地黄饮子联合耳针对肾虚髓减型内分泌治疗期绝经后乳腺癌患者认知水平及激素水平、血脂、维生素D3水平的影响
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摘要
目的:探究地黄饮子联合耳针对肾虚髓减型内分泌治疗期绝经后乳腺癌患者认知水平、临床症状及生化指标的影响。方法:100例接受内分泌治疗的绝经后乳腺癌患者,根据入院先后使用数字表法随机分为实验组和对照组,实验组患者50例,对照组患者50例。对照组患者接受常规乳腺癌内分泌、补钙治疗加耳针治疗,治疗组患者在对照组基础上服用地黄饮子煎剂,两组患者均连续治疗2个月后进行MMSE、MoCA、FSS量表评估,检测患者生化指标:游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、雌二醇(E2)、促黄体生成素(LH)、促卵泡生成素(FSH)、胆固醇(TC)、甘油三酯(TG)、维生素D3(1,25-(OH)2-VitD3)。结果:治疗组总有效率高于对照组;治疗后两组认知评分均较治疗前有所提高(P<0.05),而治疗后治疗组认知评分高于对照组(P<0.05);治疗后两组疲劳评分均较治疗前有所降低(P<0.05),而治疗后治疗组认知评分低于对照组(P<0.05);治疗后两组FT3、FT4、TSH、E2、LH、1,25-(OH)2-VitD3水平均较治疗前提高(P<0.05),而治疗后治疗组上述指标高于对照组(P<0.05);治疗后两组TC、TG、LH、FSH均较治疗前有所降低(P<0.05),而治疗后治疗组上述指标低于对照组(P<0.05)。结论:地黄饮子联合耳针可以有效地改善肾虚髓减型内分泌治疗期绝经后乳腺癌患者认知水平,其作用可能与相关激素水平、血脂及血清D3含量改变有关,且安全可靠,值得研究。
Objective: To investigate the effect of Rehmanniae Decoction combined with auricular acupuncture in improving the cognitive level, alleviating symptoms, influencing index of patients with postmenopausal breast cancer who received endocrine therapy and differentiated as kidney deficiency and marrow injury. Method: A total of 100 postmenopausal breast cancer patients were selected. According to different methods of treatment, the patients were divided into experimental group(n=50) and control group(n=50). Patients in the control group received auricular acupuncture,endocrine therapy and calcium supplementation, while those in the experimental group took Rehmannia Decoction on the basis of the control group. Mini-mental State Examination(MMSE),Montreal Congnitive Assessment(MoCA) and FSS were assessed and some indexes such as FT3,FT4,TSH,E2,LH,FSH,TC,TG and 1,25-(OH)2-VitD3 were tested before and after 2 months treatment. Results: The experimental group's total effective rate was higher than that of the control group. The MMSE score and MoCA score of patients in each group increased after treatment while the socres in experimental group were higher than those in the control group(P<0.05). The FSS score of patients in each group decreased after treatment while the socres in experimental group were lower than those in the control group(P<0.05). The levels of indexes(FT3,FT4,TSH,E2,LH,1,25-(OH)2-VitD3) of patients in each group wereincreased after treatment, while the levels in experimental group were higher than those in the control group(P<0.05). The levels of indexes(TC,TG,LH,FSH) of patients in each group were lower after treatment, while the levels in experimental group were lower than those in the control group(P<0.05). Conclusion: Rehmanniae Decoction combined with auricular acupuncture can effectively improve the cognitive level. Its effect may be associated with changes of hormone level, blood lipid and vitamin D content. It is safe and worthy of studying.
Objective: To investigate the effect of Rehmanniae Decoction combined with auricular acupuncture in improving the cognitive level, alleviating symptoms, influencing index of patients with postmenopausal breast cancer who received endocrine therapy and differentiated as kidney deficiency and marrow injury. Method: A total of 100 postmenopausal breast cancer patients were selected. According to different methods of treatment, the patients were divided into experimental group(n=50) and control group(n=50). Patients in the control group received auricular acupuncture,endocrine therapy and calcium supplementation, while those in the experimental group took Rehmannia Decoction on the basis of the control group. Mini-mental State Examination(MMSE),Montreal Congnitive Assessment(MoCA) and FSS were assessed and some indexes such as FT3,FT4,TSH,E2,LH,FSH,TC,TG and 1,25-(OH)2-VitD3 were tested before and after 2 months treatment. Results: The experimental group's total effective rate was higher than that of the control group. The MMSE score and MoCA score of patients in each group increased after treatment while the socres in experimental group were higher than those in the control group(P<0.05). The FSS score of patients in each group decreased after treatment while the socres in experimental group were lower than those in the control group(P<0.05). The levels of indexes(FT3,FT4,TSH,E2,LH,1,25-(OH)2-VitD3) of patients in each group wereincreased after treatment, while the levels in experimental group were higher than those in the control group(P<0.05). The levels of indexes(TC,TG,LH,FSH) of patients in each group were lower after treatment, while the levels in experimental group were lower than those in the control group(P<0.05). Conclusion: Rehmanniae Decoction combined with auricular acupuncture can effectively improve the cognitive level. Its effect may be associated with changes of hormone level, blood lipid and vitamin D content. It is safe and worthy of studying.
