疏肝消癥方治疗乳腺增生症65例
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摘要
目的:探讨疏肝消癥方治疗乳腺增生症肝郁痰凝证的疗效及对血清中血管内皮生长因子(vascular endothelial growth factor,VEGF)和碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)的影响。方法:纳入在本院就诊的女性乳腺增生症患者130例,随机分为治疗组和对照组各65例,对照组口服枸橼酸他莫昔芬片,每次10 mg,日2次。治疗组在对照组治疗的基础上予疏肝消癥方治疗,日1剂,常规水煎早晚各1次。所有患者给予8周治疗。比较两组乳腺症状、临床症状评分及临床疗效,晨起抽取患者外周血,离心取血清,酶联免疫吸附法(enzyme linked immunosorbent assay,Elisa)于治疗前后检测两组血清中VEGF和bFGF水平。结果:治疗后,治疗组乳腺肿块大小、乳腺疼痛、乳房肿块硬度及症状(胸闷胁胀、善郁易怒、失眠多梦、心烦口苦)评分明显低于对照组(P<0.01);治疗组有效率为98.46%,明显高于对照组的87.69%(P<0.05)。治疗后,治疗组血清中VEGF和bFGF水平明显少于对照组(P<0.01)。结论:疏肝消癥方可以提高乳腺增生肝郁痰凝证疗效,改善乳腺增生肝郁痰凝证症状,下调患者血清中VEGF和bFGF含量。
Objective: To observe the clinical curative effect of Shugan Xiaozheng Fang(SGXZF) on hyperplasia of mammary glands with stagnation of liver qi and phlegm stasis syndrome,and its influence on vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF). Methods: One hundred and thirty women patients with hyperplasia of mammary gland who were treated in our hospital were chosen as the research subjects,and randomly divided into the control group and the treatment group,with 65 cases in each group. The ones in the control group were treated with Tamoxifen Citrate Tablets,10 mg each time,and twice a day,while the ones in the treatment group were treated with SGXZF based on the treatment of the control group,one doses a day,in the conventional water decoction,once in the morning and in the evening respectively. All patients were treated for 8 weeks. Then the breast symptoms,clinical symptom scores and clinical efficaces were compared between the two groups. The peripheral blood of the patients in the morning was collected and the blood samples were centrifuged. Then the serum VEGF and bFGF levels were detected before and after treatment by enzyme linked,immunosorbent assay(Elisa). Results: After the treatment,the treatment group's breast tumor size,breast pain,breast lumps hardness and symptoms(abdominal distension,chest tightness,depression irritability,insomnia,dreaminess,restlessness and bitter mouth) scores were all significantly lower than those of the control group(P < 0. 01). The total effective rate of the treatment group was 98. 46%,which was significantly higher than that of the control group: 87. 69%(P < 0. 05). After the treatment,the serum levels of VEGF and bFGF in the treatment group were significantly lower than those in the control group(P < 0. 01). Conclusion: SGXZF can improve the curative effect of hyperplasia of mammary glands with stagnation of liver qi and phlegm syndrome,improve the related symptoms and decrease the serum levels of VEGF and bFGF which may be one of its mechanisms.
