疏肝消癥方治疗乳腺增生症65例

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(P0.01);治疗组有效率为98.46%,明显高于对照组的87.69%(P0.05)。治疗后,治疗组血清中VEGF和bFGF水平明显少于对照组(P0.01)。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。

The Clinical Observation of Sixty-Five Cases of Hyperplasia of Mammary Glands Treated with Shugan Xiaozheng Fang

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,10mg 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 symnptom 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,insomnnia,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.