乳腺癌内分泌治疗主要用于乳腺癌患者的术前新辅助治疗、术后辅助治疗和晚期乳腺癌的解救治疗。骨质疏松症是 乳腺癌内分泌治疗的常见不良反应，严重影响患者的生活质量。肝肾同源与骨质疏松症的病因病机及治则密切相关。乳腺 癌内分泌治疗相关性骨质疏松症的发病与肝肾的关系最为密切，其病机特点为本虚标实，本虚为肝肾不足，标实为瘀血阻 络。补益肝肾的中医药干预可用于乳腺癌患者的不同内分泌治疗阶段。在术前新辅助治疗阶段，中医药干预应重在攻癌， 与新辅助治疗协同发挥抗癌功效，辅以扶正，减少不良反应的发生率，可选用六味地黄丸加减治疗。在术后辅助治疗阶段， 中医药干预应重在扶正，帮助患者恢复身体机能，预防骨质疏松症，可选用独活寄生汤、左归丸等加减治疗。在晚期解救 治疗阶段，治疗以扶正为主要方向，用药除选用补益肝肾、强筋壮骨、行气活血止痛等方药外，还可增加血肉有情之品， 以增强补益肝肾之效果。

Endocrine therapy is mainly used as preoperative neoadjuvant therapy and postoperative adjuvant therapy for breast cancer patients and as salvage therapy for advanced breast cancer patients. Osteoporosis is the common adverse reaction of endocrine therapy for breast cancer，which seriously affects the quality of life of the patients. The theory of “liver and kidney sharing the common source” is closely related to the etiology， pathogenesis and therapeutic principle of osteoporosis. It is believed that the pathogenesis of endocrine therapy associated osteoporosis in breast cancer is most closely related to liver and kidney， and is characterized by deficiency in origin and excess in superficiality. Deficiency in origin manifests as deficiency of liver and kidney， and excess in superficiality manifests as blood stasis blocking collaterals. Chinese herbal medicine with the actions of nourishing liver and kidney can be used for interventions of various stages of endocrine therapy for breast cancer. In the stage of preoperative neoadjuvant therapy， Chinese herbal medicine intervention focuses on inhibiting cancer， so as to achieve synergistic anticancer actions with neoadjuvant therapy； the intervention can also be supplemented by medicine for supporting healthy qi with modified Liuwei Dihuang Pills， thus to reduce the incidence of adverse reactions. In the stage of postoperative adjuvant therapy， Chinese herbal medicine intervention focuses on supporting healthy qi， so as to promote the recovery of body functions and prevent the occurrence of osteoporosis，and modified treatment with Duhuo Jisheng Decoction or Zuogui Pills can be chosen. In the advanced stage of salvage treatment，Chinese herbal medicine intervention focuses on supporting healthy qi， and medicines for nourishing liver and kidney， strengthening muscles and bones， and activating qi and blood circulation to relieve pain can be chosen；in addition，medicinals with affinity to flesh and blood can be added to enhance the actions of nourishing liver and kidney.

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国家自然科学基金项目（编号：82174454）