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OBJECTIVE@#To evaluate the clinical efficacy of Huangqi Sijunzi decoction (HQSJZD) for treating cancer-related fatigue (CRF) of spleen and stomach Qi deficiency type after chemotherapy in patients with breast cancer.@*METHODS@#A total of 94 breast cancer patients who developed CRF of spleen and stomach Qi deficiency type after chemotherapy were randomized into chemotherapy group (n=47) and traditional Chinese medicine (TCM) + chemotherapy group (n=47). The patients in chemotherapy group received the AC or EC regimen and non-drug interventions including psychological counseling, and those in TCM + chemotherapy group received oral administration of HQSJZD in addition to chemotherapy for 21 days as a treatment cycle, after which improvement of fatigue was assessed using Modified Piper Fatigue Scale. The active ingredients and targets of HQSJZD were screened using the TCM System Pharmacology Analysis Platform (TCMSP); the CRF- and breast cancer-related disease targets were retrieved based on data from the GeneCards, NCBI gene and OMIM databases to construct the component-target network and the protein-protein interaction (PPI) network. GO functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes KEGG pathway enrichment analysis of the target genes were performed to construct the component-disease-pathway-target biological network. The binding strength of the major drug ingredients and CRF key targets were predicted using AutoDock software.@*RESULTS@#The scores for somatic fatigue, emotional fatigue and cognitive fatigue, along with the overall fatigue score, showed more significant improvements in TCM+chemotherapy group than in chemotherapy group (P < 0.001), and the response rate reached 89.4% in the combined treatment group. We identified 250 targets for HQSJZD, 2653 CRF-related genes, 15 329 breast cancer-related genes and 161 prescription-disease intersected targets, from which topological analysis identified 66 potential key targets. GO and KEGG enrichment analyses predicted multiple pathways related with the disease. Molecular docking results suggested that the core ingredients of HQSJZD showed high affinities to the key targets AKT1, CASP3, IL6, JUN and VEGFA, among which AKT1 might be the most important target for HQSJZD to treat CRF.@*CONCLUSION@#HQSJZD can obviously improve CRF symptoms in breast cancer patients possibly by regulating multiple signaling pathways including PI3K-Akt through AKT1.
Subject(s)
Female , Humans , Breast Neoplasms/drug therapy , Drugs, Chinese Herbal/pharmacology , Medicine, Chinese Traditional , Molecular Docking Simulation , Network Pharmacology , Phosphatidylinositol 3-KinasesABSTRACT
OBJECTIVE@#To evaluate the clinical efficacy and partial action mechanism of mild moxibustion combined with salt-separated moxibustion for gastrointestinal discomfort caused by chemotherapy for breast cancer.@*METHODS@#A total of 48 patients were randomly divided into an observation group and a control group, 24 cases in each group. The patients in the control group were treated with intravenous infusion of tropisetron hydrochloride (5 mg), once a day for three days; the patients in the observation group were additionally treated with mild moxibustion at Zusanli (ST 36), Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6) and salt-separated moxibustion at Shenque (CV 8), 15 min per treatment, once a day for 7 days. Before treatment and on the 7th day of chemotherapy, the levels of pepsinogenⅠ(PGⅠ), pepsinogenⅡ (PGⅡ), the ratio of PGⅠto PGⅡ (PGR) and gastrin 17 (G-17) in serum were measured. Before treatment and on the 3rd, 5th, 7th day of chemotherapy, the gastrointestinal reactions (nausea, vomiting, constipation, diarrhea) were compared between the two groups.@*RESULTS@#On the 7th day of chemotherapy, the serum levels of PGⅠ, PGⅡand G-17 in the observation group were lower than those in the control group (0.05). The total scores of nausea, vomiting and constipation during chemotherapy in the observation group were significantly lower than those in the control group (all <0.05).@*CONCLUSION@#The mild moxibustion combined with salt-separated moxibustion could effectively improve the symptoms of nausea, vomiting and constipation caused by chemotherapy in patients with breast cancer, and its mechanism may be related to the down-regulation of the levels of PGⅠ, PGⅡ and G-17 in serum.
