Department of Frontier Japanese-Oriental (Kampo) Medicine, Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan.
J Altern Complement Med. 2011 Nov;17(11):1075-7. doi: 10.1089/acm.2010.0536. Epub 2011 Nov 9.
Breast cancer is the fourth most frequent cause of death, and it is currently the most frequent cause of death among Japanese women. As to breast cancer therapy, lengthy hormonal therapy is very important for the treatment and prevention of recurrence. Aromatase inhibitors (AIs) are the initial drug of choice for postoperative adjuvant therapy of breast cancer in Japan. AIs require long-term use and occasionally cause serious side-effects. In this report, the effects of Kampo medicines (Japanese traditional medicines) on AIs-induced side-effects are described.
A 55-year-old woman visited the Kampo outpatient department of Chiba University Hospital for atypical genital bleeding and arthralgia. At the age of 54, she suffered from left breast cancer and underwent left total mastectomy followed by chemotherapy for 6 months. Afterwards, 1 mg/day of anastrozole, one of the AIs, was used for therapy. Three (3) months later, atypical genital bleeding from vaginal mucosa and joint pains of bilateral hands and knees occurred as side-effects of anastrozole. Her attending doctor could only prescribe nonsteroidal external medicine for the inflammation of vaginal mucosa and do close follow-up. However, her symptoms showed no improvement.
Her deficiency of both ki (qi) and ketsu (Blood) was diagnosed based on Kampo diagnostics. Juzentaihoto was used for treatment. After taking juzentaihoto for 5 weeks, the atypical genital bleeding disappeared, and she no longer need topical medicine. Because her arthralgia showed no improvement, powdered processed aconitine root was added. After taking 3.0 g/day of this medication, her arthralgia almost completely disappeared.
Controlling the side-effects is a clinical issue from the viewpoint of adherence to drug treatment. Kampo therapy should be considered one of the choices for side-effects in the process of cancer treatment.
乳腺癌是第四大死亡原因，目前也是日本女性最常见的死亡原因。在乳腺癌的治疗中，长期的激素治疗对治疗和预防复发非常重要。芳香化酶抑制剂（AIs）是日本乳腺癌术后辅助治疗的首选药物。AIs 需要长期使用，偶尔会引起严重的副作用。在本报告中，描述了汉方药（日本传统药物）对 AI 引起的副作用的影响。
一位 55 岁女性因非典型生殖器出血和关节痛到千叶大学医院的汉方门诊就诊。她在 54 岁时患有左侧乳腺癌，接受了左侧全乳切除术，并接受了 6 个月的化疗。之后，每天使用 1 毫克阿那曲唑（一种 AI）进行治疗。3 个月后，她出现了阿那曲唑的副作用，即阴道黏膜的非典型出血和双侧手膝关节的关节痛。她的主治医生只能为阴道黏膜炎症开非甾体外用药物，并进行密切随访。然而，她的症状没有改善。
根据汉方诊断，她被诊断为气（qi）和血（ketsu）两虚。给予她进行治疗。服用 5 周后，她的非典型生殖器出血消失，不再需要局部用药。由于她的关节痛没有改善，加入了制川乌粉。服用 3.0 克/天的制川乌粉后，她的关节痛几乎完全消失。
从药物治疗依从性的角度来看，控制副作用是一个临床问题。在癌症治疗过程中，应考虑汉方疗法作为副作用的选择之一。
