超声检查评价乳腺增生症中成药治疗疗效的价值

目的探讨超声检查评价乳腺增生症中成药治疗疗效的价值。 方法选择2014年3月至2014年9月北京中医药大学第三附属医院收治的乳腺增生症患者50例，给予消癥丸口服治疗。在治疗前后分别用超声测量乳腺增生症患者乳腺腺体层厚度、输乳管内径、囊肿体积、结节体积及低回声区直径，并对乳腺增生结构进行评级，同时对乳腺增生象限计数。采用配对t检验比较治疗前后乳腺增生症患者乳腺腺体层厚度、输乳管内径、囊肿体积、结节体积、低回声区直径、乳腺增生象限数差异；采用秩和检验比较治疗前后乳腺增生症患者乳腺增生结构评级差异。 结果与治疗前相比，治疗后乳腺增生症患者乳腺腺体层变薄（13.02±4.20）mm vs （15.92±4.73）mm]，输乳管明显变细（2.26±0.58）mm vs（1.71±0.47）mm]，低回声区缩小（21.14±5.57）mm vs（17.80±4.63）mm]，且差异均有统计学意义（t值分别为2.240、5.202、5.529，P均<0.01）；而治疗前后乳腺增生症患者乳腺囊肿体积、结节体积差异均无统计学意义。治疗前后乳腺增生症患者乳腺增生结构评级差异有统计学意义（z=-5.667，P<0.01）。治疗后，乳腺增生症患者乳腺增生象限数为2.83±0.99，少于治疗前的4.62±2.02，且差异有统计学意义（t=7.566，P<0.01）。 结论超声是乳腺增生症中成药治疗疗效评价的有效方法。乳腺超声征象在治疗前后的变化可作为乳腺增生症中成药治疗疗效判断依据，而乳腺增生结构评级和增生象限数可使疗效判断更全面。

The value of ultrasonographic assessment in the breast dysplasia treated with the traditional Chinese medicine

ObjectiveTo investigate the value of high-frequency ultrasound in assessment of the therapeutic efficacy of traditional Chinese medicine in patients with breast dysplasia using. MethodsFrom March to September in 2014, 50 patients with breast dysplasia in the Third Affiliated Hospital of Beijing University of Chinese Medicine were enrolled in the study. In addition, they were treated with Xiaozheng pills. Before and after treatment, these patients were examined using ultrasound. The thickness of the breast gland layer in each patient was measured. When the dilated ducts lactiferous, cysts, hypoechoic areas, or nodules of the breast were detected, the diameter or volume was measured or calculated. A grading system of the breast dysplasia was used to evaluate the disease degree, and the quadrants of the breast dysplasia were counted. The thickness of the breast gland layer, the volume of cysts and nodules, the diameter of hypoechoic areas and the dilated ducts lactiferous, the number of the breast dysplasia were compared with the paired t-test. The grading of the breast dysplasia was compared with rank sum test. ResultsThere were significant decreases in the thickness of the grand layer, the diameters of the ducts lactiferous and the hypoechoic area after treatments (15.92±4.73) mm vs (13.02±4.20) mm, t=2.240, P<0.01; (2.26±0.58) mm vs (1.71±0.47) mm, t=5.202, P<0.01; (21.14±5.57) mm vs (17.80±4.63) mm, t=5.529, P<0.01]. However, there were no significant differences in the volume of cysts and nodules. The grading of the breast dysplasia showed statistical difference (z=-5.667, P<0.01), and the number of the breast dysplasia quadrants was reduced markedly (5.38±1.85 vs 3.28±1.97, t=7.566, P<0.01). ConclusionsUltrasound can be an effective method in assessment of patients with breast dysplasia treated with the traditional Chinese medicine. The assessment can be based on some signs, including the thickness of the grand layer, the diameters of the ducts lactiferous, and the diameters of the hypoechoic area. The grading system and breast quadrants counting in these patients may be added as supplementary criteria to make a complete therapeutic evaluation.