| Mammary glands are important for women, which are also interfered by manydisease. Hyperplasia of mammary glands(HMG) is the most common breast disease.Its incidence is about 40％in women who are in childbearing period and is about75％in all breast disease. The incidence of this disease shows a significant rising trendwith the development of society, economy and the change of our environment.Epidemiology shows that HMG would be a precancerous lesion, because HMG withmoderate hyperplasia increases the risk of developing breast cancer by 1.5-2.0 times,HMG with atypical hyperplasia increases breast cancer risk by 5 times.HMG belongs to the category of Rupi in traditional Chinese medicine(TCM).Deficiency of kidney-qi, liver depression and qi stagnation, hollow blood flow, loss ofsupply to liver and Chongren imbalance were the causes or the "root" of HMG.Mammary pain and masses due to qi stagnation, phlegm congealing and blood stasiswere the results or manifestations of HMG. Presently, to restore the physiologicbalance of female and to cure the HMG, the main therapeutic method of TCM issoothing the liver, promoting the flow of the liver-qi, activating blood circulation toalleviating mammary pain, dispersing masses and regulating Chongren.Modern medicine holds that HMG has relationship with the state of ovarianendocrine function. Firstly, it is caused by disorder of sexual hormone metabolism andovarian dysfunction, which entails a relatively or absolutely higher level of estrogen.Secondly, the quality and quantity of hormone receptors in partial breast tissue areabnormal, with the result that degree of hyperplasia in different part of the breast isnot uniform. Endocrine therapy is the main treatment for this disease.Tamoxifen(TAM), which is the most commonly used drug in endocrine therapy, hasdefinitely therapeutic effect but more side effects. On the other hand, the efficiency ofTCM in treatment of HMG could reach more than 90％, because of its high efficiency,safety and without side effects, TCM becomes the primary treatment for HMG.In this study, the progress in treating of HMG by TCM was discussed thoroughlyby reviewing many papers of TCM and western medicine. Under the direction of mytutor, professor Xu Zhi-yin, and according to the principles of correct differentiationand proper administration in TCM, it was demonstrated that the characteristic ofHMG was qi-stagnation and blood stasis due to deficiency of kidney and Chongrenimbalance. To cure the HMG, Xiaopi tablet(Xianlingpi, Danpi, Shancigu, Chishao)was developed, which had the effects of nourishing the kidney, promoting the flow ofthe qi, activating blood circulation, dispersing stasis and alleviating the pain. Theprescription of Xiaopi tablet was explored to demonstrate the theoretic basis for itstherapeutic effect on HMG.At the same time, with the help of methods used in modern medicine, andaccording to the principles of random, control and repeat, the therapeutic effect ofXiaopi tablet on HMG in experimental rats was studied in order to find out the mechanisms of Xiaopi tablet in treating HMG and provide the basis for its applicationin clinical practice, that would be important for further research and development ofTCM in this field.At first, experiment was performed to evaluate the analgesia effect of Xiaopi tableton rats which were given the medicine prophylactically. It was showed that Xiaopitablet had very good analgesia effect by relieving the pain induced by thermal andchemical stimulus. The analgesia effect of Xiaopi tablet was non-specific and muchbetter than Rupixiao tablet. Secondly, to examine the therapeutic effect of Xiaopitablet on HMG, the model of rats with HMG was constructed by injecting estradiolbenzoate and progesterone. Then the rats were given Xiaopi tablet by stomachperfusion. The level of serum sexual hormone in rats was measured by chemicalluminescence. It was showed that Xiaopi tablet could reduce the level of E2 and P inrats with HMG. Morphology and pathohistology of the breast tissues in rats wereobserved to evaluate the amounts of acini, acini dilation and secretion, and degrees ofhyperplasia of the acini or ductal epithelium in different lobular. The expression of ERand PR were tested by immunohistochemistry. It was found that high dose Xiaopitablet could reduce the nipple height of rats with HMG, alleviate congestion andedema of breast tissue, decrease the amounts of acini in lobular, alleviate thehyperplasia of acini or ductal epithelium, and inhibit the secretion of the acini. Thesensitivity of breast tissue to estrogen was reduced by decreasing the ER amounts. Itis concluded that high dose Xiaopi tablet had much better therapeutic effect on ratswith HMG than Rupixiao tablet and TAM.Based on the soul of TCM and inheriting scientific attainments from tutor, toprovide the foundation for clinical application, we research the disease deeply andsystematically, and partly uncover the mechanism of Xiaopi tablet by means oftheoretical study, animal experiment and clinical observation. |
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