中医联合激素治疗肉芽肿性乳腺炎疗效观察  

Observation on the therapeutic effect of traditional Chinese medicine combined with hormone on granulomatous mastitis

作　　者：李斐斐 刘晓菲 王圆圆 韩笑 LI Feifei;LIU Xiaofei;WANG Yuanyuan;HAN Xiao(The First Clinical Medical College of Shandong University of Traditional Chinese Medicine/Collaborative Innovation Center of Shandong Provincial Classical Traditional Chinese Medical Decoction, Jinan 250335, Shandong, China)

机构地区：[1]山东中医药大学第一临床医学院/山东省中医经典名方协同创新中心,山东济南250335

出　　处：《现代中西医结合杂志》2020年第14期1499-1503,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：山东省重点研发项目(2015GSF119014);山东省医药卫生科技发展计划项目(2018WS191)。

摘　　要：目的探讨中医联合激素治疗肉芽肿性乳腺炎的临床疗效。方法选择山东中医药大学附属医院乳腺甲状腺外科2017年10月—2018年5月收治的83例肉芽肿性乳腺炎患者(肿块期31例,脓肿期32例,溃后期20例),根据治疗方法不同将患者分为3组:中医外治组18例给予以“提脓祛腐”为核心的外治法治疗,中医外治+激素组30例在中医外治组基础上给予激素治疗,中医内外治+激素组35例在中医外治+激素组基础上给予温阳散结化痰中药内服。观察3组患者治疗2个月后的总疗效及不同分期疗效,统计3组患者治疗周期,随访3组患者治愈后6个月的复发率。结果中医外治组、中医外治+激素组、中医内外治+激素组患者总有效率分别为72.2%(13/18)、80.9%(24/30)、85.7%(30/35),中医内外治+激素组明显高于中医外治组(P<0.05),中医外治+激素组、中医内外治+激素组比较差异无统计学意义(P>0.05);中医外治+激素组和中医内外治+激素组中肿块期与脓肿期患者治疗总有效率均明显高于中医外治组(P均<0.05),且中医内外治+激素组脓肿期患者治疗总有效率明显高于中医外治+激素组(P<0.05);3组溃后期患者治疗总有效率比较差异无统计学意义(P均>0.05)。中医外治+激素组和中医内外治+激素组肿块期与脓肿期患者治疗周期及中医内外治+激素组溃后期患者治疗周期均明显短于中医外治组(P均<0.05),中医内外治+激素组脓肿期与溃后期患者治疗周期均明显短于中医外治+激素组(P均<0.05)。中医内外治+激素组患者复发率明显低于中医外治组(P<0.05),中医外治组和中医外治+激素组比较差异无统计学意义(P>0.05)。结论激素治疗更适用于肿块期及脓肿期患者,肿块期疗效最佳,溃后期未发现正向作用。中医内外治联合激素治疗肉芽肿性乳腺炎疗效显著,可显著缩短治疗周期,有助于减少愈后复发。Objective It is to explore the clinical efficacy of Chinese medicine combined with hormones in the treatment of granulomatous mastitis.Methods A total of 83 patients with granulomatous mastitis(31 in the mass stage,32 in the abscess stage,and 20 in the late ulcer stage)were selected from the Department of Breast and Thyroid Surgery,Affiliated Hospital of Shandong University of Traditional Chinese Medicine from October 2017 to May 2018 were selected and divided into 3 groups according to their treatment methods:18 cases in the TCM external treatment group(groupⅠ)were given external treatment with the core of“lifting pus and removing rot”,and 30 cases in the TCM+hormone group(groupoⅡ)were given hormone based on the TCM external treatment group,35 cases of TCM internal and external treatment+hormone group(groupⅢ)was treated with the Chinese medicine for Wenyang Sanjie Huatan by oral administration on the basis of groupⅡ.The total efficacy after 2 months of treatment and the efficacy at different stages were observed,the treatment cycles were counted,and the relapse rate after 6 months of cure was followed up in the three groups.Results The total effective rates of groupⅠ,groupⅡand groupⅢwere 72.2%(13/18),80.9%(24/30),85.7%(30/35),the rate in groupⅢwas higher than that in groupⅠ(P<0.05),but there was no significant difference between groupⅡand groupⅡ(P>0.05);The total effective rates of in the lump stage and abscess stage of groupⅡand groupⅢwere significantly higher than that of groupⅠ(all P<0.05),and the total effective rate of groupⅢwas significantly higher than that of groupⅡ(P<0.05);There was no statistically significant difference in the total effective rate in the late stage of ulceration among the three groups(all P>0.05).The treatment cycle of patients in the lump stage and abscess stage in groupⅡand groupⅢand treatment cycle of patients in late ulcer stage in groupⅢwere significantly shorter than those in groupⅠ(P<0.05),the treatment cycle of patients at abscess an

关 键 词：肉芽肿性乳腺炎 中医治疗 激素治疗 

分 类 号：R655.8[医药卫生—外科学]