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中药产品的处方与浸润性乳腺癌风险降低相关。

Prescription of Chinese herbal products is associated with a decreased risk of invasive breast cancer.

作者信息

Tsai Yueh-Ting, Lai Jung-Nien, Lo Pei-Chia, Chen Chin-Nu, Lin Jaung-Geng

机构信息

Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei School of Chinese Medicine, College of Chinese Medicine, China Medical University Departments of Chinese Medicine, China Medical University Hospital Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.

出版信息

Medicine (Baltimore). 2017 Sep;96(35):e7918. doi: 10.1097/MD.0000000000007918.

Abstract

The finding of a decrease in endometrial cancer incidence among breast cancer survivors following the use of Chinese herbal products (CHPs) has led to speculation that CHPs might play a role in breast cancer prevention.This study provides an overview of breast cancer incidence, comparing CHP users with those who do not use traditional Chinese medicine (TCM), referred to as non-TCM users. The results can provide information to clinicians for counseling women about the preventive use of TCM.A total of 184,386 women (20-79 years of age) were recruited from a nationwide 1-million-person representative sample of those covered by National Health Insurance in Taiwan and were followed from 1999 to 2012. A total of 1853 incidents of invasive breast cancer were diagnosed. The person-year approach with the Poisson assumption was used to estimate the incidence density rate. The age-specific hazard ratios of breast cancer in relation to either CHP or siwutang (SWT) use were calculated with multivariate Cox proportional hazard regression.More than 78% of patients had used a CHP at some point previously. The overall incidence density rate of breast cancer for non-TCM users was estimated at 1.73 per 10,000 patient-years. The corresponding values for CHP and SWT users were lower than those of the non-TCM group (CHP group = 0.85; SWT group = 0.63 per 10,000 patient-years). The covariate adjusted HRs for breast cancer were 0.57 (95% confidence interval [CI] 0.50-0.65) and 0.36 (95% CI 0.28-0.46) in women using CHPs and SWT, respectively. The findings were confirmed using propensity score matching.Consumption of CHPs reduces the incidence of invasive breast cancer. Although the mechanism of action of these products is unclear, their use as a preventive agent for breast cancer is appropriate for many women at an increased risk of breast cancer.

摘要

在乳腺癌幸存者中,使用中草药产品(CHPs)后子宫内膜癌发病率降低这一发现引发了人们的猜测,即CHPs可能在乳腺癌预防中发挥作用。本研究概述了乳腺癌发病率,将CHP使用者与未使用传统中药(TCM)的人(即非TCM使用者)进行比较。研究结果可为临床医生为女性提供关于预防性使用TCM的咨询提供信息。

从台湾参加国民健康保险的100万人全国代表性样本中招募了总共184,386名年龄在20至79岁之间的女性,并从1999年至2012年进行随访。共诊断出1853例浸润性乳腺癌事件。采用基于泊松假设的人年法来估计发病率密度率。通过多变量Cox比例风险回归计算使用CHP或四物汤(SWT)与乳腺癌相关的年龄特异性风险比。

超过78%的患者曾在某个时间使用过CHP。非TCM使用者的乳腺癌总体发病率密度率估计为每10,000患者年1.73例。CHP使用者和SWT使用者的相应数值低于非TCM组(CHP组 = 每10,000患者年0.85例;SWT组 = 每10,000患者年0.63例)。使用CHP和SWT的女性中,经协变量调整后的乳腺癌风险比分别为0.57(95%置信区间[CI] 0.50 - 0.65)和0.36(95% CI 0.28 - 0.46)。使用倾向得分匹配法证实了这些发现。

使用CHPs可降低浸润性乳腺癌的发病率。虽然这些产品的作用机制尚不清楚,但对于许多乳腺癌风险增加的女性来说,将其用作乳腺癌预防剂是合适的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209c/5585506/0d0f483a9416/medi-96-e7918-g001.jpg

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