疏肝解郁方对肝郁气滞证乳腺增生结节患者血清神经递质及性激素的影响  

Effect of Shugan Jieyu Formula on serum neurotransmitter and sex hormone in patients with hyperplasia of mammary gland nodules of liver qi stagnation

作　　者：营在道 张娜 付鹏 郝亮 赵艳梅 YING Zaidao;ZHANG Na;FU Peng;HAO Liang;ZHAO Yanmei(Department of Traditional Chinese Medicine,Shandong Provincial Third Hospital,Jinan,Shandong 250031;Department of Internal Medicine,Shandong Sports Rehabilitation Research Center,Jinan,Shandong 250101;Department of Traditional Chinese Medicine,Jinan Tianqiao People's Hospital,Jinan,Shandong 250031)

机构地区：[1]山东省立第三医院中医科,山东济南250031 [2]山东省运动康复研究中心内科,山东济南250101 [3]山东省济南市天桥人民医院中医科,山东济南250031

出　　处：《河北中医》2023年第9期1459-1463,1467,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：山东省基层卫生协会2022年基层卫生科技创新计划项目(编号:JCK22016)。

摘　　要：目的观察疏肝解郁方治疗肝郁气滞证乳腺增生结节患者的临床疗效及可能作用机制。方法将76例肝郁气滞证乳腺增生结节患者按照随机数字表法分为2组,对照组38例采用西医常规治疗,治疗组38例在对照组治疗基础上加疏肝解郁方治疗,均30天为1个疗程(经期停药),连续治疗3个疗程后统计疗效。比较2组治疗前后中医证候积分、血清神经递质[血清5-羟色胺(5-HT)、多巴胺(DA)、去甲肾上腺素(NE)]、性激素[孕酮(P)、雌二醇(E_(2))、泌乳素(PRL)、卵泡刺激素(FSH)、黄体生成激素(LH)]水平变化。结果2组共70例完成试验,治疗组36例,对照组34例。治疗后,2组乳房疼痛等各项中医证候评分及总分均低于本组治疗前(P<0.05),且治疗组均低于对照组(P<0.05)。治疗后,2组血清5-HT、DA、NE水平均低于本组治疗前(P<0.05),且治疗组均低于对照组(P<0.05)。治疗后,2组血清P、FSH水平均高于本组治疗前(P<0.05),E_(2)、PRL、LH水平均低于本组治疗前(P<0.05),且治疗组血清P、FSH水平高于对照组(P<0.05),E_(2)、PRL、LH水平低于对照组(P<0.05)。治疗组总有效率91.67%(33/36),对照组总有效率73.53%(25/34),治疗组临床疗效优于对照组(P<0.05)。结论疏肝解郁方能够缓解肝郁气滞证乳腺增生结节患者临床症状,提高治疗效果,可能与调节血清神经递质、性激素水平等因素有关。Objective To observe the clinical efficacy of Shugan Jieyu Formula on patients with hyperplasia of mammary gland nodules of liver qi stagnation and its possible mechanism.Methods Totally 76 patients with hyperplasia of mammary gland nodules(liver qi stagnation)were randomly assigned into the treatment group(n=38,2 cases dropped off)and the control group(n=38,4 cases dropped off).All patients were managed by routine Western medicine,and those in the treatment group were additionally treated with Shugan Jieyu Formula.The treatment continued for 3 courses(1 course for 30 days,stopping treatment during menstruation),the aim was to compare traditional Chinese medicine(TCM)syndrome scores,serum neurotransmitter(5-hydroxytryptamine[5-HT],dopamine[DA],norepinephrine[NE]),sex hormone(progesterone[P],estrogen[E 2],prolactin[PRL],follicle-stimulating hormone[FSH],luteinizing hormone[LH]).The curative effect was assessed.Results After treatment,the scores of TCM syndromes such as breast pain and the total score in groups were decreased(P<0.05),which decreased in the treatment group compared with the control group(P<0.05).5-HT,DA,NE in groups decreased(P<0.05),which were decreased in the treatment group relevant to the control group(P<0.05).Increased P and FSH,and decreased E 2,PRL,LH were detected in the two groups(all P<0.05),and the treatment group was superior to the control group for P,FSH,E 2,PRL,LH(all P<0.05).The overall effective rate was higher in the treatment group(91.67%[33/36])compared with the control group(73.53%[25/34]),(P<0.05).Conclusion For patients with hyperplasia of mammary gland nodules(liver qi stagnation),Shugan Jieyu Formula can relieve clinical symptoms and improve therapeutic effect by regulating serum neurotransmitter and sex hormone levels.

关 键 词：乳腺疾病 肝郁 疏肝解郁药 神经递质 性腺甾类激素 

分 类 号：R655.820.531[医药卫生—外科学]