| Objective: To observe the effect of Bushen Huatan Decoction plus zoledronic acid on serum TRACP5 b level in patients with bone metastasis of breast cancer of Kidney-Deficiency and phlegm-coagulation type,and to study the mechanism of Bushen Huatan Decoction in inhibiting bone metastasis of breast cancer;To verify the efficacy of Bushen Huatan Decoction by comparing the improvement of TCM symptom score,KPS score,bone metastasis focus and equivalent oral morphine dose of two groups.Methods:Sixty breast cancer patients with bone metastasis were selected.According to the random number table,the patients were divided into treatment group(30 cases)and control group(30 cases).On the 1st to 3rd day of treatment,the dosage of analgesics was titrated to NRS score < 4 in all patients treated with opioid analgesics.On the fourth day of treatment,the treatment group received intravenous drip of 4 mg zoledronic acid injection,once every 4 weeks,and oral Bushen Huatan Formula Granules,once a day,once in the morning and once in the evening,once every 4 weeks as a course of treatment;the control group was only given zoledronic acid injection(dosage,usage and frequency of the same treatment group),and the curative effect was evaluated after 2 courses of treatment.Enzyme-linked immunosorbent assay(ELISA)was used to detect the changes of serum TRACP5 b.The improvement of TCM symptom score,serum TRACP5 b content,KPS score and bone metastasis were observed on the first day and the last day of treatment.The changes of equivalent oral morphine dosage in the fourth and last 24 hours were observed and analyzed statistically.Results: Before treatment,there were no significant differences in age,KPS score,NRS score,TCM symptom score,distribution of bone metastases,equivalent oral morphine dose and serum TRACP5 b content between the two groups(P > 0.05).After treatment:1.The serum TRACP5 b level in the treatment group was lower than that in the control group after treatment,and the difference was statistically significant(P < 0.01).2.Quality of life assessment showed that the effective rate of the treatment group was 83.3%,and that of the control group was 43.3%.Bushen Huatan Decoction combined with zoledronic acid and zoledronic acid alone improved the quality of life to some extent,but the difference was statistically significant(P <0.05).3.Improvement of bone metastases.Comparing the imaging findings before and after treatment,there were 0 cases of complete remission(CR)and 19 cases of partial remission(PR)in the treatment group,with an effective rate of 63.3%,0 cases of complete remission(CR)and 16 cases of partial remission(PR)in the control group,with an effective rate of 53.3%.Compared with the control group,the therapeutic effect of the treatment group was better,but there was no significant difference(P >0.05).4.TCM symptom score.After treatment,the effective rate of improving TCM symptoms in TCM combined with zoledronic acid group was 86.7%,and that in single zoledronic acid group was 56.7%.The difference was statistically significant(P <0.05).5.Equivalent oral morphine dose in the treatment group was significantly lower than that before treatment(P < 0.01).The equivalent oral morphine dose in the control group was significantly lower than that before treatment(P < 0.01).After treatment,the equivalent oral morphine dose was reduced in both groups,but the difference was statistically significant(P < 0.01).Compared with the control group,the difference of equivalent oral morphine dose before and after treatment in the treatment group was greater,with statistical difference(P < 0.01).Conclusions: Bushen Huatan Decoction combined with zoledronic acid can reduce the level of serum TRACP5 b in treatment group,inhibit osteolytic effect of osteoclasts,delay the development trend of bone metastasis of breast cancer,alleviate bone pain,reduce the dosage of opioid analgesics,and improve the quality of life.It is worthy of clinical application and promotion. |
