Observation on lower-reinforcing and upperreducing acupuncture method for hyperplasia of mammary gland and its influence on estradiol and progesterone

To observe the clinical effect of lower-reinforcing and upper-reducing acupuncture method for hyperplasia of mammary gland (HMG) and its influence on estradiol (E2) and progesterone (P). A randomized, single-blinded and controlled trial was conducted. A total of 124 cases conforming to the inclusion criteria were randomized by random number table into a treatment group and a control group, with 62 cases in each group. Patients in both groups received acupuncture therapy at the same acupoints, while patients in the treatment group received lower-reinforcing and upper-reducing method, and patients in the control group received even reinforcing-reducing manipulation. The treatment started around 10 d before menstruation and was conducted every other day. Patients received 5 treatments in each menstruation cycle for consecutive 3 cycles. The levels of E2, P and E2/P and clinical efficacy were measured before and after treatment. After treatment, the breast lump size, pain intensity and concomitant symptoms score in both groups were substantially lower than those before treatment, showing statistical significances (all P<0.01), and the improvement in the treatment group was higher than that in the control group, and the between-group comparisons showed statistical significances (all P<0.01). After treatment, the overall effective rate was 91.9% in the treatment group, higher than 72.6% in the control group, and the between-group comparison showed a statistical significance (P<0.01). After treatment, levels of E2, P and E2/P value showed no statistical significance when compared with those before treatment in the two groups (all P>0.05). Lower-reinforcing and upper-reducing acupuncture method can effectively alleviate clinical symptoms and signs in HMG patients, and produce a better effect than even reinforcing-reducing manipulation. The majority of HMG patients’ E2, P level and E2/P value were not beyond the normal ranges; therefore, acupuncture showed no substantial influence on E2and P levels and E2/P value. 观察下补上泻针刺法治疗乳腺增生病的临床疗效, 以及对雌二醇(E2)和孕酮(P)水平的影响。 采用随机、单盲、对照设计, 将124例符合纳入标准的患者按随机数字法随机分为观察组和对照组, 每组62例。两组取穴相同, 观察组采用下补上泻针刺法, 对照组予平补平泻针刺法。两组均于月经前10 d针刺, 隔日治疗1次。每个月经周期治疗5次连续治疗3个月经周期。观察治疗前后两组E2、P、E2/P值的变化及治疗后的临床疗效。 治疗后, 两组患者的乳房肿块大小、疼痛程度及伴随症状评分均较同组治疗前明显降低(均P<0.01), 且观察组的改善程度优于对照组, 组间评分差异均有统计学意义(均P<0.01)。治疗后, 观察组的总有效率为91.9%,高于对照组的72.6%, 组间差异具有统计学意义(P<0.01)。治疗后, 两组患者E2、P及E2/P值与治疗前均无统计学差异(均P>0.05)。 下补上泻针法能有效缓解乳腺增生病患者的临床症状和体征, 疗效优于平补平泻针刺法。因多数乳腺增生病患者的E2、P及E2/P值并未超出正常范围, 故针刺治疗对患者E2、P及E2/P值的影响不明显。