乳腺癌辅助内分泌治疗的不良反应及其中医药治疗探讨
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摘要
辅助内分泌治疗是目前国内外推荐的标准的激素受体阳性乳腺癌的辅助治疗手段。然长期使用内分泌药物治疗乳腺癌,将使患者产生激素减退相关的不良反应,降低患者内分泌治疗的依从性,影响乳腺癌的治疗效果。祖国传统中医药能从整体观出发,辨证论治已成为降低长期使用内分泌药物所引起的不良反应的重要治疗手段之一。本文将对临床常用的乳腺癌辅助内分泌药物所引起的相关不良反应作一总结,并从中医药角度概述其病因病机及治法方药。
Adjunctive endocrine therapy is the standard adjuvant treatment for hormone receptor-positive patients with breast cancer currently recommended at home and abroad. However, long-term use of endocrine drugs to treat breast cancer may cause adverse reactions related to hormone reduction, reduce the compliance of patients with endocrine therapy, and affect the therapeutic effect of breast cancer. Traditional Chinese medicine can treat the patients differentially from a holistic view, and has become one of the important treatments to reduce the adverse reactions caused by long-term use of endocrine drugs. This article will summarize the adverse reactions caused by adjuvant endocrine therapy for breast cancer and outline the pathogenesis and treatment from the perspective of Chinese medicine.
Adjunctive endocrine therapy is the standard adjuvant treatment for hormone receptor-positive patients with breast cancer currently recommended at home and abroad. However, long-term use of endocrine drugs to treat breast cancer may cause adverse reactions related to hormone reduction, reduce the compliance of patients with endocrine therapy, and affect the therapeutic effect of breast cancer. Traditional Chinese medicine can treat the patients differentially from a holistic view, and has become one of the important treatments to reduce the adverse reactions caused by long-term use of endocrine drugs. This article will summarize the adverse reactions caused by adjuvant endocrine therapy for breast cancer and outline the pathogenesis and treatment from the perspective of Chinese medicine.
引文
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[11]梁荣华,黄旭晖,王昌俊.中医药对乳腺癌内分泌治疗致骨质疏松的机理探讨[J].陕西中医,2015,35(7):882-885.
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[15]赵怡.补肾法对乳腺癌芳香化酶抑制剂相关骨丢失的临床观察[D].广州中医药大学,2011.
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[19]吴疆,魏巍,袁永兵.补骨脂的化学成分和药理作用研究进展[J].药物评价研究,2011,34(3):217-219.
[20]李铁,卓睿.知柏地黄丸降低三苯氧胺治疗乳腺癌乳腺癌产生的毒副作用临床研究[J].广西中医药,2009,32(4):192-194.
[21]张小玲.逍遥散加味缓解乳腺癌内分泌不良反应84例[J].浙江中西医结合杂志,2011,21(11):754-756.
[22]蒋益兰,赵晔,蔡美.益肾调肝方治疗乳腺癌患者类更年期综合征肝肾阴虚证的临床研究[J].湖南中医药大学学报,2012,32(11):61-64.
[23]冯锦.健脾化痰祛湿方治疗高脂血症脾虚痰浊型56例[J].中国中医药科技,2012,19(1):93.
[24]冷雪,贾连群,杨关林,等.化瘀祛痰方对脾虚型高血脂症大鼠肝脏SREBP-2信号通路的干预作用[J].中国中西医结合杂志,2015,35(3):320-326.
[25]贾连群,陈文娜,赵秋宇,等.化瘀祛痰方药对动脉粥样硬化型小鼠肝脏胆固醇代谢相关基因表达调控的影响[J].中华中医药杂志,2014,39(1):214-218.
[2]Abraham J,Caldera H,Coleman R,et al.Endocrine therapy and related issues in hormone receptor-positive early breast cancer:A roundtable discussion by the breast cancer therapy expert group(BCTEG)[J].Breast Cancer Res Treat,2018,169(1):1-7.
[3]中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2015版)[J].中国癌症杂志,2015,25(9):692-754.
[4]Li Q,Zhao X,Wang S,et al.Letrozole induced low estrogen levels affected the expressions of duodenal and renal calcium-processing gene in laying hens[J].Gen Comp Endocrinol,2018,255:49-55.
