The Study Of Investigation On The Clinical Symptoms And The Rules Of Traditional Chinese Medicine Of AIMSS In Breast Cancer

ObjectiveThe article is to study the incidence and clinical symptoms and clinical medications usage in postmenopausal breast cancer patients taking aromatase inhibitors(AIs)and analyze the rule of traditional Chinese medicine(TCM),which make clinicians have a more comprehensive understanding with aromatase inhibitor-associated musculoskeletal symptoms(AIMSS).They also provide reference for clinicians to find out and treat AIMSS in the early stage.Methods1.After completing the questionnaire,the clinical follow-up was conducted for postmenopausal breast cancer patients who started AIs endocrine therapy and basic information was collected.The clinical characteristics of patients with and without AIMSS breast cancer were analyzed.2.Patients with musculoskeletal symptoms in this study were required to fill out the Brief Pain Inventory-Short Form(BPI-SF)and The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)and The Modified Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands(M-SACRAH)at baseline,after 6 weeks and 12 weeks follow-up,and are observed the rating scale change.3.TCM prescriptions of AIMSS patients were collected for frequency analysis and cluster analysis.Resuls1.A total of 146 postmenopausal breast cancer patients were included in this study,with an average age of 61.74 years and a median age of menopause of 50 years.The average menopausal time was 12.26 years,and the average time of taking AIs was about 6 months.Of the 146 patients,68 patients(46.6%)were reported muscle and joint pain.Among them,60 patients(41.1%)showed symptoms of muscle and joint pain,and 56 patients(38.4%)showed symptoms of joint stiffness,mainly manifested as mild and moderate discomfort.82.4%of patients appeared symptoms within 90 days.Symptoms mainly appeared in the hands,knees and waist,accounting for 64.7%,39.7%and 17.6%of the total population,respectively.2.There was no significant correlation between the occurrence of AIMSS in postmenopausal breast cancer patients and the time of menopause,BMI,bone density,stage and molecular classification of breast cancer,surgical method,chemotherapy,radiotherapy and targeted therapy(p>0.05).However,there was a statistical difference between the symptomatic group and the asymptomatic group in the previous history of muscle and joint disease and the use of different types of AIs,with a p value of less than 0.05.In the symptomatic group,more patients(72.0%)had a history of muscle and joint disease.In Medication,58.8%of patients in the symptomatic group took anastrozole,compared with 41%in the asymptomatic group.3.During clinical follow-up,scores of BIMS-SF scale,M-SACRAH scale and WOMAC scale of AIMSS patients after 6-week and 12-week follow-up were lower than those at baseline.The scores of each scale of 12 weeks’follow-up decreased more(P<0.05),and the difference was statistically significant.4.In terms of the medication rules of TCM,a total of 82 prescriptions of herbal medicine were collected,and 139 herbs were obtained,with a total of 1105 occurrences.There were 31 high frequency TCM herbs that appeared more than 10 times,and the cumulative frequency was 65.5%.There were 9 herbs occurring more than 30 times,which be respectively for poria cocos,atractylodes,yam,astragalus,codonopsis,coix seed,licorice,wolfberry,shan yu meat.The 31 high frequency Chinese medicines were divided into 14 categories.The first three categories are tonic medicine(35.6%),diuretic and dampness medicine(9.5%),and blood activating and stasis removing drugs(6.4%).The highest frequency of medicinal property was warm(30.3%),and the second was planally(27.3%).The frequency of sweet taste was the highest,accounting for 71.0%..Spleen,lung,kidney and liver were the main distribution of drugs in zang-fu and meridians,and their occurrence frequency was 40.1%,30.0%,27.7%and 21.9%,respectively.Cluster analysis was carried out on 31 high-frequency TCM,which were divided into 6 clustering prescriptions.Poria cocos is in the first category.The second category is codonopsis;The third category is rhizoma atractylodes,astragalus and Chinese yam.The fourth category is:coix seed,licorice,cornus officinalis,medlar;The fifth category is rhizoma zedoary,radix pseudostellariae,rhizoma corydalis,hyacinth,tangerine peel,peony,eucommia ulmoides,cuscuta,cinnamomum SPP.The 6th kind is alisma,malt,pinellia miltiorrhiza,radix salviae miltiorrhiza,radix ophiopogonis,spatholobus spatholobi,sand kernel,cistanche cistanche,white hyacinth bean,jujube kernel,radix aconitae spatholobi.Conclusion1.The incidence of musculoskeletal and joint symptoms in postmenopausal breast cancer patients after taking AIs is 46.6%,and 82.4%of patients appeared within 90 days.Previous history of muscle and joint pain and different AIs treatment drugs showed statistically difference between AIMSS patients and asymptomatic patients.After 6 weeks and 12 weeks of clinical follow-up,AIMSS patients’ scores of each scale decreased,and compared with baseline,the difference was statistically significant after 12 weeks’follow-up.2.In clinical patients with AIMSS,TCM was mainly used for tonic,with proper use of water infiltration and moistening drugs,and drugs to promote blood circulation and remove stasis.The main channels of zang fu were spleen,lung,kidney and liver.The main property and taste of Chinese medicine were warm and sweet.According to the high frequency traditional Chinese medicine clustering analysis,the clustering formula is reasonable and can be used as a reference for clinical treatment.