消乳散结胶囊联合他莫昔芬治疗乳腺增生症的疗效观察

目的 研究瑞香狼毒Stellera chamaejasme花中黄酮和木脂素类化学成分及其抗氧化活性，分析构效关系。方法 利用大孔吸附树脂、正反相硅胶、Sephadex LH-20等色谱分离材料，通过柱色谱和高效液相色谱等分离方法进行分离纯化，运用核磁共振（NMR）、质谱（MS）等波谱技术鉴定化合物结构，并采用FRAP法、DPPH法和ABTS法对分离得到的化合物进行体外抗氧化活性测试。结果 从瑞香狼毒花甲醇提取物中分离鉴定了12个化合物，分别鉴定为艾黄素（1）、槲皮素（2）、isoscutellarein-8-O-β-D-glucuronopyranoside（3）、槲皮素-3-O-β-D-葡萄糖苷（4）、紫云英苷（5）、hypolaetin-8-O-β-D-glucuronopyranoside（6）、kaempferol 3-O-β-D-glucopyranosyl-（1→2）-O-α-L-xylopyranoside（7）、rel-（3R，3''S，4R，4''S）-3，3''，4，4''-tetrahydro-6，6''-dimethoxy[3，3''-bi-2H-benzopyran]-4，4''-diol（8）、马台树脂醇（9）、乌拉尔醇（10）、环黄芪醇（11）、松脂醇（12）。抗氧化活性实验表明，黄酮和木脂素类化合物均显示了较强的抗氧化活性。结论 化合物1、3、5～7和10为首次从该植物中分离得到；化合物2、4、5和10表现出显著的抗氧化活性，其中黄酮类化合物C-3或C-8位连有糖链会降低其抗氧化活性。

Clinical observation of Xiaoru Sanjie Capsules combined with tamoxifen in treatment of mammary hyperplasia

Objective To observe the clinical effect of Xiaoru Sanjie Capsules combined with tamoxifen in treatment of mammary hyperplasia. Methods Patients (77 cases) with mammary hyperplasia in the Third Affiliated Hospital of Zhengzhou University from February 2017 to April 2019 were randomly divided into control (38 cases) and treatment (39 cases) groups. Patients in the control group were po administered with Tamoxifen Citrate Tablets, 1 tablet/time, twice daily. Patients in the treatment group were po administered with Xiaoru Sanjie Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacy was evaluated, and the sex hormone levels and the improvement of clinical symptoms in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 71.05% and 92.31%, respectively, and there were differences between two groups (P<0.05). After treatment, the levels of P and FSH in two groups were significantly increased (P<0.05), but the levels of LH and E2 were significantly decreased (P<0.05), and the sex hormone levels in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the maximum diameter of the mass and VAS score in two groups were significantly decreased (P<0.05), and these indexes in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Xiaoru Sanjie Capsules combined with tamoxifen in treatment of mammary hyperplasia can obviously relieve breast tenderness, reduce breast lumps, improve sex hormone levels, which has a good clinical effect.