Clinical Observation Of Yiqi Jianpi Recipe In Treating Bone Loss In Postmenopausal Breast Cancer Patients Caused By Letrozole

ObjectiveTo observe the efficacy and safety of Yiqi Jianpi Recipe in the treatment of bone loss in postmenopausal breast cancer patients caused by letrozole,aiming to use this medicine to treat aromatase inhibitor related bone loss(aromatase inhibitors-associated bone loss(AIBL)provides the basis.MethodThis study observed 60 postmenopausal estrogen receptor positive breast cancer patients who were treated in the outpatient department and inpatient department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from October 2018 to December 2019.Sixty patients who met the inclusion criteria were randomly divided into the conventional treatment group and the combined Chinese medicine group,with 30 cases in each group.The conventional treatment group was treated with letrozole and calcium carbonate D3 tablets,and the combined Chinese medicine group was given Yiqi Jianpi prescription,letrozole and calcium carbonate D3 tablets.After 3 months of treatment,observe the changes in bone mineral density(lumbar spine,hip joint),serum bone metabolic biochemical indicators,TCM symptom scores,Carr's score,estradiol levels,and safety indicators at the time of enrollment and after treatment To evaluate the clinical effect and safety of Yiqi Jianpi Recipe in the treatment of bone loss in postmenopausal breast cancer patients caused by letrozole.All data are statistically analyzed using SPSS21.0 software.Measurement data that meets the normal distribution are compared with the t test;measurement data that do not conform to the normal distribution use non-parametric tests,and count data use the chi-square test.P <0.05 was considered statistically significant.ResultIn this study,a total of 60 patients were followed up.During the follow-up,1 patient in the combined Chinese medicine group suffered from bacterial pneumonia and was not suitable for taking Yiqi Jianpi Recipe,which was excluded.The actual effective observationcases were 59 cases,including 29 cases in the combined traditional Chinese medicine group and 30 cases in the conventional treatment group.Age before treatment,age at menopause,bone density,bone alkaline phosphatase,25-hydroxyvitamin D,blood calcium,blood phosphorus,estradiol level,total score of symptoms of traditional Chinese medicine,score of symptoms of traditional Chinese medicine(bone and joint pain,There was no statistically significant difference between the groups of mental fatigue,lack of appetite,palpitations,insomnia,hot flashes and sweating),Carr's score and safety index(P>0.05).After 3 months of treatment,the changes in the observation indicators are as follows:1.Bone mineral density: The bone mineral density of the lumbar spine and hip joint of the patients in the combined Chinese medicine group were higher than before treatment,and the difference was statistically significant(P<0.05);the bone density of the lumbar spine in the conventional treatment group was also higher than before treatment(P <0.05),but the bone mineral density of the hip was slightly increased compared with before treatment,but it was not statistically significant(P>0.05);compared between groups,the increase of lumbar bone mineral density in the combined Chinese medicine group was better than that in the conventional treatment group(P <0.05).2.Bone type alkaline phosphatase: After treatment,the serum bone type alkaline phosphatase of both groups decreased compared with before treatment,which was statistically significant(P<0.05),and the combination of traditional Chinese medicine group was better than the conventional treatment group(P<0.05).3.25-Hydroxyvitamin D: After treatment,the serum 25-hydroxyvitamin D level of the two groups was significantly higher than before treatment,the difference was statistically significant(P<0.05),but there was no statistical significance between the two groups after treatment(P> 0.05).4.Blood calcium and blood phosphorus: There were no significant fluctuations in blood calcium and blood phosphorus levels before and after treatment in both groups(P>0.05),and they were at normal levels.5.Estradiol level: There was no statistically significant difference in estradiol levelbetween the two groups after treatment(P>0.05),which was decreased compared with before treatment(P<0.05).6.TCM symptom score and Carr's score: After treatment,the combined Chinese medicine group can significantly improve the patient's TCM symptom score and Carr's score,which are statistically significant compared with the conventional treatment group(P<0.05);and Each symptom score of traditional Chinese medicine,the combined Chinese medicine group has obvious advantages in improving the five symptom scores of bone and joint pain,eating less and less,fatigue,hot flashes,sweating,and insomnia,which have statistics compared with the conventional treatment group.Significance(P<0.05).7.Safety index: There were no adverse events in the two groups of patients throughout the trial.There was no abnormality in the detection of safety indexes(vital signs,blood routine,liver function,kidney function)after treatment,and no statistics compared with before treatment Academic significance(P>0.05).Conclusion1.Yiqi Jianpi Recipe can not only effectively improve the patient's bone metabolism balance,reduce bone loss,and increase bone density,but also significantly improve the patient's clinical symptoms and physical condition,and improve the patient's quality of life.2.Yiqi Jianpi Recipe will not affect the clinical benefits of endocrine therapy of breast cancer by affecting the estrogen level of the patient's body.It is safe and effective,and is worthy of clinical promotion and application.