三苯氧胺辅助手术切除乳腺增生结节对内分泌水平和预防复发的影响

摘要

目的 通过观察临床应用三苯氧胺辅助手术切除治疗乳腺增生结节的临床疗效及对内分泌水平的影响,探讨三苯氧胺辅助手术切除治疗乳腺增生结节对术后复发的预防机制.方法 80例具有手术指征的乳腺增生结节患者按照随机平行分组法随机分为治疗组与对照组,每组40例,2组患者均给予常规手术切除,治疗组在此基础上辅助应用三苯氧胺口服,连续服用12周.比较2组患者临床疗效及血清内分泌激素水平[促黄体生成素(LH)、孕酮(P)、雌二醇(E2)和催乳素(PRL)].结果 2组患者术前血清LH、P、E2及PRL水平比较差异无统计学意义(P＞0.05),术后12周时2组患者LH、P均较术前明显升高,E2、PRL均较术前明显降低,差异均有统计学意义(P＜0.05),但同期组间比较治疗组较对照组升高或降低更明显(P＜0.05),随访12个月,治疗组患者愈显率明显优于对照组,复发几率低于对照组,差异均有统计学意义(P＜0.05).结论 三苯氧胺辅助手术切除治疗具有手术指征的乳腺增生结节效果理想,可以有效促进内分泌水平恢复、且有助于降低近期复发率.%Objective To observe the clinical curative effects of tamoxifen combined with surgical resection on mammary glands nodular hyperplasia and its effects on endocrine levels of patients,and to explore its action mechanism of preventive effects on disease relapse.Methods Eighty patients with mammary glands nodular hyperplasia who were admitted and treated in our hospital from April 2015 to April 2016 were randomly divided into observation group and control group,with 40 patients in each group.The patients in both groups were treated by conventional surgical resection,moreover,the patients in observation group were given tamoxifen orally,with a treatment course of 12 weeks.The clinical efficacy and the serum levels of related endocrine hormones including luteinizing hormone (LH),progesterone (P),estradiol (E2) and prolactin (PRL) were observed and compared between the two groups.Results Before treatment there were no significant differences in serum levels of LH,P,E2 and PRL between two groups (P ＞ 0.05),however,on 12 weeks after operation,the serum levels of LH and P were significantly increased in both groups,however,the serum levels of E2 and PRL were significantly decreased,as compared with those before treatment (P ＞ 0.05),moreover,the increase or decrease degree in observation group was more obvious than that in control group (P ＜ 0.05).After 12-month follow up,the effective rate in observation group was steprior to that in control group,moreover,the relapse rate in observation group was significantly lower than that in control group (P ＜ 0.05).Conclusion The tamoxifen combined with surgical resection can get satisfactory therapeutic effects on mammary glands nodular hyperplasia,which can effectively promote the recovery of endocrine levels and also helps to reduce short-term relapse rate.