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中药益肾健骨颗粒对芳香化酶抑制剂相关肌肉骨骼症状的影响:一项随机对照临床试验。

Effects of the Chinese medicine Yi Shen Jian Gu granules on aromatase inhibitor-associated musculoskeletal symptoms: A randomized, controlled clinical trial.

机构信息

Department of Oncology, Beijing Hospital of Traditional Chinese Medicine Affiliated with Capital Medical University, No 23, Back Road of Art Gallery, Dongcheng District, Beijing 100010, China.

Guidance Centre for Clinical Evidence-Based Research, World Federation of Chinese Medicine Societies, Room 516, Building A, Wealth Garden No. 19 Xiaoying Street, Chaoyang District, Beijing 100101, China.

出版信息

Breast. 2018 Feb;37:18-27. doi: 10.1016/j.breast.2017.08.003. Epub 2017 Oct 20.

Abstract

UNLABELLED

Aromatase inhibitor-associated musculoskeletal symptoms (AIMSS) are prevalent among patients on AI therapy, which leads to a lower quality of life and poor adherence to AI treatment. We evaluated whether Yi Shen Jian Gu granules (YSJG) is effective and safe to relieve AIMSS in patients with breast cancer. Eligible participants were randomly assigned to the YSJG group or the placebo group. Both groups had a 12-week treatment period and a 12-week follow-up period. Brief Pain Inventory-Short Form (BPI-SF), Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index, and the Modified Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands (M-SACRAH) were obtained at baseline and at 4, 8, 12 and 24 weeks. Of 146 participants enrolled, 84 were randomly assigned, and 77 were evaluable at 12 weeks. Baseline characteristics were comparable between two groups. The primary outcome was the differences in mean BPI-SF scores at 12 weeks. The worst pain scores decreased by 3.10 points (50.2%; 95% CI, 2.50 to 3.65) for YSJG group compared with a 1.63-point decrease (26.9%; 95% CI, 3.86 to 4.97) for the placebo group (P = 0.001). Significantly improvements were also observed for the WOMAC and M-SACRAH. Possibly YSJG-related side effects were grade 1 nausea (10%) and grade 2 diarrhea (2%). Serum follicle-stimulating hormone and serum estradiol were kept in the postmenopausal range before and after YSJG treatment. Patients with AIMSS treated with YSJG granules had significant improvements in musculoskeletal symptoms. YSJG is effective, safe and well-tolerated in managing AIMSS.

TRIAL REGISTRATION

ISCTN: ISRCTN06129599 (assigned 14 August 2013).

摘要

背景

芳香化酶抑制剂相关的肌肉骨骼症状(AIMSS)在接受 AI 治疗的患者中很常见,这导致生活质量下降,对 AI 治疗的依从性差。我们评估了益肾健骨颗粒(YSJG)是否能有效且安全地缓解乳腺癌患者的 AIMSS。

方法

合格的参与者被随机分配到 YSJG 组或安慰剂组。两组均有 12 周的治疗期和 12 周的随访期。在基线和 4、8、12 和 24 周时使用简短疼痛量表-简表(BPI-SF)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)和改良的手慢性类风湿关节炎评估和量化评分(M-SACRAH)进行评估。在纳入的 146 名参与者中,84 名被随机分配,77 名在 12 周时可评估。两组的基线特征具有可比性。主要结局是 12 周时 BPI-SF 评分的差异。YSJG 组的最差疼痛评分下降 3.10 分(50.2%;95%CI,2.50 至 3.65),而安慰剂组下降 1.63 分(26.9%;95%CI,3.86 至 4.97)(P=0.001)。WOMAC 和 M-SACRAH 也有显著改善。可能与 YSJG 相关的副作用为 10%的 1 级恶心和 2%的 2 级腹泻。在 YSJG 治疗前后,血清卵泡刺激素和雌二醇均保持在绝经后范围内。接受 YSJG 颗粒治疗的 AIMSS 患者肌肉骨骼症状有显著改善。YSJG 在治疗 AIMSS 方面有效、安全且耐受良好。

临床试验注册

ISCTN:ISRCTN80650567(2013 年 8 月 14 日分配)。

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