刺血疗法联合消散方外敷治疗乳腺增生的疗效观察  

Clinical Observation on the Therapeutic Effect of Blood-Pricking Therapy Combined with Xiaosan Prescription on Hyperplasia of Mammary Glands

作　　者：熊禄娅 李雪真[2] 郭智涛[2] XIONG Lu-Ya;LI Xue-Zhen;GUO Zhi-Tao(Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510095 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]广东省第二中医院,广东广州510095

出　　处：《广州中医药大学学报》2023年第4期893-898,共6页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】探讨刺血疗法联合消散方(由炙蜂房、郁金、公丁香、乳香、没药、生半夏、姜黄等中药组成)外敷治疗乳腺增生的临床疗效。【方法】将72例肝郁痰凝型乳腺增生患者随机分为研究组和对照组,每组各36例。研究组给予刺血疗法联合消散方外敷治疗,刺血疗法7 d治疗1次,消散方外敷隔日治疗1次;对照组给予枸橼酸他莫昔芬片口服治疗,每次10 mg,每日2次。14 d为1个疗程,共治疗3个疗程。观察2组患者治疗前后中医证候积分和血清雌二醇(E2)、催乳素(PRL)、孕酮(P)水平的变化情况,并评价2组患者的临床总疗效和安全性。【结果】(1)疗效方面,治疗3个疗程后,研究组的总有效率为94.44%(34/36),对照组为72.22%(26/36),组间比较,研究组的临床总疗效明显优于对照组(P<0.05)。(2)中医证候方面,治疗后,研究组的主要证候积分和肝郁痰凝相关证候积分均较治疗前降低(P<0.01),而对照组仅主要证候积分较治疗前降低(P<0.01);组间比较,研究组在降低主要证候积分和肝郁痰凝相关证候积分方面均明显优于对照组,组间治疗后及差值比较,差异均有统计学意义(P<0.01)。(3)雌孕激素方面,治疗后,2组患者血清E2、PRL水平均较治疗前降低,而血清P水平研究组较治疗前升高,对照组较治疗前降低,差异均有统计学意义(P<0.01);组间比较,研究组虽然在降低E2水平方面略逊于对照组,但在降低PRL水平和升高P水平方面均优于对照组,差异均有统计学意义(P<0.01),表明相比西药他莫昔芬,刺血疗法联合消散方外敷在改善乳腺增生患者雌孕激素比例失调方面更有优势。(4)安全性方面,治疗期间,对照组有1例出现月经不调,2例出现食欲不振,1例出现腹泻,不良反应发生率为11.1%(4/36),而研究组无不良反应发生,组间不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】刺血疗法联合消散方外敷治疗肝郁痰凝型乳�Objective To investigate the clinical efficacy of the combination of blood-pricking therapy and external application of Xiaosan Prescription(mainly composed of roasted Vespae Nidus, Curcumae Radix, Caryophylli Flos,Olibanum,Myrrha,raw Pinelliae Rhizoma,and Curcumae Longae Rhizoma)in treating hyperplasia of mammary glands. Methods Seventy-two patients with hyperplasia of mammary glands differentiated as liver depression and phlegm coagulation type were randomly divided into the study group and the control group,with36 patients in each group. The study group was treated by blood-pricking therapy once every 7 days together with the external application of Xiaosan Prescription once every other day. The control group was treated with oral use of Tamoxifen Citrate Tablets 10 mg each time and twice per day. The treatment for 14 days constituted a course of treatment and both groups were treated for a total of 3 courses. The changes in the traditional Chinese medicine(TCM)syndrome scores and serum estradiol(E2),prolactin(PRL)and progesterone(P)levels in the two groups were observed before and after treatment,and the overall clinical efficacy and safety of the two groups were also evaluated. Results(1)After 3 courses of treatment,the total effective rate of the study group was 94.44%(34/36)and that of the control group was 72.22%(26/36). The intergroup comparison showed that the study group had stronger overall efficacy than the control group(P<0.05).(2)After treatment,the main syndrome scores and the scores related to liver depression and phlegm coagulation syndrome in the study group were all decreased compared with those before treatment(P<0.01),while only the main syndrome scores in the control group were decreased compared with those before treatment(P<0.01). The intergroup comparison showed that the study group had stronger effect on decreasing the main syndrome scores and the scores related to liver depression and phlegm coagulation syndrome than the control group, and statistically significant difference was prese

关 键 词：刺血疗法 消散方 肝郁痰凝型 乳腺增生 雌二醇 催乳素 孕酮 

分 类 号：R246.3[医药卫生—针灸推拿学]