Meta-analysis Of The Adverse Reactions Related To Endocrine Therapy In The Prevention And Treatment Of Breast Cancer With Traditional Chinese Medicine And Mining Of The Rules Of Medication

Objective:To evaluate the effectiveness and safety of traditional Chinese medicine to adverse reactions of endocrine therapy for breast cancer.To analyze composition principles of the prescriptions for the treatment of adverse reactions of endocrine therapy for breast cancer.Methods:According to the systematic review writing manuals,which is produced by Cochrane collabiation network.Six domestic and abroad databases were screened by computer until2018.Randomized controlled trials(RCT)that Chinese medicine to side effect of endocrine therapy for breast cancer were included,BMD,E2and kupperman scores were choosen as outcome.The evaluation of the quality was performed using Cochrane Risk of Bias Tool and the data was analyzed by using RevMan5.3,Mean difference(MD)and95%confidence interval(CI)were used to describe quantitative data.The prescription for side effect of endocrine therapy for breast cancer are collected,sorted,entered in to TCM inheritance system.And analyzed the medication rules of Chinese medicines in the treatment of adverse reactions of endocrine therapy for breast cancer.Results:There are 64 RCT included in the meta-analysis,and only 4 were performed by blind method.Meta analysis of the effect of traditional Chinese medicine on osteoporosis in breast cancer patients:combined effect volume MD=0.08(95%CI[0.06,0.10]),overall effect test Z=8.64(p<0.001),the difference was statistically significant.Meta-analysis of the effect of traditional Chinese medicine on estrogen level in postmenopausal breast cancer patients:the combined effect value MD=0.53(95%CI[-0.14,1.211),and the overall effect test Z=0.69(p=0.49),the difference was not statistically significant.Based on the analysis of 129 cases of prescriptions,the most commonly used drugs are poria cocos,atractylodes macrocephala and paeoniae alba,twenty-nine medications with more than 18 frequencies are mined from the database.Statistics showed that there were 12core combinations and 6 new prescriptions are found by hierarchical clustering method.Each of prescriptions climacteric syndrome and osteoporosis,finding 3 new prescriptions by hierarchical clustering method.Conclusion:Traditional Chinese medicine can improve the bone density of patients with endocrine therapy for breast cancer.also has no effect on estradiol level in premenopausal and postmenopausal breast cancer patients.The effect of traditional Chinese medicine on endocrine therapy of breast cancer is significant.TCM inheritance system is a useful tool to analyze the composition principles of prescription.