目的 观察健脾益肾方防治芳香化酶抑制剂致骨关节痛的临床疗效。方法 收集2017年10月至2018年9月就诊的绝经后、激素受体阳性、接受芳香化酶抑制剂内分泌治疗的早期乳腺癌患者81例，采用简单随机、平行对照的方法，分为治疗组41例，对照组40例。对照组给予常规钙剂及维生素D补充治疗，治疗组患者在此基础上服用健脾益肾方中药汤剂口服。观察比较两组治疗前后骨密度（bone mineral density，BMD）、简明疼痛量表（brief pain inventory short form, BPI-SF）评分、Morisky服药依从性量表（Morisky medication adherence scale-8，MMAS-8）评分变化情况。观察时间为6个月。结果 治疗后，治疗组患者腰椎、股骨颈BMD升高值均显著大于对照组（P＜0.05）。治疗组BPI-SF的最严重疼痛评分降低值显著大于对照组（P＜0.05）。治疗3、4、5、6个月末，治疗组MMAS-8评分均显著高于对照组（P＜0.05）。结论 健脾益肾方防治芳香化酶抑制剂致骨关节痛的疗效满意，能够减轻骨关节疼痛，提高乳腺癌患者内分泌治疗的依从性。
Objective To investigate the clinical effect of spleen-tonifying and kidney-nourishing prescription in the prevention and treatment of aromatase inhibitor-induced arthralgia. Methods A total of 81 postmenopausal patients with early-stage hormone receptor-positive breast cancer who underwent endocrine therapy with aromatase inhibitors from October 2017 to September 2018 were enrolled and randomly divided into treatment group with 41 patients and control group with 40 patients based on the method of simple randomization and parallel control. The patients in the control group were given conventional calcium+vitamin D treatment, and those in the treatment group were given oral administration of the spleen-tonifying and kidney-nourishing prescription in addition to the treatment in the control group. The two groups were compared in terms of bone mineral density (BMD), Brief Pain Inventory-Short Form (BPI-SF) score, and Morisky Medication Adherence Scale-8 (MMAS-8) score before and after treatment. All patients were observed for 6 months. Results Compared with the control group, the treatment group had significantly greater increases in BMD of the lumbar vertebra and the femoral neck after treatment (P<0.05). Compared with the control group, the treatment group had a significantly greater reduction in the most severe pain score of BPI-SF (P<0.05). At the end of months 3, 4, 5, and 6 of treatment, the treatment group had a significantly higher MMAS-8 score than the control group (P<0.05). Conclusion Spleen-tonifying and kidney-nourishing prescription has a satisfying clinical effect in the prevention and treatment of aromatase inhibitor-induced arthralgia and can alleviate arthralgia and improve compliance with endocrine therapy in patients with breast cancer.
仲姗姗,万 华,李 蓉,毛佳琳,瞿文超,卢亚云,张 纯.健脾益肾方防治芳香化酶抑制剂致骨关节痛临床观察[J].安徽中医药大学学报,2020,39(2):20-24复制