乳腺增生病中医辨证分型与性激素水平的关系

目的：研究乳腺增生病（HDB）中医辨证分型与患者黄体期血清性激素水平的关系。方法：收集240例HDB患者按中医辨证分型分为：肝郁气滞型98例、痰瘀互结型73例、冲任失调型69例,乳腺正常的健康女性20例作对照组,在黄体期检测血清性激素孕酮（PRGE）、雌二醇（E2）、垂体泌乳素（PRL）的水平,进行组间对比分析。结果：在黄体期HDB组与正常对照组E2水平比较：HDB组明显高于正常对照组,差异具有统计学意义（P〈0.001）;两组PRGE、PRL水平比较差异无统计学意义（P〉0.05）。不同分型患者在黄体期对PEGR水平进行两两比较,痰凝血瘀组、冲任失调组低于肝郁气滞组,差异具有统计学意义（P〈0.05）,而痰凝血瘀组与冲任失调组比较差异无统计学意义（P〉0.05）;对E2、PRL水平进行两两比较,三型之间差异无统计学意义（P〉0.05）。结论：在黄体期PRGE/E2比例失调、E2水平升高是引发HDB的重要因素,PRGE、E2、PRL的水平的测定可作为HDB的病因诊断及治疗前后疗效评价的参考,但不能作为HDB中医辨证分型的客观依据。

Relationship Between TCM Syndrome Differentiation of Hyperplastic Disease of Breast and the Level of Sex Hormone

Objective： To study the relationship between the TCM Syndrome differentiation of hyperplastic disease of breast（HDB）and the levels of serum sex hormones in patients. Methods：According to the TCM syndrome differentiation,in the HDB group,240 cases of HDB were divided into 3 types：98 cases of liver qi stagnation type,73 cases of congealation of phlegm and blood stasis type and 69 cases of dysfunction of thoroughfare and Conception vessels type. What＇s more,20 cases of normal healthy women were collected as control group. During the luteal phase,the levels of progesterone （PRGE）,estradiol （E2） and prolactin （PRL）in the two groups were tested and analyzed. Results：During the luteal phase,the level of E2 in the HDB group was obviously higher than that in the control group,with significant difference （P0.01）;the levels of PRGE and PRL between the two groups were no statistical difference（P0.05）. Compared with the levels of PEGR among the 3 types,the level in the type of congealation of phlegm and blood stasis and the type of dysfunction of thoroughfare and Conception vessels were lower than that in the type of liver qi stagnatio（nP0.05）,but without significant difference between the former two type（sP0.05）; compared with the levels of E2 and PRL,there were no statistical difference among the three types（P0.05）. Conclusion：During the luteal phase,the imbalance of PRGE/E2 and the increasing level of E2 are the significant etiologies of HDB. The tests of the level of PRGE,E2 and PRL could be used as the referrence for the pathogenic diagnosis of HDB and the therapeutic assessment between the pre-and post-treatment,but couldn＇t be applied as the objective basis for the syndrome differentiation of HDB.