乳腺增生症中医辨证分型与钼靶X线表现的相关性研究

Correlation Between Traditional Chinese Medicine Syndrome Types of Mammary Gland Hyperplasia and Molybdenum Target X-ray Imaging Performance

【目的】探讨乳腺增生症中医辨证分型与钼靶X线表现的相关性。【方法】选取300例乳腺增生症患者,经2名高年资中医乳腺科医师进行中医辨证分型,并同时应用乳腺钼靶X线摄影机分别进行头尾位(CC)和侧斜位(MLO)检查,观察不同中医证型患者的钼靶X线表现情况。【结果】(1)中医证型分布情况:300例患者中,以肝郁气滞型患者比例最多(128例,占42.7%),其他证型从高到低依次为阴虚火旺型(76例,占25.3%)>冲任失调型(59例,占19.7%)>痰瘀互结型(37例,占12.3%)。(2)钼靶X线分型情况:300例患者中,以片状及团块状增生比例最多(99例,占33.0%),其他分型从高到低依次为结节状增生(78例,占26.0%)>条索状及囊性增生(63例,占21.0%)>增生伴钙化(60例,占20.0%)。(3)不同中医证型患者的钼靶X线表现情况:肝郁气滞型患者主要表现为片状及团块状增生,共54例,占42.2%;阴虚火旺型患者主要表现为结节状增生,共28例,占36.8%;冲任失调型患者主要表现为条索状及囊性增生,共23例,占39.0%;痰瘀互结型患者主要表现为增生伴钙化,共18例,占48.7%。【结论】乳腺增生症属中医“乳癖”范畴,不同中医证型患者的钼靶X线表现特点不同,该结果可为乳腺增生症的临床中医辨证论治从主观化、经验化走向客观化、标准化提供参考依据。

Objective To explore the correlation between traditional Chinese medicine(TCM)syndrome types of mammary gland hyperplasia and molybdenum target X-ray imaging performance.Methods A total of 300 cases of breast hyperplasia patients were enrolled into the study.All of the patients were given syndrome differentiation by two professional TCM physicians and received molybdenum target X-ray mammography by the craniocaudal position(CC)and the medio-lateral oblique position(MLO).The molybdenum target X-ray imaging performance in mammary gland hyperplasia patients with various TCM syndrome types was compared.Results(1)Of the 300 included studying subjects,the syndrome of liver qi stagnation was the predominated type(128 cases,accounting for 42.7%),and then came the syndrome of flaring of fire due to yin deficiency(76 cases,accounting for 25.3%),syndrome of dysfunction of thoroughfare vessel and conception vessel(59 cases,accounting for 19.7%),and the syndrome of phlegm blended with blood stasis(37 cases,accounting for 12.3%).(2)Of the 300 cases,99 cases(accounting for 33.0%)had the molybdenum target X-ray mammography characterized by sheetlike and lumpy hyperplasia,78 cases(accounting for 26.0%)had nodular hyperplasia,63 cases(accounting for 21.0%)had striate and cystic hyperplasia,and 60 cases(accounting for 20.0%)had hyperplasia accompanyingby calcification.(3)Of the patients with the syndrome of liver qi stagnation,54 cases(accounting for 42.2%)hadthe sheet-like and lumpy hyperplasia.Of the patients with the syndrome of flaring of fire due to yin deficiency,28cases(accounting for 36.8%)had the nodular hyperplasia.Of the patients with the syndrome of dysfunction ofthoroughfare vessel and conception vessel,23 cases(accounting for 39.0%)had the striate and cystic hyperplasia.Of the patients with the syndrome of phlegm blended with blood stasis,18 cases(accounting for 48.7%)had thehyperplasia accompanying by calcification.Conclusion Breast hyperplasia can be classified into the category of“breast nodules”in the field of traditional Chinese medicine.The results indicated that the molybdenum targetX-ray imaging performance in breast hyperplasia patients with various syndrome types is different,which isexpected to supply evidence for the TCM syndrome differentiation from being subjective and experienced to beingobjective and standardized.