活血散结类中成药抗乳腺增生作用机制及联合用药的研究进展

Mechanism of blood-activating and mass-dissipating Chinese patent medicine against hyperplasia of mammary glands and use with other medicine:a review

乳腺增生(hyperplasia of mammary gland,HMG)是由内分泌激素紊乱导致的一种增生性疾病,发病趋势呈年轻化、上升化,并有癌变风险,严重危害女性健康,因此对HMG的防治越来越重视。随着中医药的发展,许多学者发现中成药在治疗内分泌紊乱方面有着独特优势和巨大潜力,尤其以具有活血散结作用的小金丸、消癥丸等已是临床常用治疗HMG的中成药,具有多靶点调控、疗效显著、副作用小、便于携带和服用的优点。有临床研究发现中成药联合用药后不仅可以提高疗效、缓解增生及疼痛等症状,还可降低西药的毒副作用,因此使用中成药及联合用药逐渐成为了临床治疗HMG的常用手段。在查阅了相关的药理及临床研究文献基础上,以活血散结类中成药和联合用药2个方面,从调节体内激素及受体水平、促进细胞凋亡、抑制新血管形成、改善血液流变学、增强免疫力、提高抗氧化能力等角度进行综述,深入阐述其作用机制,并且针对其现状提出不足之处和有待解决的问题,为活血散结类中成药及联合用药抗HMG的进一步研究和临床应用提供理论依据。

Caused by endocrine disorder,hyperplasia of mammary glands(HMG)tends to occur in the young with increasing incidence,putting patients at the risk of cancer and threatening the health of women.Therefore,the prevention and treatment of HMG is attracting more and more attention.Amid the modernization of traditional Chinese medicine(TCM),many scholars have found that Chinese patent medicine has unique advantages and huge potential in treatment of endocrine disorder.Particularly,Chinese patent medicine with the function of blood-activating and mass-dissipating,such as Xiaojin Pills and Xiaozheng Pills,has been commonly used in clinical treatment of HMG,which features multiple targets,obvious efficacy,small side effect,and ease of taking and carrying around.Clinical studies have found that the combination of Chinese patent medicine with other medicine can not only improve the efficacy and relieve symptoms such as hyperplasia and pain but also reduce the toxic and side effects of western medicine.Therefore,based on precious pharmacological research and clinical research,this study reviewed the mechanisms of blood-activating mass-dissipating Chinese patent medicine alone and in combination with other medicine,such as regulating levels of in vivo hormones and receptors,promoting apoptosis,inhibiting angiogenesis,improving hemorheology indexes,enhancing immunity,and boosting antioxidant ability.In addition,limitations and problems were summarized.Thereby,this study is expected to lay a theoretical basis for the further study and clinical application of blood-activating mass-dissipating Chinese patent medicine alone or in combination with other medicine against HMG.