| ObjectiveAbout 70%of breast cancers are hormone receptor-positive.Aromatase inhibitors are the first-line standard treatment for postmenopausal breast cancer patients.The treatment time is as long as 5-10 years.Dyslipidemia is one of the major adverse reaction,increase the risk of cardiovascular disease,cardiovascular disease related death in addition to its breast cancer deaths has become the first place,a serious threat to the life and health of patients,reduce the patients' compliance and quality of life,so how to reduce the risk of cardiovascular disease and improve their quality of life become a clinical doctor needs to solve the problem.Acupuncture can be used as an important supplement in the treatment of dyslipidemia,regulating lipid levels is simple and feasible way of intervention,so this study endocrine hormone dependent breast cancer patients after treatment caused abnormal lipid metabolism as the research object,using traditional Chinese medicine press the needle joint atorvastatin comprehensive treatment method of its intervention,to explore the press for hormone dependent aromatase inhibitor therapy in postmenopausal breast cancer patients after the adjustment of dyslipidemia and influence on blood lipid related inflammatory factors,and to observe the influence of quality of life,to press the needle will provide a scientific basis for clinical promotion.MethodsA randomized controlled clinical study was conducted to select 70 patients with hormone-dependent breast cancer with dyslipidemia after AI treatment,and 70 patients were divided into the treatment group and the control group by random number method,with 35 patients in each group.Treatment group:acupuncture treatment of ear endocrine,sympathetic,zusanli,fenglong,such as three Yin jiao.Acupuncture method:each time take unilateral acupoints,with iodine volts first disinfection,after being dry after using 75%alcohol to take off the iodine,sterile forceps use will press the needle clamp tightly,with tape on the treatment of acupuncture and perpendicular to the skin will be its press,the pressed flat needle stick on the skin,and pressure,with the stomach to the appropriate pressure to stay for a few seconds to make the fixed on the acupuncture point,retaining needle for 24 hours,daily before a meal and a half hours to press the point with the hand,time is about 1 to 3 min,with light stimulate advisable,remove,clamp with forceps press the adhesive part of the needle gently pull outward.Once a week,combined with atorvastatin calcium tablets 10mg 1/night oral administration.Control group:atorvastatin calcium tablets 10mg 1/night oral administration.The course of treatment is 1 month.Main observation indicators:observe the lipid profile(TC,TG,LDL-C,HDL-C)before and after treatment in the two groups,and review the lipid profile again after 1 month of drug withdrawal,and observe the lipid rebound rate.Secondary observation indicators:inflammatory factors(Hs-CRP,IL-6),whose elevated level is an important factor inducing hyperlipidemia,is a sensitive marker of cardiovascular disease,quality of life scale(FACT-B)of breast cancer patients,third-generation aromatase inhibitor(AI)drug-related adverse reactions scale and KPS.Safety indicators(ALT,AST,Cr,BUN,CK).ResultsIn this study,70 patients who met the inclusion criteria from July 2019 to December 2019 were selected,all of whom were female.A total of 2 patients were lost during the study period.Finally,68 patients completed the experiment,34 in the treatment group and 34 in the control group.There were no statistically significant differences between the two groups in pre-treatment age,histological grade,pathological type,type of AI drugs,treatment time of AI,lipid profile and baseline comparison of inflammatory factors(P>0.05),suggesting comparability.1 Blood lipid results1.1 The total cholesterol(TC)level of patients with hyperlipidemia of breast cancer can be reduced by using the method of thumbtack needleThe results of this study showed that in the treatment group,the blood lipid levels were(6.48±1.42)mmol/L,(4.83± 1.34)mmol/L,and(4.62±1.28)mmol/L,respectively,before treatment,30 days after treatment and 30 days after discontinuation of lipid-lowering drugs.The TC level at 30 days after treatment and 30 days after withdrawal was lower than that before treatment(P<0.01),and the difference was statistically significant.In the control group,the blood lipid levels were(6.53±1.39)mmol/L,(5.45±1.38)mmol/L,and(5.93±1.26)mmol/L,respectively,before treatment,30 days after treatment and 30 days after discontinuation of lipid-lowering drugs.The TC level at 30 days after treatment was lower than that before treatment(P<0.01),and the difference was statistically significant.The mean value of TC after 30 days of drug withdrawal was significantly higher than that after 30 days of treatment(P<0.05),and the difference was statistically significant.In comparison between the two groups,TC levels in the treatment group and the discontinuation group were significantly lower than those in the control group(P<0.05),with statistically significant differences.1.2 The level of low density lipoprotein cholesterol(LDL-C)in patients with hyperlipidemia of breast cancer can be further reduced by using thumbtack needleThe results of this study showed that in the treatment group,the lipid levels were(4.52±0.57)mmol/L,(2.83 ± 0.62)mmol/L,and(2.66±0.43)mmol/L,respectively,before treatment,30 days after treatment and 30 days after discontinuation of lipid-lowering drugs.LDL-C level at 30 days after treatment and 30 days after drug withdrawal was lower than that before treatment(P<0.01),and the difference was statistically significant.In the control group,blood lipid levels were(4.41±0.52)mmol/L,(3.35±0.65)mmol/L,and(3.75±0.41)mmol/L,respectively,before treatment,30 days after treatment,and 30 days after discontinuation of lipid-lowering drugs.LDL-C level at 30 days after treatment was lower than that before treatment(P<0.01),and the difference was statistically significant.The mean LDL-C value at 30 days after drug withdrawal was significantly higher than that at 30 days after treatment(P<0.05),and the difference was statistically significant.Comparison between the two groups:in the treatment group,the mean LDL-C of 30 days after treatment and 30 days after drug withdrawal