[5]Beom SH,Oh J,Kim TY,et al.Efficacy of letrozole as first-line treatment of postmenopausal women with hormone receptor-positive metastatic breast cancer in Korea[J].Cancer Res Treat,2017,49(2):454-463.
[6]Milovanovic J,Todorovic-Rakovic N,Abu Rabi Z,et al.The role of interleukin 8 and matrix metalloproteinases 2and 9 in breast cancer treated with tamoxifen[J].Journal of the Balkan Union of Oncology,2017,22(3):628-637.
[7]Tyler R Chesney,Jennifer Xin Yin,Nikoo Rajaee,et al.Tamoxifen with radiotherapy compared with Tamoxifen alone in elderly women with early-stage breast cancer treated with breast conserving surgery:A systematic review and Meta-analysis[J].Radiother Oncol,2017,123(1):1-9.
[8]Takagi K,Miki Y,Ishida T,et al.The interplay of endocrine therapy,steroid pathways and therapeutic resistance:Importance of androgen in breast carcinoma[J].Mol Cell Endocrinol,2017,466:31-37.
[9]Partridge AH,LaFountain A,Mayer E,et al.Adherence to initial adjuvant anastrozole therapy among women with early-stage breast cancer[J].J Clin Oncol,2008,26(4):556-562.
[10]胡兰,姚莉,范芳芳.151例乳腺癌患者骨丢失及药物防治现况调查[J].中国骨质疏松杂志,2017,23(11):1484-1487.
[11]梁荣华,黄旭晖,王昌俊.中医药对乳腺癌内分泌治疗致骨质疏松的机理探讨[J].陕西中医,2015,35(7):882-885.
[12]Lenihan DJ,Esteva FJ.Multidisciplinary strategy for managing cardiovascular risks when treating patients with early breast cancer[J].Oncologist,2008,13(12):1224-1234.
[13]Amir E,seruga B,Niraula S,et al.Toxicity of adjuvant endocrine therapy in postmenopausal breast cancer patients:A systematic review and meta-analysis[J].J Nati Cancer Inst,2011,103(17):1299-1309.
[14]喻璐,补肾法对绝经后芳香化酶抑制剂治疗乳腺癌患者雌激素水平的影响[D].广州中医药大学,2011.
[15]赵怡.补肾法对乳腺癌芳香化酶抑制剂相关骨丢失的临床观察[D].广州中医药大学,2011.
[16]Wang X,Morris-Natschke Susan L,Lee KH.New developments in the chemistry and biology of the bioactive constituents of Tanshen[J].Med Res Rev,2007,27(1):133-148.
[17]贾正平,张汝学,曾艳.地黄化学成分及药理研究进展[J].中成药,2006,28(4):609-611.
[18]孟宁,孔凯,李师翁.淫羊藿属植物化学成分及药理活性研究进展[J].西北植物学报,2010,30(5):1063-1073.
[19]吴疆,魏巍,袁永兵.补骨脂的化学成分和药理作用研究进展[J].药物评价研究,2011,34(3):217-219.
[20]李铁,卓睿.知柏地黄丸降低三苯氧胺治疗乳腺癌乳腺癌产生的毒副作用临床研究[J].广西中医药,2009,32(4):192-194.
[21]张小玲.逍遥散加味缓解乳腺癌内分泌不良反应84例[J].浙江中西医结合杂志,2011,21(11):754-756.
[22]蒋益兰,赵晔,蔡美.益肾调肝方治疗乳腺癌患者类更年期综合征肝肾阴虚证的临床研究[J].湖南中医药大学学报,2012,32(11):61-64.
[23]冯锦.健脾化痰祛湿方治疗高脂血症脾虚痰浊型56例[J].中国中医药科技,2012,19(1):93.
[24]冷雪,贾连群,杨关林,等.化瘀祛痰方对脾虚型高血脂症大鼠肝脏SREBP-2信号通路的干预作用[J].中国中西医结合杂志,2015,35(3):320-326.
[25]贾连群,陈文娜,赵秋宇,等.化瘀祛痰方药对动脉粥样硬化型小鼠肝脏胆固醇代谢相关基因表达调控的影响[J].中华中医药杂志,2014,39(1):214-218.