中医周期疗法对乳腺增生伴乳痛患者内分泌激素及症状的改善观察  

Effect of TCM Periodic Therapy in Improvement of Endocrine Hormones and Symptoms of Patients with Breast Hyperplasia and Breast Pain

作　　者：林旭丰 严梅娣 谢小红[3] 杨真 封伟亮[4] 曲冬梅 

机构地区：[1]丽水市中医医院乳腺科,浙江丽水323000 [2]宁波市第七医院普外科,浙江宁波315202 [3]浙江省中医院乳腺诊疗中心,浙江杭州310006 [4]浙江省肿瘤医院乳腺外科,浙江杭州310022

出　　处：《中华中医药学刊》2017年第3期745-748,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：丽水市第四批医学重点学科项目(20140131)

摘　　要：目的:探讨中医周期疗法对乳腺增生伴乳痛患者内分泌激素及症状的改善效果。方法:回顾性分析104例伴乳痛症状的乳腺增生症患者临床资料,根据其用药情况分为研究组(n=62)和对照组(n=42)两组,分别予以中医周期疗法(经前予以柴胡舒肝散加减+经后予以六味地黄汤加减+二至丸)和西药疗法(枸橼酸他莫昔芬片,10 mg/次,2次/d,口服),2个月经周期后观察疗效。对比其治疗前后临床症状(乳腺胀痛、乳头溢液、月经失调)评分、内分泌激素指标[雌二醇(E2)、孕酮(PRG)、催乳素(PRL)]变化情况,分析其临床疗效、用药不良反应发生情况、3个月内症状复发率及肿块最大直径缩小程度差异。结果:治疗2个月经周期后,研究组治疗总有效率为98.39%,显著高于对照组的88.10%(P<0.05);两组受试者乳腺胀痛、乳头溢液、月经失调等症状评分均较治疗前显著降低,且研究组<对照组[(3.14±0.65)分vs(4.93±1.70)分,P<0.05]。两组受试者除PRG水平较治疗前无明显变化(P>0.05)外,E2水平均较治疗前显著提升,且研究组>对照组[(75.63±4.21)pmol/L vs(71.26±3.96)pmol/L,P<0.05];PRL水平[(2.55±0.50)μg/L vs(2.86±0.46)μg/L,P<0.05]及乳房肿块最大直径[(0.83±0.25)cm vs(1.13±0.33)cm]则较治疗前明显降低,且研究组<对照组(P<0.05)。两组患者3个月内症状复发率比较差异无统计学意义(P>0.05),但研究组不良反应发生率显著低于对照组(0.00%vs7.14%),差异具有统计学意义(P<0.05)。结论:对伴乳痛症状的乳腺增生症患者予以中医周期疗法,能有效调节其内分泌激素水平、促进病情转归,于患者预后恢复有利。Objective： To explore the effect of traditional Chinese medicine （TCM） periodic therapy in the improvement of endocrine hormones and symptoms of patients with breast hyperplasia and breast pain. Methods ： The clinical data of 104 patients with breast hyperplasia complicated with breast pain was analyzed retrospectively. According to the situa- tion of drug use, the patients were divided into study group （ n = 62 ） and control group （ n = 42 ）. The two groups were treated with TCM periodic therapy （modified Chaihu Shugan Powder before menstruation combined with modified Liuwei Dihuang Decoction and Erzhi Pill） and western medicine therapy （tamoxifen citrate tablets, 10 mg/times ,twice/day, orally） respectively. After two cycles of menstruation, the curative effects were observed. The changes of scores of clinical symptoms （ breast swelling pain, nipple discharge, menstrual disorder） and endocrine hormone indexes [ estradiol （ E2 ）, progesterone （PRG） , prolactin（PRL） ] before and after treatment were compared between the two groups. The differences in clinical curative effect, incidence of adverse drug reactions, recurrence rate of symptoms in 3 months and reduction de- gree of the maximum diameter were analyzed. Results ： After 2 cycles of menstruation, the total effective rate in the study group （98.39%） was significantly higher than that in the control group （P 〈 0. 05 ）. The scores of symptoms such as breast swelling pain, nipple discharge and menstrual disorder in the two groups of subjects were significantly lower than those before treatment, and study group 〈 control group [ （3.14 ± 0.65 ） vs （4.93 ± 1.70） , P 〈 0. 05 ]. There were no significant changes of PRG levels in the two groups of subjects before and after treatment （ P 〉 0. 05 ）. E2 levels were significantly higher than those before treatment and study group 〉 control group [ （75.65 ±4.21） pmol/L vs. （71.26± 3.96） pmol/L, P 〈 0.05 ] while PRL levels [ （2.55 ±0.

关 键 词：中医周期疗法 乳腺增生 乳痛 内分泌激素 临床症状 

分 类 号：R655.8[医药卫生—外科学]