Subject(s)
Humans , Acupuncture Points , Breast Neoplasms , Therapeutics , Moxibustion , Nausea , Treatment OutcomeABSTRACT
Introduction: Breast cancer has a good prognosis when treated early. However, the mortality rate in Brazil is still high. The time interval between radiological suspicion and diagnosis/treatment impacts the survival. Methods: This is a retrospective crosssectional study that assessed patients treated at a reference center, with abnormal breast imaging findings and subsequent confirmation of breast cancer, from January 2011 to June 2015. We reviewed variables related to the dates of the abnormal test result, first mastology appointment, biopsy, surgery, and the start of chemotherapy when indicated. Time intervals were compared using the Friedman and Kruskal-Wallis tests with the software SPSS® 23.0. Results: We analyzed 65 patients. The median time between the abnormal test result and first mastology appointment was 35 days; between first mastology appointment and biopsy, 31 days; between biopsy and surgery, 85 days; and between surgery and chemotherapy, 137 days. The last two intervals showed significant differences (p<0.001). Discussion: Breast cancer patients had a significant delay until surgery and the start of chemotherapy. Early integration of the multidisciplinary team involved in this process and internal audits are necessary to optimize time intervals.
Introdução: O câncer de mama apresenta bom prognóstico quando tratado precocemente, entretanto, a mortalidade no Brasil continua elevada. O tempo entre suspeita radiológica e diagnóstico e tratamento tem impacto na sobrevida. Métodos: Foi realizado um estudo transversal e retrospectivo que avaliou pacientes atendidas em centro de referência com imagem mamária alterada e posterior confirmação de câncer de mama de janeiro de 2011 a junho e 2015. Foram revisadas variáveis relacionadas às datas do exame alterado, da primeira consulta, da biópsia, da cirurgia e do início da quimioterapia, quando indicada. Os intervalos de tempo foram comparados pelos testes Friedman e Kruskal-Wallis, pelo programa SPSS® 23.0. Resultados: Foram analisadas 65 pacientes. A mediana de tempo entre exame alterado e primeira consulta foi 35 dias, entre consulta na mastologia e biópsia foi 31 dias, entre biópsia e cirurgia foi 85 dias e entre cirurgia e quimioterapia foi 137 dias. Foram observadas diferenças significativas nos dois últimos intervalos (p<0,001). Discussão: As pacientes com câncer de mama apresentaram atraso significativo até a cirurgia e até o início da quimioterapia. Há necessidade da integração precoce da equipe multidisciplinar implicada nesse processo e auditorias internas a fim de otimizar os intervalos de tempo
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Objectives: Accurate medical information is essential among health care professionals to aid dissemination of information to the public. This study aimed to determine the level of knowledge about breast cancer and to identify related factors among undergraduate health sciences students in a public university in Terengganu, Malaysia. Methods: The respondents included students aged 18 years old or older who were enrolled in nursing, medical laboratory technician (MLT) and radiography diploma programmes. A Breast Cancer and Chemotherapy Questionnaire (BCCQ) was administered; higher scores on it indicated better knowledge. The reliability and validity of the BCCQ was considered adequate. Descriptive statistics, independent t test, one-way analysis of variance (ANOVA) and multiple logistic regressions were employed (SPSS 16). Results: A total of 239 respondents participated (mean age = 19.8 ± 0.1 years; females = 83.7%). The knowledge level was moderate. Females, nursing, and final-year students possessed significantly better knowledge. After adjusting for covariates, significant factors determining good breast cancer knowledge include being in the nursing discipline and years of study. Conclusion: This study has generally ascertained that knowledge related to breast cancer and chemotherapy among this sample population remains moderate and is not uniformly disseminated. An increase in knowledge is required to ensure an optimal level of knowledge, particularly for the junior students and those from courses other than nursing.
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Introducción: El cáncer de mama (CaMa), es uno de los cánceres más comunes en las mujeres, en México es la segunda causa de muerte. La quimioterapia es el tratamiento de elección común, que tienen profundo impacto en la vida de mujer, se ha observado que las mujeres presentan incertidumbre, por lo que comprender el fenómeno desde la experiencia que ellas viven, motivó a indagar sobre el significado que las mujeres CaMa de atribuyen a la quimioterapia. Objetivo: Develar el significado que las mujeres con cáncer de mama le atribuyen a la quimioterapia. Metodología: Investigación de enfoque cualitativo, se utilizó como método la fenomenología interpretativa, la información se obtuvo mediante entrevistas semiestructuradas a seis pacientes con cáncer de mama en tratamiento de quimioterapia previo consentimiento informado, durante el período de Noviembre de 2009 a noviembre de 2010 en una Institución de tercer nivel de atención en el Distrito Federal. Resultados: Se encontraron cuatro temas: 1.apoyo familiar. En donde la familia es una fuente de apoyo maternal, filial fraternal y de pareja, en el seguimiento del tratamiento. 2. sentimientos y emociones vivenciados durante el diagnóstico. Transitan por el proceso de vivir una enfermedad estigmatizaste construida por miedo cólera e incertidumbre. 3. efectos físicos y emocionales del tratamiento. La quimioterapia es una oportunidad para seguir viviendo aún con el miedo a los efectos secundarios. 4. percepción de la atención percibida por la institución, emergieron temas de percepción del personal médico y de enfermería. Conclusiones: El vivir una enfermedad estigmatizaste asociada a la muerte matizada por los efectos físicos y emocionales, llevan a sentir a las pacientes cuerpo diferente, aunado al trato que reciben por parte del personal médico y de enfermería, el tratamiento significa un infierno, sin embargo es una esperanza para prolongar el tiempo de vida. Por consiguiente la comprensión del fenómeno puede constituir un medio para sensibilizar al personal de salud y proporcionar un cuidado humano, e individualizado centrado en las necesidades de la persona, con acompañamiento durante el proceso.
