针药并用对肝郁痰凝型乳腺增生病患者内分泌激素与血管生成因子的影响  

Effects of Acupuncture Combined with Medication on Endocrine Hormones and Angiogenic Factors in Patients with Mammary Gland Hyperplasia of Liver Depression and Phlegm Coagulation Pattern

作　　者：杨甫臣[1] 张世超 YANG Fu-chen;ZHANG Shi-chao(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China)

机构地区：[1]辽宁中医药大学附属医院,沈阳110032

出　　处：《上海针灸杂志》2021年第6期709-714,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家“十二五”科技支撑计划项目(2014BAI10B00)。

摘　　要：目的观察在口服西药治疗基础上针刺联合自拟消结通乳汤治疗肝郁痰凝型乳腺增生病(MGH)的临床疗效,并观察其对患者内分泌激素与血管生成因子的影响。方法纳入肝郁痰凝型MGH患者120例,采用对应随机数字表法分为观察组和对照组,每组60例。对照组口服枸橼酸他莫昔芬片,观察组在对照组治疗基础上加用针刺联合自拟消结通乳汤治疗。比较两组临床疗效,并观察两组治疗前后乳腺增生症状评分、肝郁痰凝症状积分、疼痛视觉模拟量表(VAS)评分。分别检测治疗前后两组患者血清内分泌激素[雌二醇(E2)、孕酮(P)、催乳素(PRL)和黄体生成素(LH)]与血管生成因子[血管内皮生长因子(VEGF)和成纤维细胞生长因子(FGF)]。结果治疗后,观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组患者乳腺肿块大小及乳房肿块质地评分、肝郁痰凝症状评分、VAS评分均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组患者血清E2、PRL、LH水平均低于对照组,而P水平高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组患者血清VEGF和FGF水平均低于对照组,差异有统计学意义(P<0.05)。结论在口服西药治疗基础上加用针刺联合自拟消结通乳汤治疗肝郁痰凝型乳腺增生病能提高临床疗效,可减小乳腺肿块大小和改善乳房肿块质地,减轻肝郁痰凝症状和疼痛,其作用机制可能与调节血清内分泌激素(E2、P、PRL和LH)与血管生成因子(VEGF和FGF)水平相关。Objective To observe the clinical efficacy of acupuncture plus self-established Xiao Jie Tong Ru decoction in treating mammary gland hyperplasia(MGH)of liver depression and phlegm coagulation pattern based on oral administration of Western medication,as well as its effects on endocrine hormones and angiogenic factors.Method A total of 120 patients with MGH of liver depression and phlegm coagulation pattern were enrolled and allocated into an observation group and a control group using random number table method,with 60 cases in each group.The control group was treated with oral administration of Tamoxifen citrate tablets,while the observation group was given additional acupuncture treatment plus self-established Xiao Jie Tong Ru decoction.Clinical efficacy was compared between the two groups.Before and after treatment,MGH symptoms score,liver depression and phlegm coagulation symptoms score and visual analogue scale(VAS)score were observed,and the serum endocrine hormones[estradiol(E2),progesterone(P),prolactin(PRL)and luteinizing hormone(LH)]and angiogenic factors[vascular endothelial growth factor(VEGF)and fibroblast growth factor(FGF)]were detected in both groups.Result After treatment,the total effective rate was higher in the observation group than in the control group and the difference was statistically significant(P<0.05).The mammary gland lump size and texture scores,liver depression and phlegm coagulation symptoms score and VAS score were lower in the observation group than in the control group after treatment,and the differences were statistically significant(P<0.05).After intervention,the serum E2,PRL and LH levels were lower and the P level was higher in the observation group than in the control group,and the differences were statistically significant(P<0.05).After treatment,the serum VEGF and FGF levels in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Based on oral administration of Western medication,acupuncture plus self-established Xiao Jie Tong

关 键 词：针刺疗法 针药并用 纤维囊性病 乳腺 乳腺增生病 肝郁痰凝 内分泌激素 血管生成因子 

分 类 号：R246.3[医药卫生—针灸推拿学]