was significantly lower than that of the control group(P<0.05),and the difference was statistically significant.1.3 There was no significant improvement of triglyceride(TG)level in patients with hyperlipidemia of breast cancer treated by using the method of thumbtack needleThe results showed that in the treatment group,the blood lipid levels were(3.36±0.42)mmol/L,(2.53±0.34)mmol/L,and(2.47±0.33)mmol/L,respectively,before treatment,30 days after treatment and 30 days after drug withdrawal.TG levels at 30 days after treatment and 30 days after drug withdrawal were lower than before treatment(P<0.05),with statistically significant differences.In the control group,blood lipid levels were(3.42±0.44)mmol/L,(2.75±0.38)mmol/L,and(2.82±0.31)mmol/L,respectively,before treatment,30 days after treatment and 30 days after drug withdrawal.TG level at 30 days after treatment was lower than that before treatment(P<0.05),and the difference was statistically significant.Compared with the control group,TG levels in the treatment group at 30 days after treatment and 30 days after drug withdrawal showed no significant difference(P>0.05),showing no statistical significance.1.4 There was no significant effect on HDL-C levels in breast cancer patients with hyperlipidemia by thumbtack needleThe results showed that in the treatment group,the blood lipid levels were(1.16±0.32)mmol/L,(1.72±0.34)mmol/L,and(1.74±0.33)mmol/L,respectively,before treatment,30 days after treatment and 30 days after drug withdrawal.HDL-C level was higher than that before treatment 30 days after treatment and 30 days after drug withdrawal(P<0.05).In the control group,blood lipid levels were(1.18±0.34)mmol/L,(1.63±0.38)mmol/L,and(1.61±0.31)mnol/L,respectively,before treatment,30 days after treatment and 30 days after drug withdrawal.Hdl-c level was higher at 30 days after treatment and 30 days after discontinuation than before treatment(P<0.05).Compared with the control group,hdl-c level in the treatment group at 30 days after treatment and 30 days after drug withdrawal showed no significant difference(P>0.05),showing no statistical significance.1.5 Thumbtack needle can effectively reduce the rate of lipid rebound after stopping lipid-lowering drugs in patients with hyperlipidemia of breast cancerAccording to the results of lipid level in the two groups after 30 days of drug withdrawal,4 patients in the treatment group had lipid rebound,with a rebound rate of 11.76%.There were 14 patients with lipid rebound in the control group,and the rebound rate was 41.18%.The rebound rate in the treatment group was significantly lower than that in the control group,with statistical significance(P<0.05).The level of TC and ldl-c in the treatment group was lower than that in the control group 30 days after drug withdrawal,which was statistically significant.1.6 The level of inflammatory factors(Hs-CRP,IL6)in patients with hyperlipidemia of breast cancer can be effectively reduced by thumbtack needleThe results showed that the levels of Hs-CRP and IL6 at 30 days of treatment in the two groups were significantly lower than those before treatment(P<0.05).After 30 days of treatment,Hs-CRP level in the treatment group was significantly lower than that in the control group(P<0.05),which was statistically significant(P<0.05).The level of il-6 in the treatment group was significantly lower than that in the control group(P<0.05)after 30 days of drug withdrawal,which was statistically significant.1.7 Positive correlation between inflammatory factors and LDL-C levelAccording to the research results,with the increase of LDL-C level,Hs-CRP and IL-6 levels showed an upward trend on the whole,indicating that they were positively correlated with LDL-C level.1.8 The quality of life of breast cancer patients with hyperlipidemia can be improved by the use of thumbtack needleFACT-B results showed that the functional status of the control group was significantly improved after treatment compared with before treatment(P<0.05).The physiological status,emotional status,functional status and social/family status of the treatment group after treatment were significantly improved compared with those before treatment,with statistical differences(P<0.05).Compared with the control group,the physiological status,emotional status and social/family status of the treatment group were significantly improved after treatment,with statistical differences(P<0.05).The results of other AIs related adverse reactions showed that the symptoms of headache and depression were significantly different before treatment(P<0.05),without comparability.After treatment,the scores of hot flashes,sweating,fatigue,nausea and rash in the treatment group were all lower than before treatment,with statistical significance(P<0.05).The headache in the control group was relieved after treatment compared with before treatment,indicating that the headache symptoms might be relieved by the patients themselves.In comparison between the two groups,the scores of symptoms such as hot flashes,sweating,fatigue and nausea after treatment in the treatment group were lower than those in the control group,with statistically significant differences(P<0.05).KPS results showed that KPS was 89.72±5.54 points in the treatment group and 80.53±5.66 points in the control group after treatment,and the KPS score in the treatment group was significantly higher than that in the control group(P<0.05),showing statistical significance.1.9 Good safety in clinical application of thumbtack needleThe results showed that the safety indexes of liver and kidney function(ALT,AST,Cr,BUN)and creatine kinase(CK)did not change significantly in the treatment group and the control group.Conclusion1.The treatment of thumbtack needle can regulate the dyslipidemia caused by AI treatment in patients with breast cancer hyperlipidemia2.The thumbtack needle can effectively reduce the lipid rebound rate of patients with breast cancer hyperlipidemia after stopping lipid-lowering drugs3.The effective reduction of lipids in patients with hyperlipidemia in breast cancer by using thumbtack needle may be related to the reduction of inflammatory factors4.The quality of life and safety of breast cancer patients with hyperlipidemia can be improved by the use of thumbtack needle... |
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