乳腺增生病的治疗现状

乳腺增生病是最常见的乳房疾病,发病率高,占全部乳房病的75%。目前,其治疗方面,单用中药治疗虽疗效肯定,但起效较慢,如单用西药治疗虽起效快,但作用难于持续,长期服用毒副反应多,复发率较高。目前在临床上对乳腺增生病尚无疗效肯定、起效快、毒副作用小的治疗方法,本文就当前乳腺增生病的治疗及临床应用进行概括。     

腋部多汗症的临床诊断与治疗进展

腋部多汗症(axillary hyperhidrosis)是临床常见病,多见于青少年,虽对健康不产生严重危害,但对患者的社会交往和日常生活产生较大影响.目前对于该病的治疗方法较多,疗效各异.A型肉毒毒素局部注射治疗腋部多汗症临床操作简捷,起效快,不影响日常生活,是一种安全、有效的治疗方法.本文对A型肉毒毒素局部注射治疗腋部多汗症的研究进展作一综述.     

逍遥散加减治疗乳腺增生病80例疗效观察

乳腺增生病占乳腺疾病发病率的75%,发病年龄在25～45岁.笔者采用中医辨证,予逍遥散加减治疗乳腺增生病,取得了满意疗效,现报告如下.     

末端病基础研究和临床治疗的国内外研究现状

末端病是运动损伤中常见的一种慢性疾病.在运动员中发病率尤高,治疗困难,严重影响运动员的训练和运动成绩的提高.甚至缩短运动寿命.近年来,在末端病研究方面虽然已取得了一些突出成就,对末端区的解剖结构及病理变化的研究比较透彻,大部分学者已达成共识.但对末端病的病因、发病机制还了解较少,临床治疗也多为非手术疗法,疗效大多不肯定,并缺乏系统的机理研究;手术治疗虽见效快,但都不同程度地存在负面影响.预防和治疗仍感到是一个棘手的问题.因此,目前尚需运用组织学、细胞学、酶化学和生物力学等多学科相结合的方法,进一步完善末端病的病因病理及发病机制等基础研究和加强临床治疗的作用机理研究,从而研制出疗效肯定的损伤预防和临床治疗方法.本文通过阅读近年来有关末端病的研究报道.对末端病的基础研究和临床治疗的国内外研究现状做一综述,以期为今后该方面的研究提供方向.     

消乳散结胶囊治疗兔乳腺增生的实验研究

目的:观察消乳散结胶囊(XRSJ)在治疗兔乳腺增生中的作用,探讨其治病机理。方法:将90只日本大耳兔随机分为6组,分别为XRSJ高、中、低剂量组,逍遥丸组,模型和正常对照组,每组15只,前5组用肌内注射己烯雌酚、黄体酮1个月建立兔乳腺增生模型。造模完成后,行XRSJ灌胃给药,分别取XRSJ给药前、XRSJ给药3个月后及XRSJ停药3个月后作为3个时间观测点。观察乳房高度变化;乳腺光、电镜形态学变化;放射免疫法监测血清雌激素水平。结果:与治疗前及模型对照组相比,中、高剂量XRSJ治疗能明显降低乳房高度(P<0.05);降低增生乳腺小叶腺泡数目、导管腺上皮细胞层数、结缔组织和毛细血管数量(P<0.05);减少乳腺上皮细胞胞质内线立体、高尔基体、粗面内质网数量(P<0.05),使部分增生细胞调亡;显著降低血清雌二醇(E2)含量(P<0.01),停药3个月后治疗效果稳定无反弹。结论:XRSJ治疗具有减轻乳腺组织增生病变、降低E2水平、对兔乳腺增生具有显著的治疗作用。     

皮下乳腺切除术治疗乳腺增生伴癌症临床分析

目的:探讨皮下乳腺切除术治疗乳腺增生伴癌症的临床疗效和预后分析。方法:随机选取2009年1月至2012年2月在我院就诊乳腺增生伴癌症女性患者68例,均为已婚已育女性,随机分为观察组和对照组,观察组35例给予乳房切除术治疗,对照组33例给予药物保守治疗,观察并比较两组的临床疗效、美容效果和预后情况。结果:观察组临床有效率高达88.57%,显著高于对照组(66.67%)(P<0.05);观察组美容效果良好率为74.29%显著高于对照组(30.30%)(P<0.01);观察组局部复发率、再住院率和死亡率均低于对照组,差异具有统计学意义(P<0.05)。结论:乳腺切除术治疗乳腺增生伴癌症不但安全性高、操作简便、疗效显著、预后好,而且能满足形体要求又能保留其乳腺功能,值得临床进一步的推广和研究。     

