围刺配合电针对乳腺增生大鼠乳头大小、乳腺病理变化、血清性激素含量和雌激素受体表达的影响

目的:探讨围刺配合电针治疗乳腺增生的作用机制。方法:将40只Wistar大鼠随机分为正常组、模型组、针刺组和药物组。采用己烯雌酚联合黄体酮肌肉注射的方法建立乳腺增生模型。针刺组在大鼠第2对左右乳房进行围刺后,电针30min,并针刺"膻中"穴,留针30min,1次/d,共治疗30d;药物组每日予以三苯氧胺(1.8mg/kg)灌胃。于治疗前,治疗10、20、30d测量各组大鼠第2对乳头高度、直径;于末次治疗后采用放射免疫法检测血清雌二醇(E2)、孕酮(P)、泌乳素(PRL)、睾酮(T)含量;取大鼠第2对乳房常规H.E.染色,光镜下观察组织形态表现;运用免疫组化法观察乳腺组织雌激素受体(ER)表达情况。结果:模型组乳头高度、直径均高于正常组(P<0.05),治疗后针刺组和药物组乳头高度、直径均低于模型组(P<0.05)。模型组E2、PRL、T含量明显高于正常组(P<0.05),针刺组和药物组E2、PRL、T含量均低于模型组(P<0.05);模型组P含量低于正常组(P<0.05),针刺组和药物组P含量高于模型组(P<0.05)。模型组与正常组乳腺组织形态比较,乳腺小叶、腺泡、腺导管数目明显较多,腺泡腔和腺导管明显扩张;针刺组和药物组与模型组比较,乳腺小叶、腺泡、腺导管数均减少,腺泡腔及腺导管萎缩。模型组乳腺组织ER阳性细胞表达与正常组相比明显增高(P<0.05),针刺组和药物组大鼠乳腺组织ER阳性细胞表达与模型组比较明显降低(P<0.05)。结论:围刺配合电针能够改善大鼠乳腺组织病理形态,其作用与调节血清性激素含量及降低乳腺组织ER表达有关。

Effects of encircled needling plus electroacupuncture on hyperplastic mammary glands and serum sex hormones in the rat

Objective To observe the effect of encircled needling plus electroacupuncture(EA) of the second pair of nipples on hyperplastic mammary glands,serum estradiol(E2),progesterone(P),prolactin(PRL)and testosterone(T)contents,estrogen receptor(ER) expression of the mammary glands in mammary hyperplasia rats.Methods Forty Wistar rats were equally randomized into normal control,model,acupuncture and medication groups.Mammary gland hyperplasia model was established by intramuscular injection of diethylstilbestrol(0.5 mg/kg,once daily for 25 days) and progesterone(4 mg/kg,once daily for 5 days).For rats of the acupuncture group,4 filiform needles were inserted into the surrounding tissues of the second pair of breasts,respectively,followed by giving the animal with EA stimulation for 30 min.Another one acupuncture needle was inser-ted into "Danzhong"(CV 17) and retained for 30 min.For rats of the medication group,tamoxifen solution(1.8 mg/kg) was given by gavage.Both medication and EA intervention were given once daily for 30 days.The diameter and height of the second pair of nipples were measured before and on the 10th,20th and 30th days of the treatment.Serum E2,P,PRL and T levels were assayed by radioimmunoassay,and the tissues of the second pair of nipples were stained with H.E.method.Estrogen receptor immunoactivity of the breast tissue was detected by immunohistochemistry.Results The diameter and height of the second pair of nipples,serum E2,PRL and T contents,and breast ER protein expression level were significantly higher in the model group than in the normal control group(P<0.05),while serum P content was remarkably lower in the model group than in the normal control group(P<0.05).In comparison with the model group,the diameter and height of the second pair of nipples,serum E2,PRL and T contents,and breast ER protein expression level were considerably lower in both acupuncture and medication groups(P<0.05),and serum P contents were significantly higher in the latter two groups(P<0.05).In addition,H.E.staining showed that the numbers of the lobule,alveolus and ducts of mammary glands were significantly increased,and the expansion of the acinar lumina and ducts was found in the model group.These pathological changes were relatively milder in both acupuncture and medication groups.Conclusion Encircled needling plus EA stimulation of the surrounding tissues of the nipples can improve the hyperplasic nipples and pathological changes of the breast tissue in mammary gland hyperplasia rats,which is closely asso-ciated with its functions in lowering serum estradiol,prolactin,testosterone contents and estrogen receptor protein expression of the breast,and in increasing serum progesterone level.