward＇s） and bone metabolism indexes- N -MID and CTX - I levels in serum befoe treatment and at 6, 12 months after treatment were detected respectively ; serum levels of estradiol were monitored. Results： BMD values of lumbar vertebra （L2-4 ） and bilateral femoral triangle of ward （Ward＇s） in control group decreased continual- ly at 6 and 12 months after treatment （ P 〈 0. 001 ） , which increased continually with the increases of N - MID and CTX - I levels （ P 〈 0. 001 ） . In study group, serum N - MID and CTX - I levels increased significantly at 6 months after treatment （ P 〈 0. 001 ） , but BMD values did not decrease ; at 12 months after treatment, serum N - MID and CTX - I levels decreased significantly, which were slightly higher than those before treatment （ P = 0. 067, P = 0. 052） , BMD values increased significantly compared with before treatment （ P 〈 0. 001, P = 0. 005 ） . Estradiol levels at 6 months after treatment in the two groups decreased （P 〈 0. 001, P = 0. 003 ） , which maintained at low levels. Conclusion： Liuwei Dihuang pills is safe and effective in preventing AIBL.
出处
《中国妇幼保健》
CAS
北大核心
2014年第33期5434-5436,共3页
Maternal and Child Health Care of China
基金
广东省中医药局建设中医药强省科研课题〔20111133〕
关键词
六味地黄丸
芳香化酶抑制剂
骨丢失
骨密度
Liuwei Dihuang pill
Aromatase inhibitor
Bone loss
Bone mineral density