基于数据挖掘和网络药理学探究海洋中药治疗乳腺增生的用药规律及作用机制

基于数据挖掘、网络药理学及动物实验,挖掘含海洋中药的授权专利组方治疗乳腺增生的用药规律、探究核心药组治疗乳腺增生的作用机制。搜集1993年至2022年间治疗乳腺增生的授权复方专利文献,其中含海洋中药的专利组方有157首。组方中高频海洋中药有牡蛎、海藻、昆布等,高频非海洋中药有柴胡、当归、夏枯草等;高频药物可聚为三类;关联规则分析获得的核心药组为柴胡-牡蛎-当归。网络药理学分析显示柴胡-牡蛎-当归药组治疗乳腺增生的核心靶点有TP53、AKT1、ALB、ESR1;核心成分有槲皮素、山柰酚、异鼠李素、β-谷甾醇;核心药组治疗乳腺增生与P13K-ATK信号通路关系密切。分子对接结果显示核心药组中的核心成分与核心靶点对接良好,动物实验表明核心药组能有效改善乳房形态,抑制乳腺增生。本研究初步揭示海洋中药治疗乳腺增生的用药规律及机制,为海洋中药治疗乳腺增生作用机制的深入研究奠定基础,同时为相关专利的申请提供参考。     

蛹虫草菌丝体多糖对乳腺增生患者ER 和PR 表达的影响

目的:探究蛹虫草菌丝体多糖对良性乳腺增生患者增生乳腺组织中雌激素受体(ER)、孕激素受体(PR)表达的影响。方法:选取我院收治的良性乳腺增生患者50例,行随机数字表法随机分为两组,其中对照组行乳癖消临床常规治疗;实验组在乳癖消治疗基础上加用蛹虫草菌丝体多糖联合治疗,检测和比较两组患者治疗前后增生乳腺组织中ER和PR表达的变化情况。结果:治疗后,两组患者增生乳腺组织中ER和PR表达均明显低于对照组,且实验组显著低于对照组,差异均有统计学意义(P0.05)。结论:蛹虫草菌丝体多糖能有效抑制良性乳腺增生症患者增生乳腺组织中ER、PR是表达,为临床治疗良性乳腺增生症提供了新的思路和方法,值得临床应用和推广。     

青龙肠溶胶囊治疗乳腺增生病30例报告

青龙肠溶胶囊治疗乳腺增生病３０例报告廊坊市安次区第四医院郭榜林,王世清,张玉坤乳腺囊性增生病属非炎症,亦非肿瘤,而是乳腺导管和小叶在结构上的退行性和进行性病变。我院根据祖国医学辨证论治理论采用口服青龙肠溶胶囊治疗本病３０例,效果满意,报告如下：３０例...     

乳腺增生病动物模型的实验研究

目的探索建立与人类乳腺增生病相类似动物模型的最佳方法。方法采用手术、己烯雌酚、黄体酮处理动物。检测血液中雌二醇(E2)、黄体酮(P)、促卵泡生成激素(FSH)、促黄体生成激素(LH)水平;乳腺组织作组织形态学观察与评价。结果与对照组比较,各实验组动物的乳腺组织切片均有典型的乳腺增生;血清中各激素的水平也有不同的变化。结论采用“己烯雌酚 黄体酮”方法,以家兔为实验对象,建立乳腺增生病的动物模型是目前最好的方法。     

Glucocorticoid stimulation of choline kinase activity during the development of mouse mammary gland.

Mouse mammary gland contains choline kinase activity that can be stimulated by polyamines. Developmental studies show that the activity of choline kinase in mammary gland is low in both virgin and nonpregnant primiparous animals but increases severalfold during pregnancy and reaches a maximal level during the lactation period. Similar increases in enzyme activity are observed by cultivation of tissue explants in the presence of insulin, cortisol, and prolactin, a combination of hormones which induces the ultrastructural and biochemical changes associated with the development of mammary gland during pregnancy and lactation. The increase in enzyme activity in cultured explants is dependent only on the actions of both insulin and cortisol and parallels the formation of rough endoplasmic reticulum, which is effected by the same combination of hormones. The hormonal stimulation of choline kinase activity appears to involve the action of spermidine, a polyamine which accumulates in the cells under the influence of cortisol and mimicks the effect of cortisol on milk-protein synthesis in cultured explants.     

Alterations in ornithine decarboxylase activity in the rat mammary gland after different periods of 50 Hz magnetic field exposure.

