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成都中医药大学,成都 610036
Received:12 September 2020,
Published Online:27 November 2020,
Published:20 April 2021
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赵玉民,冯叶雯,张黎等.理冲汤治疗子宫肌瘤的研究进展[J].中国实验方剂学杂志,2021,27(08):228-234.
ZHAO Yu-min,FENG Ye-wen,ZHANG Li,et al.Research Progress on Lichongtang in Treatment of Uterine Leiomyoma[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(08):228-234.
赵玉民,冯叶雯,张黎等.理冲汤治疗子宫肌瘤的研究进展[J].中国实验方剂学杂志,2021,27(08):228-234. DOI: 10.13422/j.cnki.syfjx.20210322.
ZHAO Yu-min,FENG Ye-wen,ZHANG Li,et al.Research Progress on Lichongtang in Treatment of Uterine Leiomyoma[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(08):228-234. DOI: 10.13422/j.cnki.syfjx.20210322.
子宫肌瘤(UL)是育龄期妇女最常见的生殖系统良性肿瘤,以月经量增多、经期延长、乳房胀痛、腰腹酸胀及下腹包块等临床症状为特征。随着现代社会的不断进步,女性婚育年龄逐渐推迟,在一定程度上导致了现代女性罹患UL的概率升高。相关文献表明,UL的发病率约为70%,有25%~50%的患者表现出临床症状,严重危害女性生理健康。现代医疗针对UL的防治,目前仅停留在药物控制雌孕激素水平和手术切除两方面。中医学在改善UL患者临床症状方面表现出明显的优势,在辨证论治和整体观念的基础上调节机体气血,应用前景十分广阔。理冲汤作为益气行血、活血化瘀的中医名方,由清代名医张锡纯所创,记载于《医学衷中参西录》,临床上被广泛应用于妇科疾病领域。研究表明理冲汤治疗UL疗效显著,临床病例观察显示经理冲汤治疗后能显著缓解UL患者经期延长、痛经、腰腹酸胀及阴道不规则出血等临床症状,具有疗效稳定、安全性高、不良反应少、复发率低的特点。实验研究显示理冲汤通过抑制UL细胞增殖并诱导其凋亡、降低血清雌孕激素水平、调节肿瘤细胞凋亡途径、促进细胞外基质降解等途径,对UL的防治作用呈现出多途径的综合调节特征。笔者检索了PubMed,中国知网等数据库,通过对文献理论、临床疗效及作用机制3个方面进行总结归纳,将理冲汤治疗UL的研究报道做出一综述,为理冲汤后续的深入药理作用机制研究和进一步的临床运用及推广提供参考。
Uterine leiomyoma (UL), the most common benign tumor of the reproductive system in women of childbearing age, is characterized by clinical symptoms such as increased menstrual flow, prolonged menstrual period, breast tenderness,backache, lower abdominal pain and mass in the lower abdomen. With the continuous progress of modern society, the age of women's marriage and childbirth is gradually pushed back, which to a certain extent has led to an increase in the probability of modern women suffering from UL. Relevant literature shows that the incidence of UL is about 70%, and 25%-50% of the patients have clinical symptoms, seriously endangering women's physical health. The prevention and treatment of UL by modern medicine is currently limited to two aspects: drug control of estrogen and progesterone levels and surgical removal. Traditional Chinese medicine(TCM)has shown obvious advantages in improving the clinical symptoms of UL patients, with very broad application prospects as it can regulate body's Qi and blood on the basis of syndrome differentiation, treatment and overall concepts. Lichongtang, as a famous TCM prescription for replenishing Qi, activating blood and removing blood stasis, was created by ZHANG Xi-chun, a famous Chinese medicine doctor in the Qing dynasty, and recorded in the
Records of Tradition Chinese and Western Medicine in Combination
. It is widely used in the field of gynecological diseases in clinical practice. Studies have shown that Lichongtang is effective in treating UL. Clinical observations show that Lichongtang can significantly relieve the clinical symptoms of UL patients such as prolonged menstrual period, dysmenorrhea, waist and abdomen swelling and irregular vaginal bleeding, with the characteristics of stable curative effect, high safety, less side effect and low recurrence rate. The experimental results show that Lichongtang has a comprehensive regulatory effect on UL through inhibiting the proliferation of UL cells and inducing apoptosis, reducing serum estrogen and progesterone level, regulating the apoptosis pathway of tumor cells, and promoting the degradation of extracellular matrix(ECM). After retrieval in PubMed, CNKI and other databases, the authors made a review by summarizing the theories, clinical efficacy and action mechanisms of Lichongtang in the treatment of UL, in order to provide reference for the follow-up in-depth study of pharmacological mechanism of Lichongtang and its further clinical application and promotion.
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