| Objective: To observe and evaluate the effect of Sanyin Decoction on clinical symptoms,neuropsychological evaluation,TCM symptoms and physical condition of chemotherapy-related cognitive impairment(CRCI)in triple-negative breast cancer(TNBC)patients by a prospective cohort study.Methods:(1)90 symptom self-assessment scale of breast cancer patients treated with chemotherapy: Patients with chemotherapy of breast cancer treated in outpatient and ward of Longhua Hospital in Shanghai from May 2017 to December were studied,and the 90 symptom self-assessment scale was tested by trained professionals.(2)Clinical study on the intervention of Sanyin Decoction on CRCI symptoms of TNBC after breast surgery: Using prospective cohort study method,the patients were divided into 2 groups according to the treatment sub-center.Taking whether or not to take Sanyin Decoction after breast surgery with traditional Chinese medicine as the exposure factor,64 cases were enrolled in the Western Medicine cohort(Cancer Hospital Branch Center Affiliated to Fudan University sub-center)66 cases were enrolled in the Traditional Chinese Medicine cohort(Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine sub-center)from January 2018 to January 2019.All patients were followed up for 3 months,including FACT-cog score,neuropsychological test,symptoms of traditional Chinese medicine after breast cancer surgery,physical condition score and safety index.Results:(1)Neuropsychological tests found that: DST test results were compared with the norm: after follow-up,49 patients had cognitive abnormalities in the DST evaluation of Western medicine cohort,accounting for 79.03%.47 patients had cognitive abnormalities in the DST evaluation of traditional Chinese medicine cohort,accounting for 75.81%.The number of cognitive impairments in the DST evaluation of Western medicine cohort increased by 3.22% compared with that in the follow-up of traditional Chinese medicine cohort based on syndrome differentiation.According to the results of DST,RR and AR showed that the relative risk of exposure factors of traditional Chinese medicine was 0.93,and exposure factors had a weak protective effect on CRCI of triple-negative breast cancer.The attributive risk of traditional Chinese medicine in exposure group was-5.36,and the triple-yin prescription after breast surgery might be effective in improving memory and execution,and had a weak positive effect on the prevention of CRCI.(2)There was no significantdifference in STT-A,STT-B and DST scores between the two cohorts at the end of follow-up,and the time-consuming comparison of STT-A and STT-B showed an upward trend before and after the same cohort was followed up.(3)After breast surgery,the STT scores of the patients with high school education and above improved significantly;the improvement of intelligence and attention of the 30-40 age group was more significant(all P < 0.05);the improvement of intelligence and attention of the 40-50 age group,the 60-year-old age group was not able to provide evidence to delay their decline;it may be the decline of intelligence and attention of the 50-60 age group.During the follow-up period,the cognitive impairment related events perceived by patients in the Chinese medicine cohort gradually decreased,and the improvement of patients' quality of life was significantly different from that in the Western medicine cohort(P < 0.05),while the symptoms related to other people's evaluation and self-perceived cognitive ability dimension did not improve significantly.Among them,the symptoms related to self-perceived cognitive ability dimension tended to aggravate;the quality of life in the Western medicine cohort only improved,while the symptoms related to the evaluation of other dimensions were gradually aggravated.After the follow-up,the quality of life of patients in the Chinese medicine cohort was 24.46% higher than that in the Western medicine cohort,and the symptoms related to self-perceived cognitive impairment were reduced by 10.63%.(5)The symptoms of each dimension of FACT-cog were correlated with the symptoms of traditional Chinese medicine after breast surgery.After 3 months of follow-up,the scores of TCM symptoms in TCM cohort patients were significantly lower than those in western medicine cohort(P < 0.05).The symptoms of mental fatigue,alopecia,dry mouth and bitter mouth,obstruction in pharynx,palpitation,loss of appetite,nausea,pantothenic acid,incompatibility,weakness of waist and knee,disturbance of sleeping at night and irregular menstruation were significantly improved(P < 0.05).The scores of cohort symptoms of Western medicine were partly decreased,and the symptoms related to cognitive impairment evaluated by FACT-cog were worse than those before follow-up: mental fatigue,poor memory,blockage in pharynx,sigh,nausea pantothenic acid,noisy stomach,sleep disturbance,inconvenience,irritability and suspicion.(6)During the follow-up period,the scores of KPS and ECOG of the two cohorts were comparable.After the follow-up,the physical condition of the Chinese medicine cohort patients evaluated by KPS and ECOG was better than that of the western medicine cohort.(7)The blood routine,urine routine,liver and kidneyfunction of the two groups were in the normal fluctuation range before and after the follow-up.There were no significant abnormalities in electrocardiogram,abdominal B-ultrasonography and breast B-ultrasonography,and no adverse events were reported during the follow-up period.Conclusion: 1.Chemotherapy-related cognitive impairment of breast cancer is one of the main factors leading to discomfort after chemotherapy.This phenomenon is independent of somatic symptoms and psychological problems.The use of anthracyclines is a risk factor for its occurrence.Triple-negative breast cancer is more prone to chemotherapy-related cognitive impairment than other types of breast cancer.2.The effect of Sanyinfang on cognitive improvement after breast surgery is not clear,but it can improve self-perceived cognitive impairment-related symptoms of triple-negative breast cancer patients by alleviating discomfort symptoms of traditional Chinese medicine and regulating mood,and it has a certain preventive effect on the cognitive impairment related to chemotherapy of triple-negative breast cancer.3.Social environment can affect the symptoms of cognitive impairment related to chemotherapy in patients with breast cancer,and health education plays an important role in promoting its alleviation. |
PDF Full Text Request