乳腺增生病辨证分型与性激素的相关性研究

目的:探讨乳腺增生病中医辨证分型与性激素的关系,建立乳腺增生病中医分型的客观指标.方法:112例乳腺增生病患者经中医辨证分为肝郁气滞、痰瘀互结、冲任失调3型,测定患者排卵期雌二醇(E2)、孕酮(PT)、睾酮(TT)、催乳素(PRL)、促卵泡刺激素(FSH)及促黄体生成素(LH)值.观察不同证型患者性激素含量变化并分析其与辨证分型的关系.结果:乳腺增生病患者排卵期LH、E2水平降低,PRL、PT水平升高,TT、FSH无显著变化.其中肝郁气滞型和痰瘀互结型的LH、E2水平均明显低于正常值,PRL、PT水平明显高于正常值.冲任失调型虽然LH、E2水平也明显低于正常值,但FSH水平却明显高于正常值.E2水平按肝郁气滞型、痰瘀互结型、冲任失调型依次降低.结论:乳腺增生病患者排卵期内分泌呈紊乱状态,不同中医证型患者性激素分泌各不相同,性激素的变化可作为中医辨证分型的客观指标及临床用药的依据.

Study on Correlativity of TCM Syndrome Types with Sexual Hormones in Patient of Hyperplasia of Mammary Glands

Objective:To explore relation of TCM syndrome types in patient with sexual hormones of hyperplasia of mammary glands,so as to establish objective indexes of TCM syndrome types of hyperplasia of mammary glands.Methods:112 cases of hyperplasia of mammary glands were divided into 3 types:stagnation of liver-Qi,intermingled phlegm and blood stasis,disharmany of thoroughfare vessel and conception vessel.Level of estradiol(E_2),progestin(PT),testosterone(TT),prolactin(PRL),follicle- stimulating hormone(FSH)and luteotropic hormone(LH)during ovulatory period in the patients were determined.The relation of hormone level with TCM syndrome types was analyzed.Results:Level of LH and E_2 decreased,PRL and PT increased and level of TT and FSH did not significantly change during ovulatory period in the patient of hyperplasia of mammary glands.LH and E_2 level in the patients with stagnation of liver-Qi or intermingled phlegm and blood stasis was significantly lower than normal values,and the level of PRL and PT was significantly higher than that of normal values.The level of LH and E_2 was also lower than the normal value in the patient with disharmany of thoroughfare vessel and conception vessel,but the level of FSH was significantly higher than normal value.Conclusion:The patient of hyperplasia of mammary glands during ovulatory period manifests endocrine dysfunction,and the patients with different TCM syndrome are different in secretion of sexual hormones; Changes of sexual hormones can be used as objective indexes of TCM syndrome types and basis of clinical medicinal application.