Premature Ovarian Failure Induced By Chemotherapy With Breast Cancer Of Reproductive Endocrine And Traditional Chinese Medicine Syndromes

Objective:Study the effects menstruation and reproductive endocrine induced by chemotherapy with breast cancer, and to explore the characteristics of TCM syndromes of POF induced by chemotherapy and to lay the foundation of ovarian injury induced by chemotherapy.Method:Collecting 120 patients before the age of 40 who have been diagnosed breast cancer with postoperative from the clinic of first affiliated hospital of Guangzhou University of Chinese Medicine From January 2011 to February 2016,all patients were treated with surgical treatment, according to the results of pathology diagnosed with breast cancer. Complete chemotherapy after surgery.All patients understand the menstruation, detected with electrochemiluminescence before the last chemotherapy patients the blood FSH, LH, P, T, E2, compared the changes in hormone levels. Of the 101 patients completed the chemotherapy in 2 weeks (before radiotherapy) of TCM syndrome questionnaire. All the data were double input with the Excel table, two copies of the data checked for all data derived database. All the data using SPSS22.0 software for statistical analysis.Statistical description using frequency, rate, mean, standard, experimental data expressed as mean± standard(X±S).Measurement data using t test or ANOVA, pairwise comparisons using LSD tsst, count data were compared with the X2 test.Results:1. During the chemotherapy (form the first chemotherapy to the last chemotherapy),120 cases of breast cancer,67 patients retarded menstruation,45(37.5%) patients amenorrhea,2(1.67%) patients early menstruation,2(1.67%) patient Metrorrhagia,1(0.83%) patient irregular menstrual cycle,3 (2.5%) cases no significant changes in menstruation.2. Menstruation after menstruation returned to normal within six months after chemotherapy in most patients with late menstruation menstruation in 2-5 months recovering rules and median time is 3 months, of which 56 cases (83.58%) in the chemotherapy after menstruation returned to normal in 11 cases (16.42%) in the chemotherapy after 1 year in menstruation, amenorrhea patients with complex wave in time for 7 months (ranging from 3 to 24 months), 5 cases (11.11%) patients in the chemotherapy within six months of the tide, among them 2 patients (40%) and menstrual recovery of 29 cases (64.44%) patients in the chemotherapy after 1 year in the resumption of menstruation tide, of which 20 cases (68.97%) patients with menstrual regularity; 6 cases (13.33%) patients in the chemotherapy after 2 years the resumption of menstruation tide,5 cases (11.11%) amenorrhea patients are not recovery until February 2016.3.62(51.67%)cases patients had perimenopausal symptons, mainly hot flashes, sweating, et.al. Such as hot flush, sweating, depression, anxiety, irritability, suspicious, insomnia, amnesia, vaginal dryness, sexual difficulties, loss of libido.4. After the end of chemotherapy in the patients with amenorrhea FSH levels were significantly higher than that of menstruating patients, the difference was statistically significant (F<0.05); irregular menstruation level in patients with FSH was significantly higher than that of regular menstruation in patients, the difference was statistically significant (P<0.05). After chemotherapy, LH emerged amenorrhea patients was higher than that of menstruating patients, the difference was statistically significant (P<0.05);irregular menstruation in patients with LH was significantly higher than regular menstruation patients, the difference was statistically significant (P<0.05). The levels of E2 in patients with amenorrhea after chemotherapy was significantly lower than menstruation patients, the difference was statistically significant (P<0.05); no significant difference in menstruation in patients and regular menstruation E2 levels (P>0.05). Regular menstruation patients, irregular menstruation, amenorrhea after chemotherapy in patients with P, T, two two, no significant difference (P>0.05).5.After different chemotherapy cycles (including 4,6,8 cycles) of chemotherapy, peripheral blood levels of FSH were no significant difference (P>0.05).6. After chemotherapy, FSH and LH levels were significantly higher than before chemotherapy, the difference was statistically significant (F<0.05); after chemotherapy, E2, P, T levels were significantly lower than before chemotherapy, the difference was statistically significant (P<0.05).7. Firstly, yin deficiency of liver and kidney syndrome:soreness and weakness of waist and knees, hot flushes, sweating, insomnia, dizziness, tinnitus, dry mouth yanzao, dry eyes, dizziness, tinnitus, forgetful, the tongue is red, moss little fur, thready and rapid pulse. Secondly, stagnation of liver and deficiency of kidney and blood stasis syndrome:emotional depression, irritability, chest pain, soreness and weakness of waist and knees, heel pain, dizziness, tinnitus, complexion dark and gloomy, purple lips dark, dark tongue, petechiae,, thin white fur, thready pulse astringent. Thirdly, Yang deficiency of spleen and kidney:sexual indifference, aversion to cold, lumbar acid cold, diarrhea, thin leukorrhagia, pale complexion, pale tongue fat, while teeth marks, sunken pulse weak. The Qi and blood deficiency syndrome:fatigue, shortness of breath, low noise, poor appetite, pale complexion, pale tongue, thin white fur, slow pulse.8. There are more asthenia syndrome and syndrome of intermingled deficiency and excess, and less excess syndrome in the Breast cancer patients.9. Syndrome of yin deficiency of liver and kidney is of the number of cases of 37.62%,34.65% kidney deficiency and liver qi stagnation and blood stasis, 19.80% spleen-yang and kidney-yang deficiency syndrome,7.93% deficiency of the Qi and blood.Conclusion:1. Breast cancer patients induced by chemotherapy result in menstruation, or even amenorrhea.2. Chemotherapy lead to premature ovarian failure, perimenopausal symptoms.3. After chemotherapy, the disease with deficiency or excess mingled primarily, the pathogenesis with kidney deficiency and liver qi stagnation and blood stasis mainly, relates to the liver, spleen and kidney. The four syndrome types is common, syndrome of yin deficiency of liver and kidney, kidney deficiency and liver qi stagnation and blood stasis, spleen and kidney deficiency, and deficiency of the Qi and blood.