RÉSUMÉ
Objective To explore the clinical efficacy and safety of Xuefu Zhuyu decoction as an adjuvant chemotherapy in patients with advanced cervical cancer.Methods This study recruited advanced cervical cancer patients who underwent TP regimen(paclitaxel+cisplatin)chemotherapy in Luzhou District People's Hospital in Changzhi City from January 2019 to January 2021.According to the random number table method,patients with advanced cervical cancer were divided into a control group(treated with TP regimen)and an test group(treated with TP regimen combined with Xuefu Zhuyu decoction).The serum tumor marker levels(carcinoembryonic antigen,squamous cell carcinoma antigen and carbohydrate antigen 125),traditional Chinese medicine syndrome scores and clinical efficacy[objective response rate,disease control rate and overall survival time]between two groups of patients were observed and compared.The occurrence of adverse drug reactions was assessed according to the Common Terminology Standard for Adverse Events(CTCAE 4.03).Results A total of 92 cases of advanced cervical cancer were included in this study,with 46 cases in each group.Before treatment,there was no significant statistical difference in the serum tumor marker levels and traditional Chinese medicine syndrome scores between the control group and the test group with advanced cervical cancer(P>0.05).After treatment,the serum tumor marker levels and traditional Chinese medicine syndrome scores in the test group and the control group significantly decreased compared to before(P<0.05),and they were significantly lower in the test group than those in the control group(P<0.05).In terms of clinical efficacy,there was no significant difference in objective response rate between two groups(P>0.05),while the disease control rate and median overall survival time of the test group were significantly higher than those of the control group(P<0.05).In terms of safety,no fatal adverse events were observed,and most adverse events were mild and controllable.In addition,there was no significant difference in the incidence of nausea and vomiting,anemia,thrombocytopenia and renal dysfunction between two groups(P>0.05),while the incidence of leukopenia and liver function injury in the test group were significantly lower than those in the control group(P<0.05).Conclusion Xuefu Zhuyu decoction can significantly improve the efficacy of chemotherapy patients with advanced cervical cancer,reduce serum tumor marker expression levels,improve traditional Chinese medicine syndrome scores,increase disease control rate,prolong overall survival,and has high safety.
RÉSUMÉ
BACKGROUND:Increasing evidence has shown that insulin-like growth factor-1 (IGF-1) plays a regulatory role in bone metabolism and increases bone formation,stimulates osteoblast number and activity,as well as reduces osteoclast differentiation and bone resorption.The mechanism of IGF-1 is an issue of concern.OBJECTIVE:To review the research advance in IGF-1 and the bone metabolism-related indexes in postmenopausal osteoporosis.METHODS:The first author searched the PubMed and CNKI databases between January 2012 and July 2016 using the keywords of "postmenopausal osteoporosis,insulin-like growth factor,bone metabolism,biochemical markers" in English and Chinese,respectively.The repetitive articles were excluded,and 36 eligible articles were enrolled for overview.RESULTS AND CONCLUSION:Bone resorption is increased in postmenopausal woman through the regulation of a variety of cytokines,in which IGF-1 in the blood is combined with IGF binding protein 3,making growth hormone play its biological role.In addition,the growth hormone in the blood directly acts on the adipose tissue,and muscle and bones.Growth hormone exerts a direct effect on bone tissue,promotes osteoblast maturation and differentiation,and enhances the expression of collagen and non-collagen through IGF-1-mediated indirect effect,thus promoting bone formation.The process of bone metabolism is able to reflect the activities of osteoblasts and osteoclasts and the changes of bone matrix and bone mineralization.In vitro experiments show that IGF-1 stimulates the proliferation of osteoblast precursors and differentiate into osteoblasts in a dose-dependent manner,promotes the expression of osteogenic markers such as alkaline phosphatase,type Ⅰ collagen,and osteocalcin,and also stimulates the activity and number of osteoclasts.However,there are few clinical reports and few observation indicators,resulting in a lack of reference range for the detection and treatment of osteoporosis,which needs further exploration.