乳康贴联合莪术消癥丸治疗痰瘀互结型乳腺增生症临床疗效及对影像学表现的影响  

Clinical efficacy of Rukang Paste combined with Ezhu Xiaozheng Pill for breast hyperplasia of phlegm-blood stasis type and how to impact on imaging performance

作　　者：任伊宁 兴伟 徐曌 徐志峰 宋易华 REN Yining;XING Wei;XU Zhao;XU Zhifeng;SONG Yihua(First Department of Surgery,The First Affiliated Hospital of Hebei University of Chinese Medicine,Shijiazhuang,Hebei 050011)

机构地区：[1]河北中医学院第一附属医院外一科,河北石家庄050011

出　　处：《河北中医》2022年第8期1272-1276,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2018年度中医药类科研计划课题(编号:2018018)。

摘　　要：目的观察乳康贴联合莪术消癥丸治疗痰瘀互结型乳腺增生症的临床疗效及对影像学表现的影响。方法将90例乳腺增生症患者按照随机数字表法分为3组,外治组30例予乳康贴穴位贴敷,内治组30例予莪术消癥丸口服,内外合治组30例予乳康贴穴位贴敷联合莪术消癥丸口服。30 d为1个疗程,共治疗3个疗程,比较3组治疗前后乳房疼痛评分、乳房内肿块评分、性激素[雌二醇(E_(2))、催乳素(PRL)、孕酮(P)]水平的变化,并统计3组总有效率及不良反应发生情况,随访6个月后统计复发率。结果内外合治组总有效率100%(30/30),内治组总有效率66.67%(20/30),外治组总有效率83.33%(25/30),内外合治组疗效优于内治组、外治组(P<0.05)。3组治疗后乳房疼痛评分及乳房肿块各项评分和总均较本组治疗前降低(P<0.05),且内外合治组治疗后均低于内治组、外治组(P<0.05)。3组治疗后E_(2)、PRL均降低(P<0.05),P均升高(P<0.05),且内外合治组治疗后E_(2)、PRL均低于内治组、外治组(P<0.05),P均高于内治组、外治组(P<0.05)。超声结果显示,内治组可见乳腺增大,内部回声不均匀,边界不清,回声光点增粗。外治组和内外合治组的腺体层呈现中等稍强回声,相对均质,但内外合治组的边界更为清晰,后方回声增强。内外合治组对于超声影像学表现的改善效果优于外治组及内治组。内外合治组复发0例,复发率0(0/30),内治组复发4例,复发率20%(4/20),外治组复发3例,复发率12%(3/25),内外合治组复发率低于内治组、外治组(P<0.05)。结论乳康贴联合莪术消癥丸能够显著提高痰瘀互结型乳腺增生症的临床治疗效果,可改善患者症状,调节血清性激素水平,降低复发率,值得临床推广应用。Objective To observe the clinical efficacy of Rukang Paste combined with Ezhu Xiaozheng Pill for breast hyperplasia(BH)of phlegm-blood stasis type and how to impact on imaging performance.Methods Totally 90 BH patients were randomly assigned to the three groups,with 30 per group;the external treatment group received acupoint patching with Rukang Paste,the internal treatment group received oral Ezhu Xiaozheng Pill,and the combination group(combined internal and external treatment)received acupoint patching with Rukang Paste combined with oral Ezhu Xiaozheng Pill.The treatment continued for 3 courses(1 course for 30 days),the aim was to compare the scores of breast pain and breast mass,sex hormone(estradiol(E_(2)),prolactin[PRL],progesterone[P]);the overall effective rate,adverse reactions,6-month follow-up of recurrence rate were assessed.Results The overall effective rate in the combination group was better than that in the internal treatment group and the external treatment group(100%[30/30]vs 66.67%[20/30]vs 83.33%[25/30],[P<0.05],respectively).The scores of breast pain and breast mass in the three groups after treatment were lower than those before treatment(P<0.05),which in the combination group were more common(P<0.05).Decreased E_(2) and PRL and increased P vable were detected in the three groups(all P<0.05),improvements of such indexes were significantly better in the combination group than the other groups(all P<0.05).The internal treatment group showed breast enlargement with uneven internal echo,unclear border,echo light spots thickening;the external treatment group and the combination group showed the glandular layers were moderate to slightly stronger echoes,and relatively homogeneous,but more clear boundary and posterior echo enhancement were in the combination group.The recurrence rate in the combination group was lower than that in the internal treatment group and external treatment group(0[0/30]vs 20%[4/20],12%[3/25],[P<0.05],respectively).Conclusion For BH patients(phlegm-blood stasis type),Rukan

关 键 词：乳腺纤维囊性病 穴位贴敷法 中药疗法 

分 类 号：R655.820.531[医药卫生—外科学] R244.9[医药卫生—临床医学]