Yang Shu-Yi, Livneh Hanoch, Jhang Jing-Siang, Yen Shu-Wen, Huang Hua-Lung, Chan Michael W Y, Lu Ming-Chi, Yeh Chia-Chou, Wei Chang-Kuo, Tsai Tzung-Yi
Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan.
Department of Biomedical Sciences, National Chung Cheng University, Chiayi, Taiwan.
Front Psychol. 2022 Aug 18;13:884337. doi: 10.3389/fpsyg.2022.884337. eCollection 2022.
Breast cancer patients are at elevated risk of depression during treatment, thus provoking the chance of poor clinical outcomes. This retrospective cohort study aimed to investigate whether integrating Chinese herbal medicines citation(CHM) into conventional cancer therapy could decrease the risk of depression in the long-term breast cancer survivors.
A cohort of patients aged 20-70 years and with newly diagnosed breast cancer during 2000-2008 was identified from a nationwide claims database. In this study, we focused solely on survivors of breast cancer at least1 year after diagnosis. After one-to-one matching for age, sex, and baseline comorbidities, breast cancer patients who received ( = 1,450) and did not receive ( = 1,450) CHM treatment were enrolled. The incidence rate and hazard ratio citation(HR) for depression between the two groups was estimated at the end of 2012. A Cox proportional hazard model was constructed to examine the impact of the CHM use on the risk of depression.
During the study period, the incidence rate of depression was significantly lower in the treated cohort than in the untreated cohort [8.57 compared with 11.01 per 1,000 person-years citation(PYs)], and the adjusted HR remained significant at 0.74 (95% CI 0.58-0.94) in a Cox proportional hazards regression model. The corresponding risk further decreasing to 43% among those using CHM for more than 1 year.
Finding from this investigation indicated that the lower risk of depression observed in breast cancer patients treated with CHM, suggesting that CHM treatment should be considered for disease management toward breast cancer. Yet, the optimal administered dose should be determined in further clinical trials.
乳腺癌患者在治疗期间患抑郁症的风险升高，从而增加了临床预后不良的可能性。这项回顾性队列研究旨在调查将中药引用（CHM）纳入传统癌症治疗是否能降低长期乳腺癌幸存者患抑郁症的风险。
从全国索赔数据库中识别出一组年龄在20 - 70岁之间、在2000年至2008年期间新诊断为乳腺癌的患者。在本研究中，我们仅关注诊断后至少1年的乳腺癌幸存者。在按年龄、性别和基线合并症进行一对一匹配后，纳入了接受（n = 1450）和未接受（n = 1450）CHM治疗的乳腺癌患者。在2012年底估计两组之间抑郁症的发病率和风险比引用（HR）。构建Cox比例风险模型以检验CHM使用对抑郁症风险的影响。
在研究期间，治疗组的抑郁症发病率显著低于未治疗组[每1000人年引用（PYs）分别为8.57和11.01]，并且在Cox比例风险回归模型中，调整后的HR仍显著为0.74（95%CI 0.58 - 0.94）。在使用CHM超过1年的患者中，相应风险进一步降至43%。
这项调查的结果表明，接受CHM治疗的乳腺癌患者患抑郁症的风险较低，这表明在乳腺癌的疾病管理中应考虑CHM治疗。然而，最佳给药剂量应在进一步的临床试验中确定。