Objective: To observe the clinical curative effect of Shugan Xiaozheng Fang(SGXZF) on hyperplasia of mammary glands with stagnation of liver qi and phlegm stasis syndrome,and its influence on vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF). Methods: One hundred and thirty women patients with hyperplasia of mammary gland who were treated in our hospital were chosen as the research subjects,and randomly divided into the control group and the treatment group,with 65 cases in each group. The ones in the control group were treated with Tamoxifen Citrate Tablets,10 mg each time,and twice a day,while the ones in the treatment group were treated with SGXZF based on the treatment of the control group,one doses a day,in the conventional water decoction,once in the morning and in the evening respectively. All patients were treated for 8 weeks. Then the breast symptoms,clinical symptom scores and clinical efficaces were compared between the two groups. The peripheral blood of the patients in the morning was collected and the blood samples were centrifuged. Then the serum VEGF and bFGF levels were detected before and after treatment by enzyme linked,immunosorbent assay(Elisa). Results: After the treatment,the treatment group's breast tumor size,breast pain,breast lumps hardness and symptoms(abdominal distension,chest tightness,depression irritability,insomnia,dreaminess,restlessness and bitter mouth) scores were all significantly lower than those of the control group(P < 0. 01). The total effective rate of the treatment group was 98. 46%,which was significantly higher than that of the control group: 87. 69%(P < 0. 05). After the treatment,the serum levels of VEGF and bFGF in the treatment group were significantly lower than those in the control group(P < 0. 01). Conclusion: SGXZF can improve the curative effect of hyperplasia of mammary glands with stagnation of liver qi and phlegm syndrome,improve the related symptoms and decrease the serum levels of VEGF and bFGF which may be one of its mechanisms.
引文
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[12]李岚岚.消癖汤治疗乳腺增生症120例[J].河南中医,2017,37(3):477-479.
[13]Ueda Y,Masuda T,Ishida A,et al.Enhanced electrical responsivenessin the cerebral cortex with oral melatonin administration after a small hemorrhage near the internal capsule in rats[J].J Neurosci Res,2014,92(11):1499-1508.
[14]陶承静,胡健女,陈蓉.小金胶囊、逍遥丸联合舒尔经胶囊在乳腺增生患者中的应用及对血管(VEGF、b FGF)的影响[J].中国生化药物杂志,2017,37(2):90-96.
[15]谷丽艳,解静茹,刘齐,等.解毒胶囊对乳腺增生大鼠VEGF和b FGF表达的影响[J].中华中医药学刊,2016,34(7):1559-1562.
[2]胡克菲,郭琪,裴晓华,等.435例女性乳腺增生症影响因素的临床研究[J].中国实验方剂学杂志,2013,19(9):319-322.
[3]胡彦武,任立群.复方鹿角乳痛宁胶囊抗乳腺增生和镇痛的作用[J].中国实验方剂学杂志,2016,22(20):122-126.
[4]才旦多杰,赵海宁,施志军.桂枝茯苓丸辅助治疗乳腺增生的疗效及安全性观察[J].山东医药,2016,56(34):68-70.
[5]姜文婷,张敏.消癖散结汤配合中医情志疗法治疗乳腺增生临床研究[J].中医学报,2016,31(12):1995-1998.
[6]林毅,唐汉钧.现代中医乳房病学[M].北京:人民卫生出版社,2003:107-108.
[7]李曰庆.中医外科学[M].2版.北京:中国中医药出版社,2008:83.
[8]刘明跃,彭淑莲.乳痛消治疗肝郁痰凝型乳腺增生症临床观察[J].中国中医药现代远程教育,2015,13(9):49-51.
[9]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:42.
[10]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:131-132.
[11]刘京昱,韩光.针药结合治疗乳腺增生120例[J].河南中医,2014,34(3):515-516.
[12]李岚岚.消癖汤治疗乳腺增生症120例[J].河南中医,2017,37(3):477-479.
[13]Ueda Y,Masuda T,Ishida A,et al.Enhanced electrical responsivenessin the cerebral cortex with oral melatonin administration after a small hemorrhage near the internal capsule in rats[J].J Neurosci Res,2014,92(11):1499-1508.
[14]陶承静,胡健女,陈蓉.小金胶囊、逍遥丸联合舒尔经胶囊在乳腺增生患者中的应用及对血管(VEGF、b FGF)的影响[J].中国生化药物杂志,2017,37(2):90-96.
[15]谷丽艳,解静茹,刘齐,等.解毒胶囊对乳腺增生大鼠VEGF和b FGF表达的影响[J].中华中医药学刊,2016,34(7):1559-1562.