Institute of Complementary Medicine, University Hospital, Zurich, Switzerland.
Gynecol Endocrinol. 2011 Oct;27(10):844-8. doi: 10.3109/09513590.2010.538097. Epub 2011 Jan 13.
The antihormonal therapy of breast cancer patients with the antiestrogen tamoxifen often induces or aggravates menopausal complaints. As estrogen substitution is contraindicated, herbal alternatives, e.g. extracts of black cohosh are often used.
A prospective observational study was carried out in 50 breast cancer patients with tamoxifen treatment. All patients had had surgery, most of them had undergone radiation therapy (87%) and approximately 50% had received chemotherapy. Every patient was treated with an isopropanolic extract of black cohosh (1-4 tablets, 2.5 mg) for 6 months. Patients recorded their complaints before therapy and after 1, 3, and 6 months of therapy using the menopause rating scale (MRS II).
The reduction of the total MRS II score under black cohosh treatment from 17.6 to 13.6 was statistically significant. Hot flashes, sweating, sleep problems, and anxiety improved, whereas urogenital and musculoskeletal complaints did not change. In all, 22 patients reported adverse events, none of which were linked with the study medication; 90% reported the tolerability of the black cohosh extract as very good or good.
Black cohosh extract seems to be a reasonable treatment approach in tamoxifen treated breast cancer patients with predominantly psychovegetative symptoms.
乳腺癌患者采用抗雌激素他莫昔芬进行抗激素治疗时，常引发或加重绝经相关症状。由于雌激素替代疗法是禁忌的，因此常使用草药替代物，如黑升麻提取物。
对 50 例接受他莫昔芬治疗的乳腺癌患者进行了前瞻性观察性研究。所有患者均接受了手术，其中大多数患者接受了放射治疗（87%），约有 50%的患者接受了化疗。每位患者均接受了异丙醇提取的黑升麻（1-4 片，2.5 毫克）治疗 6 个月。患者使用绝经评定量表（MRS II）在治疗前和治疗后 1、3 和 6 个月记录自己的症状。
黑升麻治疗后，MRS II 总分从 17.6 降至 13.6，具有统计学意义。潮热、出汗、睡眠问题和焦虑得到改善，而泌尿生殖和肌肉骨骼症状没有改变。共有 22 名患者报告了不良反应，但均与研究药物无关；90%的患者报告黑升麻提取物的耐受性非常好或好。
黑升麻提取物似乎是治疗接受他莫昔芬治疗的乳腺癌患者以精神植物神经症状为主的合理方法。
