赵娴 候咪 乔迪

摘要：目的 观察乳乐冲剂对乳腺增生大鼠乳腺组织病理学、卵巢性激素及其受体表达的影响，探讨其作用机制。方法 采用肌注苯甲酸雌二醇20 d，再肌注黄体酮5 d建立乳腺增生模型。将66只雌性SD大鼠随机分为空白组、模型组、针刺组和中药高、中、低剂量组，每组11只。针刺组选取甲组穴“屋翳”“合谷”（均双侧）、“膻中”，乙组穴“天宗”“肝俞”“足三里”（均双侧），2组穴位交替使用，1组/d；中药各剂量组给予1.1、0.55、0.11 g/mL乳乐冲剂灌胃，1次/d。各组均连续治疗30 d后腹主动脉采血，ELISA检测血清雌二醇（E2）、孕激素（P）含量；同时切除第2对左侧乳房，光镜下观察乳腺组织变化，免疫组化检测乳腺组织雌激素受体（ER）、孕激素受体（PR）阳性表达。结果 与空白组比较，模型组大鼠乳腺组织增生明显，血清E2含量和ER、PR阳性表达积分显著升高（P<0.01），P含量显著降低（P<0.01）；与模型组比较，各治疗组大鼠乳腺组织增生均有改善，E2含量和ER、PR阳性表达积分均显著降低（P<0.05），针刺组P含量显著升高（P<0.01），且以针刺组和中药低剂量组作用最为明顯。结论 乳乐冲剂可有效改善外源性雌激素、P所致大鼠乳腺增生组织结构，其机制与降低血清E2含量和乳腺组织ER、PR阳性表达积分，升高血清P含量有关。

关键词：乳腺增生病；乳乐冲剂；针刺；激素水平；受体；大鼠

DOI：10.3969/j.issn.1005-5304.2017.11.012

中图分类号：R285.5；R245 文献标识码：A 文章编号：1005-5304（2017）11-0048-05

Abstract： Objective To observe the effect of Rule Granules on the breast tissue pathology， ovarian hormone and receptor expression of mammary glands hyperplasia rats； To explore its mechanism of action. Methods The model of mammary gland hyperplasia was established by intramuscular injection of estradiol benzoate for 20 days and intramuscular injection of progesterone for 5 d. 66 female SD rats were randomly divided into 6 groups， including blank group， model group， acupuncture group， TCM high-， medium- and low-dose groups， with 11 rats in each group. Acupuncture group chose group A （Wuyi， Hegu， on both sides， Tanzhong） and group B （Tianzong， Ganshu， Zusanli， on both sides）， and the two groups were used alternately， one group per day. TCM groups received 1.1 g/mL， 0.55 g/mL， and 0.11 g/mL dose of Rule Granules for gavage， once a day. Abdominal aorta blood was collected after continuous treatment of 30 d. The contents of serum E2 and P were detected through ELISA method， at the same time， the second left side of the breast was removed. The changes of the breast tissue was observed under light microscope， and the ER and PR positive expression was observed by SABC immunohistochemical method. Results Compared with the blank group， hyperplasia of mammary gland in the model group rats was more obvious， and serum E2， ER and PR positive expression of integral increased significantly （P<0.01）， but the content of P decreased significantly （P<0.01）； compared with the model group， hyperplasia of mammary gland was improved in all treatment groups， and

基金项目：国家自然科学基金面上项目（81473782）；陕西省中医管理局资助项目（13-LC068）

serum E2， ER and PR positive expression of integral decreased significantly （P<0.05）； the content of P in acupuncture group increased significantly （P<0.01）， and the acupunture group and TCM low-dose group were the most obvious. Conclusion Rule Granules can effectively improve hyperplasia of mammary gland organization structure in rats caused by exogenous estrogen and progesterone， with TCM low-dose group and acupuncture group having the best efficacy. Its mechanism is related to reducing the contents of serum E2 and ER， and PR positive expression in breast tissue， and increasing the content of serum P.

Key words： hyperplasia of mammary gland； Rule Granules；acupuncture； hormone level；receptors； rats

乳腺增生（mammary glands hyperplasia，MGH）是一种既非炎症又非肿瘤的乳腺疾病，是乳腺实质的良性增生，居乳腺病首位，目前临床对MGH尚无特效疗法。国医大师郭诚杰教授及其学术传承人于20世纪70年代开始循序渐进开展了针刺治疗MGH的系列临床及实验研究，并取得可靠疗效[1-3]。郭老治疗MGH除采用针刺治疗外，常配合自创乳乐冲剂口服。为更全面整理、传承郭老治疗MGH的经验，本研究聚焦乳乐冲剂对MGH的治疗作用，通过观察其对MGH大鼠性激素、免疫调节相关物质、乳腺组织病理改变的影响，探讨其治疗MGH的疗效和作用机制，为筛选更有效的针药结合治疗方案，以及研究开发治疗MGH的新药提供实验依据。……