目的系统检索、评价并总结国内外关于乳腺癌患者芳香化酶抑制剂诱导的骨关节症状预防和管理的最佳证据。方法系统检索国内外相关指南网站及专业协会网站、Cochrane Library、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、PubMe...目的系统检索、评价并总结国内外关于乳腺癌患者芳香化酶抑制剂诱导的骨关节症状预防和管理的最佳证据。方法系统检索国内外相关指南网站及专业协会网站、Cochrane Library、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、PubMed、Web of Science核心集、Embase、CINAHL、中国知网、维普数据库、万方数据库、中国生物医学文献数据库中所有关于乳腺癌患者芳香化酶抑制剂诱导的骨关节症状预防及管理的指南、专家共识、系统评价、Meta分析、最佳实践、推荐实践,检索时限为建库至2022年7月12日。由2名研究者独立进行文献质量评价和资料提取。结果共纳入21篇文献,其中循证指南1篇、共识指南3篇、系统评价或Meta分析17篇,从骨关节症状的发病率、临床表现、症状评估、风险评估、预防措施、药物干预、非药物干预、管理策略8个方面总结出37条最佳证据,其中有17条1级证据。结论乳腺癌患者芳香化酶抑制剂诱导的骨关节症状预防和管理的最佳证据可以为临床医护人员制订相关症状管理方案和开展临床实践提供参考,但仍需结合临床情境和患者意愿选择适宜的证据应用于临床实践。展开更多
Objective: To assess the effectiveness of Yishen Jiangu Granules(益肾健骨颗粒, YSJGG) on aromatase inhibitor-associated musculoskeletal symptoms(AIMSS). Methods: A single-arm, open-label study was conducted in 3...Objective: To assess the effectiveness of Yishen Jiangu Granules(益肾健骨颗粒, YSJGG) on aromatase inhibitor-associated musculoskeletal symptoms(AIMSS). Methods: A single-arm, open-label study was conducted in 34 postmenopausal women with breast cancer who experienced AIMSS. Patients were treated with YSJGG for 12 weeks(12.4 g orally twice daily). The primary outcome was a change in the mean worst pain score of Brief Pain Inventory-Short Form(BPI-SF) over 12 weeks, and the second outcomes included changes in pain severity and pain-related interference of BPI-SF and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), Modified Score for the Assessment of Chronic Rheumatoid Affections of the Hands(M-SACRAH), the Functional Assessment of Cancer Therapy-Breast(FACT-B), bone mineral density(BMD) and blood indices such as calcium(Ca), phosphate(P), and alkaline phosphatase(ALP). Results: Of 37 women recruited, 30 initiated the therapy and 24 were evaluable at 12 weeks. The primary outcome(BPI-SF worst pain scores) achieved a 2.17-point reduction compared with baseline(5.75±1.87 vs 3.58±2.15, P〈0.01). There were reductions in pain severity(decreased 1.65, P〈0.01) and pain-related interference(decreased 2.55, P〈0.01). The changes in WOMAC and M-SACRAH scores were similar to BPI-SF(P〈0.05). In the FACT-B, only physical wel-being and functional wel-being were improved compared with baseline(P〈0.05). No clinical differences were found in BMD, Ca, P and ALP. Conclusion: YSJGG is an effective and wel-tolerated agent to reduce AIMSS.展开更多
文摘目的系统检索、评价并总结国内外关于乳腺癌患者芳香化酶抑制剂诱导的骨关节症状预防和管理的最佳证据。方法系统检索国内外相关指南网站及专业协会网站、Cochrane Library、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、PubMed、Web of Science核心集、Embase、CINAHL、中国知网、维普数据库、万方数据库、中国生物医学文献数据库中所有关于乳腺癌患者芳香化酶抑制剂诱导的骨关节症状预防及管理的指南、专家共识、系统评价、Meta分析、最佳实践、推荐实践,检索时限为建库至2022年7月12日。由2名研究者独立进行文献质量评价和资料提取。结果共纳入21篇文献,其中循证指南1篇、共识指南3篇、系统评价或Meta分析17篇,从骨关节症状的发病率、临床表现、症状评估、风险评估、预防措施、药物干预、非药物干预、管理策略8个方面总结出37条最佳证据,其中有17条1级证据。结论乳腺癌患者芳香化酶抑制剂诱导的骨关节症状预防和管理的最佳证据可以为临床医护人员制订相关症状管理方案和开展临床实践提供参考,但仍需结合临床情境和患者意愿选择适宜的证据应用于临床实践。
基金Supported by Beijing Municipal Science and Technology Commission,China(No.D131100002213001,D161100005116005)Beijing Municipal Administration of Hospitals,China(No.QML20150903)
文摘Objective: To assess the effectiveness of Yishen Jiangu Granules(益肾健骨颗粒, YSJGG) on aromatase inhibitor-associated musculoskeletal symptoms(AIMSS). Methods: A single-arm, open-label study was conducted in 34 postmenopausal women with breast cancer who experienced AIMSS. Patients were treated with YSJGG for 12 weeks(12.4 g orally twice daily). The primary outcome was a change in the mean worst pain score of Brief Pain Inventory-Short Form(BPI-SF) over 12 weeks, and the second outcomes included changes in pain severity and pain-related interference of BPI-SF and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), Modified Score for the Assessment of Chronic Rheumatoid Affections of the Hands(M-SACRAH), the Functional Assessment of Cancer Therapy-Breast(FACT-B), bone mineral density(BMD) and blood indices such as calcium(Ca), phosphate(P), and alkaline phosphatase(ALP). Results: Of 37 women recruited, 30 initiated the therapy and 24 were evaluable at 12 weeks. The primary outcome(BPI-SF worst pain scores) achieved a 2.17-point reduction compared with baseline(5.75±1.87 vs 3.58±2.15, P〈0.01). There were reductions in pain severity(decreased 1.65, P〈0.01) and pain-related interference(decreased 2.55, P〈0.01). The changes in WOMAC and M-SACRAH scores were similar to BPI-SF(P〈0.05). In the FACT-B, only physical wel-being and functional wel-being were improved compared with baseline(P〈0.05). No clinical differences were found in BMD, Ca, P and ALP. Conclusion: YSJGG is an effective and wel-tolerated agent to reduce AIMSS.