The Effect Of Ovarian Protection On Lipid Metabolism In Premenopausal Breast Cancer Patients From The Perspective Of Protecting The Kidney Qi(Vital Essence)

ObjectiveThe overall view of traditional Chinese medicine holds that "kidney essence" plays an extremely important role in the life cycle.The ovarian function of women is closely related to the "kidney essence" of Chinese medicine.Perimenopausal symptoms in patients with premature ovarian failure induced by chemotherapy are related to kidney essence injury and kidney yin deficiency in TCM syndrome differentiation.A number of studies have shown that ovarian protection(chemotherapy combined with ovarian suppression)can improve the long-term survival of breast cancer patients,and the mechanism is still controversial.Therefore,according to the relationship between the protection of kidney qi and the protection of ovarian function in the theory of traditional Chinese medicine,the difference of lipid metabolism between premenopausal women with premenopausal breast cancer and those with simple chemotherapy without ovarian protection is discussed.In order to provide new ideas for improving the long-term survival of the patients with breast cancer,the overall thinking of traditional Chinese medicine(kidney-Tiangui?Chongren-Baogong axis)has been preliminarily explored to guide the effect of ovarian protection on lipid metabolism.MethodA retrospective study was used to obtain 35 cases of ovarian protection under 40 years of age from 7000 cases of breast cancer in the Guangdong Province Traditional Chinese Medical Hospital from 2004 to 2016.Control groups obtained 35 cases were obtained according to the 1:1 matching principle.The ovarian protection group combined with gonadotropin releasing hormone agonist(Goserelin 3.6mg,h).1 times every 28 days,subcutaneous injection;the control group was treated with chemotherapy alone.The blood lipids,estrogen levels and the cardiovascular and cerebrovascular events and survival of the two groups in the two group of the two groups were recorded before and after treatment,first to fourth years after treatment.ResultThe mean survival time of ovaries and chemotherapy groups were 28.66 months and 35.97 months respectively.There was no significant difference in total cholesterol,triglyceride,low density lipoprotein cholesterol and high density protein cholesterol level before and after treatment in the two groups(P>0.05),but the level of total cholesterol and low density lipoprotein cholesterol in the chemotherapy group was slightly upward,and the level of the increase was greater than that of the ovarian protection group.In the stratified subgroup analysis of the two groups,the two subgroups needed and without endocrine therapy,the comparison of the four items of the blood lipid between the ovarian protection group and the control group was not statistically significant(P>0.05).There was no significant difference in estrogen level and survival between the two groups(P>0.05).The two groups of cardiovascular and cerebrovascular events were 0.ConclusionIn the study,there was no significant difference in blood lipid level between the ovarian protection group and the chemotherapy group.However,according to the decrease trend of total cholesterol and low density lipoprotein in the two groups,the total cholesterol and low density lipoprotein of the breast cancer patients in the ovarian protection group were slightly lower than those in the chemotherapy group.Based on the existing research and the guidance of traditional Chinese medicine theory,we believe that there is a certain relationship between ovarian protection and lipid metabolism.Ovarian protection may be a protective factor for lipid changes,which requires longer follow-up or more rigorous RCT tests.