引文
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[15] Von Ah D, Storey S, Jansen CE, et al.Coping strategies and interventions for cognitive changes in patients with cancer[J]. Seminars in oncology nursing,2013,29(4):288-299.
[16] 张真,付光斌,徐春利,等.甲状腺激素在老年人轻度认知障碍中的临床意义[J]. 中国实用神经疾病杂志,2012,15(5):72-73.
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[18] 姚海乾,梁庆成,吴云,等.维生素D与认知功能障碍研究进展[J].中华神经科杂志,2011,44(10):716-718.
[19] 张跃红,冯志海.优甲乐结合温阳益气活血法及中医辅助治疗原发性甲状腺功能减退症的临床价值研讨[J]. 中华中医药学刊,2017,35(6):1620-1624.
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[21] 陈云志,管连城,高洁,等.维生素D轴:中医补肾方药的潜在靶点[J].时珍国医国药,2017,28(9):2210-2212.
[22] 刘慧慧,甘君学,谢洲.针灸康复综合干预疗法治疗血管性痴呆的临床应用进展[J].针灸临床杂志,2013,29(12):55-58.
[23] 缪小红.耳穴埋籽联合穴位按摩在老年痴呆患者中的应用[J].现代医药卫生,2016,32(20):3212-3214.
[2] Janelsins MC, Kohli S, Mohile SG, et al. An update on cancer- and chemotherapy-related cognitive dysfunction: current status[J]. Seminars in oncology, 2011,38(3):431-438.
[3] Wefel JS, Schagen SB. Chemotherapy-related cognitive dysfunction[J]. Current neurology and neuroscience reports, 2012,12(3):267-275.
[4] Ouimet LA, Stewart A, Collins B, et al. Measuring neuropsychological change following breast cancer treatment: an analysis of statistical models[J]. Journal Of Clinical And Experimental Neuropsychology,2009,31(1):73-89.
[5] Shilling V, Jenkins V, Fallowfield L,et al. The effects of hormone therapy on cognition in breast cancer[J].Journal of steroid biochemistry and molecular biology,2003,86(3):405-412.
[6] 易建,周瑜,姚汉金.恩必普联合穴位刺激治疗轻度血管性认知障碍的临床效果[J].时珍国医国药,2010,21(7):1829-1830.
[7] 程红亮,周婷,张闻东,等.针刺督脉组穴治疗血管性认知障碍的临床研究[J].中国临床保健杂志,2015,18(5):512-514.
[8] 王学美,谢竹藩.补肾益精对老年脑功能的临床研究[J].中医杂志,1993,34(6):324,347-348.
[9] 杨孟君,崔妫,许静予,等.耳疗革命[M].北京:中国科学技术出版社,2015:43,295.
[10] Zick SM, Zwickey H, Wood L, et al. Preliminary differences in peripheral immune markers and brain metabolites between fatigued and non-fatigued breast cancer survivors: a pilot study[J]. Brain imaging and behavior,2014,8(4):506-516.
[11] Eberling JL, Wu C, Tong-Turnbeaugh R, et al. Estrogen- and tamoxifen-associated effects on brain structure and function[J]. Neuroimage,2004,21(1):364-371.
[12] Von Ah D, Carpenter JS, Saykin A, et al. Advanced cognitive training for breast cancer survivors: a randomized controlled trial[J]. Breast cancer research and treatment,2012,135(3):799-809.
[13] Hotting K, Roder B. Beneficial effects of physical exercise on neuroplasticity and cognition[J]. Neuroscience and biobehavioral reviews,2013,37(9):2243-2257.
[14] Luber B, Lisanby SH. Enhancement of human cognitive performance using transcranial magnetic stimulation (TMS)[J]. Neuroimage,2014,85(2):961-970.
[15] Von Ah D, Storey S, Jansen CE, et al.Coping strategies and interventions for cognitive changes in patients with cancer[J]. Seminars in oncology nursing,2013,29(4):288-299.
[16] 张真,付光斌,徐春利,等.甲状腺激素在老年人轻度认知障碍中的临床意义[J]. 中国实用神经疾病杂志,2012,15(5):72-73.
[17] 杨畅,王希福,张惠敏.老年轻度认知障碍者的血脂改变及认知功能改变特点[J].中国医科大学学报,2006,35(3):320-321.
[18] 姚海乾,梁庆成,吴云,等.维生素D与认知功能障碍研究进展[J].中华神经科杂志,2011,44(10):716-718.
[19] 张跃红,冯志海.优甲乐结合温阳益气活血法及中医辅助治疗原发性甲状腺功能减退症的临床价值研讨[J]. 中华中医药学刊,2017,35(6):1620-1624.
[20] 韩恩爽.祛湿化浊方对老年血脂异常的干预研究[D].北京:北京中医药大学,2014:36-38.
[21] 陈云志,管连城,高洁,等.维生素D轴:中医补肾方药的潜在靶点[J].时珍国医国药,2017,28(9):2210-2212.
[22] 刘慧慧,甘君学,谢洲.针灸康复综合干预疗法治疗血管性痴呆的临床应用进展[J].针灸临床杂志,2013,29(12):55-58.
[23] 缪小红.耳穴埋籽联合穴位按摩在老年痴呆患者中的应用[J].现代医药卫生,2016,32(20):3212-3214.