Introduction: Breast cancer (CaMa) is one of the most common cancers in women, in Mexico it is the second cause of death. Chemotherapy is the treatment of common choice, which has a profound impact on the life of women, it has been seen that women present uncertainty, so they understand the phenomenon from the experience they live, prompted an inquiry into the meaning that CaMa women attribute it to chemotherapy. Objective: To reveal the meaning that women with breast cancer attribute to chemotherapy. Methodology: Qualitative approach research, interpretive phenomenology was identified as a method, the information was made through semi-structured interviews with six patients with breast cancer undergoing chemotherapy treatment with prior informed consent, during the period of November 2009 to November 2010 in a tertiary care institution in the District Federal. Results: Four themes were found: 1. family support. Where the family is a source of maternal, fraternal and partner support, in the follow-up of treatment. 2. feelings and emotions experienced during the diagnosis. They go through the process of living a stigmatized disease built out of fear, anger and uncertainty. 3. physical and emotional effects of treatment. Chemotherapy is an opportunity to continue living in fear of side effects. 4. perception of the care perceived by the institution, issues of perception of medical and nursing staff emerged. Conclusions: Living a stigmatized disease associated with death nuanced by physical and emotional effects, leading patients to feel different bodies, coupled with the treatment received by the personal doctor and nurse, the treatment means hell, however it is a hope to prolong the life time. Therefore, understanding the phenomenon can constitute a means to sensitize health personnel and provide humane care, individually focused on the needs of the person, with accompaniment during the process.
Introdução: O câncer de mama (CaMa) é um dos cânceres mais comuns em mulheres, no México é a segunda causa de morte. A quimioterapia é o tratamento de escolha comum, que tem um profundo impacto na vida das mulheres, observou-se que as mulheres têm incerteza, entendendo o fenômeno a partir da experiência que vivem, motivadas a indagar sobre o significado que as mulheres CaMa atribuído à quimioterapia. Objetivo: Revelar o significado que as mulheres com câncer de mama atribuem à quimioterapia. Metodologia: pesquisa de abordagem qualitativa, a fenomenologia interpretativa foi utilizada como método, as informações foram obtidas por meio de entrevistas semiestruturadas de seis pacientes com câncer de mama em quimioterapia, mediante consentimento prévio e informado, durante o período de novembro de 2009 a novembro de 2010 em uma instituição de terceiro nível de atenção no Distrito Federal Resultados: Foram encontrados quatro temas: 1. apoio familiar. Onde a família é fonte de apoio materno, subsidiária fraterna e de casal, no acompanhamento do tratamento. 2. sentimentos e emoções experimentados durante o diagnóstico. Eles passam pelo processo de viver uma doença estigmatizada criada pelo medo da raiva e da incerteza. 3. Efeitos físicos e emocionais do tratamento. A quimioterapia é uma oportunidade de continuar vivendo, mesmo com medo de efeitos colaterais. 4. percepção da atenção recebida pela instituição, surgiram questões de percepção da equipe médica e de enfermagem. Conclusões: Vivendo uma doença estigmatizada associada à morte, matizada por efeitos físicos e emocionais, leva os pacientes a sentirem um corpo diferente, associado ao tratamento que recebem da equipe médica e de enfermagem; o tratamento significa um inferno, no entanto É uma esperança para prolongar o tempo de vida. Portanto, a compreensão do fenômeno pode constituir um meio de sensibilizar a equipe de saúde e prestar um atendimento humano e individualizado, centrado nas necessidades da pessoa, com acompanhamento durante o processo.
Subject(s)
Female , Breast NeoplasmsABSTRACT
@#Objective To observe the level of social support and self-efficacy of the breast cancer patients with postoperative chemotherapy, and study the relationship between them. Methods 76 patients were investigated with Social Support Rating Scale and Strategies Used by Patients to Promote Health (SUPPH). Results The total and every dimension scores of SUPPH and Social Support decreased in the patients. The total and every dimension scores of Social Support positively correlated with every dimension scores of SUPPH (P<0.01). Conclusion The level of self-efficacy and social support may relate each other.