Clinical Observation Of "Shungan Tiaozhi Decoction" Combined With Lipitor In The Treatment Of Dyslipidemia After Endocrine Therapy Of Breast Cancer

objectiveThe purpose of this study was to observe the effects of "Shugan Tiaozhi" decoction combined with Lipitor on blood lipid,TCM symptoms,side effects associated with the combination of third-generation nonsteroidal aromatase inhibitors and Lipitor,tumor markers,estrogen and quality of life of patients.To provide scientific evidence for clinical promotion of "Shugan Tiaozhi" decoction.methods60 patients who met the inclusion criteria were divided into treatment group(30 patients)and control group(30 patients).The treatment group was given 1 mg qd po of anastrozole or 2.5 mg qd po of letrozole,and 10 mg qd po of Lipitor.on this basis,the treatment group was given Shugan Tiaozhi decoction granules twice a day,once a bag.The control group was given 1 mg qd po of anastrozole or 2.5 mg qd po of letrozole and 10 mg qd po of Lipitor.The total course of treatment was 3 months.Serum lipids(TG,TC,HDL-c,LDL-c),tumor markers(CEA,ca125,ca153),Estrogen(E2),safetyindicators(bloodroutine,BUM,Cr,ALT,AST,C K),TCM symptom score,side effects associated with the combination of third-generation nonsteroidal aromatase inhibitors and Lipitor scale score and KPS score were observed before treatment and after 90 days treatment.Blood lipids and safety indicators were monitored after 30 days treatment.Compare the differences between the two groups.resultsIn this study,we selected 60 patients who met the inclusion criteria from may 2017 to January 2018 in the Dongfang Hospital of BUCM,or The Cancer Hospital Chinese Academy Of Medical Sciences.There were 2 patients in the treatment group who failed to complete the treatment course,one case in the control group was not followed up;one patient was withdrawn from the control group due to elevated creatine kinase.In the end,56 patients completed the experiment,28 patients in the treatment group and 28 patients in the control group.There was no statistical difference in age,stage,pathological type,endocrine drug type and duration of endocrine drug treatment between the two groups before treatment.1.blood lipid rusult1.1 TC change:After 30 days of treatment,the mean TC value of the treatment group was 4.53 lower than that of the control group(5.01).there was significant difference between the two groups(P<0.01).There was no significant difference between the two groups after 90 days of treatment(P>0.05).It is suggested that "Shugan Tiaozhi" decoction combined with Lipitor can reduce TC more quickly.1.2TG change:There was no significant difference between the two groups after 30 days of treatment(P>0.05).After 90 days of treatment,there was significant difference between the two groups(p<0.05).TG in the treatment group was lower than that in the control group.It is suggested that "Shugan Tiaozhi" decoction can decrease the level of triglyceride in patients.1.3HDL-C change:HDL-C levels were higher in both groups at 30 days and 90 days after treatment,but there was no significant difference between the two groups(p>0.05).It is considered that Shugan Tiaozhi decoction alone may have little effect on HDL-c level.1.4 Efficacy evaluation:After 30 days of treatment,the total effective rate in the treatment group was 64.2%,and in the control group was 46.4%(p<0.05).After 90 days of treatment,the total effective rate in the treatment group was 92.8%,and in the control group was 89.2%(p>0.05).1.5TCM symptom change:After treatment there was no significant difference in dizziness symptom score between the two groups.There were significant differences in the scores of irritability,chest and abdomen distension,fullness after eating,asthenia and limb drowsiness(p<0.05).The scores of symptoms in the treatment group were lower than those in the control group.The total effective rate was 82.1%in the treatment group and 21.4%in the control group,(p<0.05).1.6Adverse reactions associated with the combination of third-generation nonsteroidal aromatase inhibitors and Lipitor change:There were significant differences in the scores of myalgia,headache and nausea between the treatment group and the control group before treatment(p<0.05).After treatment,the scores of depression and asthenia in the treatment group were significantly lower than those in the control group(p<0.05),but there was no significant difference in the scores of flashes,arthralgia.myalgia and headache between the two groups(p>0.05).The total effective rate was 79.6%in the treatment group and 14.3%in the control group(p<0.05).1.7Tumor markers and Estrogen change:The levels of ca125,ca153,CEA and E2 in the two groups had no significant change before and after treatment.1.8KPS score and safety index change:The KPS score of the treatment group was 88.93 higher than that of the control group(79.57)(p<0.05).One patient in the control group had myalgia and creatine kinase elevation after 2 weeks treatment.recovery after withdrawal.Other patients in both groups are normal.Conclusion1.Shugan Tiaozhi decoction combined with Lipitor can reduce TC and LDL-C faster.2.Shugan Tiaozhi decoction combined with Lipitor can reduce the level of TG.3.Shugan Tiaozhi decoction combined with Lipitor can elevated the level of HDL-C.4.Shugan Tiaozhi decoction combined with Lipitor can improve some symptoms of TCM in patients with "GanyuPiXu" syndrome.5.Shugan Tiaozhi decoction combined with Lipitor can improve some adverse reactions of the third generation of non-steroidal aromatase inhibitors combined with Lipitor.6.Shugan Tiaozhi decoction combined with Lipitor had no effect on tumor markers and estrogen level.7.Shugan Tiaozhi decoction combined with Lipitor was safe,also It can improve the quality of life of patients.