In a series of experiments with the chemical carcinogen DMBA (7, 12-dimethyl[a]anthracene), we recently found that exposure of female Sprague-Dawley rats in 50 Hz magnetic fields (MF) in the microtesla range significantly facilitates the development and growth of mammary tumors. One possible explanation for this finding would be enhanced proliferation of breast epithelial stem cells by MF exposure, thereby increasing the sensitivity of these cells to chemical carcinogens. In line with this possibility, we previously determined that 50 Hz, 50 microT MF exposure induces increases in ornithine decarboxylase (ODC), i.e., a key enzyme in cell proliferation, in the mammary gland of female Sprague-Dawley rats. In the present study, we examined the time course of this effect, by using different periods of exposure to a 50 Hz, 100 microT MF. Furthermore, we determined ODC in different mammary complexes of the rat mammary gland to evaluate whether differences in response to MF exist over the anterior-posterior extension of this organ. Exposure of young female Sprague-Dawley rats induced marked increases in ODC in the mammary gland that were similar to ODC increases seen in "positive control" experiments with the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA). However, this effect of MF critically depended on the duration of MF exposure, with no effect, or at least no consistent effect, for short (<1 week) or long (8 weeks and above) exposure periods, but a robust and reproducible enhancing effect on ODC activity after 2 weeks of exposure. Furthermore, we found that the effect of MF exposure depends on the part of the mammary complexes examined, the cranial thoracic (or cervical) complexes being particularly sensitive to ODC alterations in response to MF. This is in line with recent DMBA experiments of our group in which MF-induced increases in tumor development and growth were predominantly seen in this large cranial/cervical part of the mammary gland. The most likely explanation for the observed ODC changes after MF exposure is the "melatonin hypothesis," although other cellular and molecular effects of MF might be involved as well.     

Glucose transporter expression in rat mammary gland.

The expression of different glucose transporter isoforms was measured during the development and differentiation of the rat mammary gland. Before conception, when the mammary gland is mainly composed of adipocytes, Glut 4 and Glut 1 mRNAs and proteins were present. During pregnancy, the expression of Glut 4 decreased progressively, whereas that of Glut 1 increased. In the lactating mammary gland only Glut 1 was present, and was expressed at a high level. The absence of Glut 4 suggests that glucose transport is not regulated by insulin in the lactating rat mammary gland.     

The activity of phosphoenolpyruvate carboxykinase throughout the lactation cycle of the guinea pig mammary gland

The enzyme phosphoenolpyruvate carboxykinase (PEPCK) has been measured in the guinea pig mammary gland throughout the pregnancy-lactation cycle. This is of interest since the primary importance of PEPCK is thought to be its role in gluconeogenesis and it is questionable whether or not gluconeogenesis occurs in the mammary gland. The enzyme activity, present in both the cytosol and mitochondria, was shown to follow the lactation profile. During the transition into lactation, cytosolic PEPCK activity increases 11-fold and mitochondrial PEPCK activity 43-fold while tissue weight increases 4-fold. Fructose 1,6-bisphosphatase was found to increase at a rate only slightly greater than that of the tissue weight. The increase in mitochondrial PEPCK activity is thus about 10 times greater than that of general tissue expansion, whereas the cytosolic PEPCK activity increase is only 2-fold greater. The activity of fructose 1,6-bisphosphatase appears to be merely keeping pace with general tissue expansion. The mitochondrial enzyme constitutes 59 +/- 3% of the total gland PEPCK activity in the prepartum state and 86 +/- 2% at midlactation. Therefore, mitochondrial PEPCK is the isoenzyme undergoing the greater increase during the transition into lactation in the guinea pig mammary gland and thus would appear to play the more important role in the conversion of oxalacetate to phosphoenolpyruvate in this tissue.     

Expression of alpha-lactalbumin, alpha-S1-casein, and lactoferrin genes is heterogeneous in sheep and cattle mammary tissue.

We used 35S-labeled cRNA probes to localize the sites of alpha-lactalbumin, alpha-S1-casein, and lactoferrin mRNA synthesis in sheep and forcibly weaned cattle mammary tissue. Expression of alpha-lactalbumin was absent in three of four "virgin" glands studied, present in some alveoli of "pregnant" glands but not in others, despite a similar histological appearance. In the early lactating gland, expression was high in those alveoli with few fat globules in their cells and lumen and was absent in alveoli with abundant fat globules. These observations suggest either that alpha-lactalbumin gene expression is linked to the long-term secretory activity of cells and falls once cells are resting or regressing, or that there are cyclical variations in expression, or that in the lactating gland some groups of epithelial cells are synthesizing alpha-lactalbumin and some are synthesizing fat. Expression patterns of alpha-S1-casein were similar to those of alpha-lactalbumin. Lactoferrin, in contrast, was expressed almost exclusively in the "fatty alveoli" of both species. Our results show that dramatic variations in milk gene expression can occur throughout the mammary gland of sheep and cattle and that at no stage of pregnancy, lactation, or involution can the gland be considered metabolically homogeneous.     

