Ghent W R, Eskin B A, Low D A, Hill L P
Department of Surgery, Queen's University, Hotel Dieu Hospital, Kingston, Ont.
Can J Surg. 1993 Oct;36(5):453-60.
To determine the response of patients with fibrocystic breast disease to iodine replacement therapy.
Review of three clinical studies beginning in 1975: an uncontrolled study with sodium iodide and protein-bound iodide; a prospective, control, crossover study from iodide to molecular iodine; and a prospective, control, double-blind study with molecular iodine.
University affiliated breast-treatment clinics.
Study 1: 233 volunteers received sodium iodide for 2 years and 588 received protein-bound iodide for 5 years. Study 2: the treatment of 145 patients from study 1 treated with protein-bound iodide for several months who still had symptoms was switched to molecular iodine 0.08 mg/kg; 108 volunteers were treated initially with molecular iodine. Study 3: 23 patients received molecular iodine, 0.07 to 0.09 mg/kg body weight; 33 received an aqueous mixture of brown vegetable dye and quinine. The numbers in study 2 increased over the review period so that 1365 volunteers were being treated with molecular iodine by 1989.
All patients in study 3 had pre- and post-treatment mammography and measurement of serum triiodothyronine, thyroxine and thyroid-stimulating hormone levels.
Subjective evaluation--freedom from pain--and objective evaluation--resolution of fibrosis.
Study 1: 70% of subjects treated with sodium iodide had clinical improvement in their breast disease, but the rate of side effects was high; 40% of patients treated with protein-bound iodide had clinical improvement. Study 2: 74% of patients in the crossover series had clinical improvement, and objective improvement was noted in 72% of those who received molecular iodine initially. Study 3: in the treatment group 65% had subjective and objective improvement; in the control group there was a subjective placebo effect in 33% and an objective deterioration of 3%.
The fibrocystic breast reacts differently to sodium iodide, protein-bound iodide and molecular iodine. Molecular iodine is nonthyrotropic and was the most beneficial.
确定患有纤维囊性乳腺病的患者对碘替代疗法的反应。
回顾始于1975年的三项临床研究：一项关于碘化钠和蛋白结合碘的非对照研究；一项从碘化物到分子碘的前瞻性、对照、交叉研究；以及一项关于分子碘的前瞻性、对照、双盲研究。
大学附属乳腺治疗诊所。
研究1：233名志愿者接受碘化钠治疗2年，588名志愿者接受蛋白结合碘治疗5年。研究2：研究1中145名接受蛋白结合碘治疗数月仍有症状的患者转而接受0.08 mg/kg的分子碘治疗；108名志愿者最初接受分子碘治疗。研究3：23名患者接受0.07至0.09 mg/kg体重的分子碘治疗；33名患者接受棕色植物染料和奎宁的水性混合物治疗。研究2中的人数在回顾期内有所增加，到1989年有1365名志愿者接受分子碘治疗。
研究3中的所有患者在治疗前后均进行了乳房X光检查，并测量了血清三碘甲状腺原氨酸、甲状腺素和促甲状腺激素水平。
主观评估——无疼痛——和客观评估——纤维化消退。
研究1：接受碘化钠治疗的受试者中70%的乳腺疾病有临床改善，但副作用发生率较高；接受蛋白结合碘治疗的患者中有40%有临床改善。研究2：交叉系列中的74%的患者有临床改善，最初接受分子碘治疗的患者中有72%有客观改善。研究3：治疗组中65%有主观和客观改善；对照组中有33%有主观安慰剂效应，3%有客观恶化。
纤维囊性乳腺对碘化钠、蛋白结合碘和分子碘的反应不同。分子碘无促甲状腺作用，且最有益。
