Treatment of Menstrual Mastalgia from the Perspective of Simultaneous Regulation of the Liver and Spleen

Abstract

Menstrual mastalgia is a common cyclic clinical complaint among women of childbearing age. Its major manifestations include breast distension and pain, even marked tenderness, occurring before, during or after menstruation [1]. Recurrent episodes severely impair women’s physical and mental health as well as daily life. From the perspective of modern medicine, its pathological mechanism is defined as breast interstitial fluid retention and local neural sensitization induced by cyclic fluctuations of ovarian hormones [2]. Modern physiological studies demonstrate that relative changes in estrogen and progesterone levels in the late luteal phase give rise to hyperplasia of mammary ductal epithelium and interstitial edema, which constitute the direct physical basis for pain generation [3]. According to traditional TCM visceral and meridian theory, the disease is located in the breast and closely associated with the liver and spleen. Its core pathogenesis includes liverqi stagnation, impaired spleen transportation, and intermingled excess and deficiency. The liver governs dispersion and free flow of qi, while the spleen governs transportation and transformation. Dysfunction of the liver and spleen serves as the root cause of recurrent attacks [4-6]. Therapeutically, a holistic regulatory strategy of “simultaneous regulation of the liver and spleen” is emphasized [7]. Recent studies verify that this traditional syndromedifferentiation framework shares high isomorphism with modern physiological mechanisms including stressneuroendocrine regulation, gutliver axis metabolism and inflammatory modulation, laying a solid theoretical foundation for integrativemedical intervention for menstrual mastalgia [8].