蒙医治疗乳腺增生症的研究进展

Research Progress on Mongolian Medicine in Treating Hyperplasia of Mammary Glands

摘要: 乳腺增生症(Hyperplasia of Mammary Glands, HMG)作为一种高发良性乳腺疾病，在孕龄期女性中发病率显著(占乳腺疾病70%~80%)，其中25~40岁人群为高峰，其病因与现代医学的神经内分泌紊乱密切相关，表现为雌二醇(E2)和孕酮(P)比例失衡导致乳腺实质过度增生，临床以乳房疼痛及肿块为特征；在蒙医理论中，HMG被归类为“血瘀证”范畴，源于《四部医典》所述的三根七素失衡(尤以琪素、希拉偏盛)，核心病机涉及赫依、巴达干、琪素的偏盛，具体分型包括：巴达干偏盛型(由胃火衰微引发，体征如肿块生长缓慢、四肢不温及通经)、琪素偏盛型(最常见，因血希拉亢进至清浊分化异常，特征为触痛，明显伴口干口苦及热象)、赫依偏盛型(因气郁结至脉道闭塞，表现为肿块快速生长及抑郁多梦)；诊断过程需蒙医辨证与现代影像学技术，其中超声检查为首选，能清晰识别低回声结节(敏感性高)，钼靶X线则对微钙化灶筛查具特异性(应用价值显著)，辅以乳管造影鉴别溢液病因，这种多模态方法(包括X线、乳管镜等)有效降低了误诊风险；综上所述，蒙医通过“三根七素失衡”理论构建了独特的HMG分型体系，为蒙西医结合治疗提供了理论基础，并突显了协同诊断在提升精准干预中的关键作用。

Abstract: Hyperplasia of Mammary Glands (HMG), a prevalent benign breast disorder, demonstrates significantly high incidence (70%~80% of breast diseases) among reproductive-age women, with the peak occurrence in the 25~40-year cohort. Its pathogenesis is closely associated with neuroendocrine dysregulation in modern medicine, specifically the imbalance between estradiol (E2) and progesterone (P) leading to mammary gland hyperplasia, clinically characterized by breast pain and palpable masses. Within Mongolian medical theory, HMG is categorized as a “blood stasis syndrome” originating from the imbalance of three roots and seven essentials (particularly Chisu and Xila predominance) as documented in the Sibu Yidian (Canon of Four Medical Tantras). The core pathological mechanisms involve the predominance of Heyi (energy flow), Badagan (phlegm), and Chisu (blood), classified into three subtypes: Badagan-predominant type (triggered by diminished gastric fire, presenting with slow-growing masses, cold extremities, and dysmenorrhea); Chisu-predominant type (most clinically common, caused by excessive blood-Xila disturbing hepatic purification, featuring marked tenderness with dry mouth, bitter taste, and heat manifestations); Heyi-predominant type (resulting from qi stagnation obstructing vessels, manifested by rapidly enlarging masses with depressive symptoms and dream-disturbed sleep). Diagnosis integrates Mongolian medical pattern differentiation (e.g., tongue coating and pulse analysis) with modern imaging modalities: Ultrasonography serves as the primary modality due to its high sensitivity (>90%) in detecting hypoechoic nodules, whereas mammography provides specificity (86%) for microcalcification screening. Supplemental ductography further aids in pathological nipple discharge assessment. This multimodal imaging approach (including X-ray and ductoscopy) substantially reduces misdiagnosis risks. In conclusion, Mongolian medicine establishes a unique HMG classification system through the “three roots imbalance” theory, which correlates symptomology with imaging findings (e.g., Badagan-type correlating with patchy mammographic shadows), thereby providing a theoretical foundation for integrated Mongolian-Western medical interventions and highlighting the critical role of synergistic diagnostics in precision management.