Regulation of mouse mammary-gland gamma-glutamyltranspeptidase mRNA during pregnancy, lactation and weaning.

The level of gamma-glutamyltranspeptidase (GGT) activity and of its mRNA were determined in the mouse mammary gland during pregnancy, lactation and weaning. The GGT activity, which is very low in the virgin-mouse mammary gland (5 munits/mg of protein), increases progressively during pregnancy (3-fold), reaches its maximum at the onset of lactation (8-fold) and returns rapidly to basal level at weaning. Although no GGT-specific mRNA is detected in the virgin-mouse mammary gland, a single faint band of 2.2 kb in size is found during pregnancy. During lactation, an additional mRNA of 2.4 kb in size appears, and the level of both mRNAs is higher. This high level of mRNA persists during weaning as well. Southern-blot analysis of mouse mammary-gland DNA provides convincing evidence that there is only one gene which codes for the two mRNAs. The present study provides the first evidence for a physiological regulation of the two GGT mRNAs in the same tissue.     

Polyamine biogenesis in the rat mammary gland during pregnancy and lactation

Polyamines and RNA accumulate in the rat mammary gland during pregnancy, but the major increases occur after parturition. Therefore the major increases occur after the gland has obtained its maximal complement of epithelial cells. During lactation, the spermidine concentration rises above 5mm and RNA content in the lactating mammary gland reaches a value 16 times that of the unstimulated mammary gland. The ratio of spermidine/spermine, an increase of which initially signals an elevation in biosynthetic activity, is near 1 in the normal mammary gland and is greater than 10 in the lactating mammary gland. Putrescine concentration is very low during the entire course of mammary-gland development, with the exception of early pregnancy. The low putrescine concentration probably reflects the very rapid conversion of putrescine into spermidine. Both ornithine decarboxylase, the enzyme that synthesizes putrescine, and putrescine-stimulated S-adenosyl-l-methionine decarboxylase, the enzyme that synthesizes spermidine, increase in activity during middle and late pregnancy; during lactation, both enzyme activities are elevated until the 21st day of lactation, and then decline. These declines are concomitant with involution. Also, it was found that the amount of ribonuclease activity in the mammary gland was very high during lactation, almost double that in the gland during pregnancy.     

The pathway of biosynthesis of nicotinamide–adenine dinucleotide in rat mammary gland

1. The pathway of NAD synthesis in mammary gland was examined by measuring the activities of some of the key enzymes in each of the tryptophan, nicotinic acid and nicotinamide pathways. 2. In the tryptophan pathway, 3-hydroxyanthranilate oxidase and quinolinate transphosphoribosylase activities were investigated. Neither of these enzymes was found in mammary gland. 3. In the nicotinic acid pathway, nicotinate mononucleotide pyrophosphorylase, NAD synthetase, nicotinamide deamidase and NMN deamidase were investigated. Both NAD synthetase and nicotinate mononucleotide pyrophosphorylase were present but were very inactive. Nicotinamide deamidase, if present, had a very low activity and NMN deamidase was absent. 4. In the nicotinamide pathway both enzymes, NMN pyrophosphorylase and NMN adenylyltransferase, were present and showed very high activity. The activity of the pyrophosphorylase in mammary gland is by far the highest yet found in any tissue. 5. The apparent K(m) values for the substrates of these enzymes in mammary gland were determined. 6. On the basis of these investigations it is proposed that the main, and probably only, pathway of synthesis of NAD in mammary tissue is from nicotinamide via NMN.     

Effects of exogenous growth hormone on mammary function in lactating goats

The galactopoietic effect of daily injections, for five day periods, of growth hormone was examined by measuring milk yield, mammary blood flow and arteriovenous differences of glucose and amino acids on 12 occasions in four goats. In 10 periods there were marked increases (mean 18.1%) in mammary blood flow (8 statistically significant) and less-marked increases (mean 8.0%) in milk yield (6 statistically significant). On 8 of the occasions on which it was measured the maximum blood plasma growth hormone concentration was increased to more than 8 ng/ml. There were no statistically significant changes in mammary arteriovenous concentration differences of glucose or amino acids in response to growth hormone injections. It is suggested that, contrary to the usual situation in which the rate of mammary blood flow appears to be regulated by the metabolic activity of the gland, the galactopoietic response to growth hormone may be a consequence of elevated blood flow, which increases the supply to the gland of rate-limiting metabolic substrates.