小剂量泼尼松联合手术治疗肉芽肿性乳腺炎安全性及疗效的临床研究  

Clinical study on safety and efficacy of low-dose prednisone combined with operation for the treatment of granulomatous mastitis

作　　者：朱强[1] 王丕琳[1] 于腾飞[1] 杨自国 霍记平[1] ZHU Qiang;WANG Pi-lin;YU Teng-fei;YANG Zi-guo;HUO Ji-ping(Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院,北京100070

出　　处：《中国药物应用与监测》2020年第3期144-147,共4页Chinese Journal of Drug Application and Monitoring

基　　金：首都卫生发展科研专项(2011-2004-06)。

摘　　要：目的:观察小剂量泼尼松联合手术治疗肉芽肿性乳腺炎的临床疗效及安全性。方法:90例肉芽肿性乳腺炎患者随机均分为试验组和对照组。试验组口服泼尼松0.4 mg·kg^-1·d^-1,起始剂量治疗4周,第5周起每周减2.5 mg·d^-1,减量至5 mg·d^-1,维持2周后停药。对照组45例,口服泼尼松0.75 mg·kg^-1·d^-1,起始剂量治疗4周,第5周起每周减5 mg·d^-1,减量至5 mg·d^-1,维持2周后停药。两组均在激素治疗6-8周后手术,进行完整病灶清除术,若疗程中肿块缩小明显,直径<2 cm即可采取手术治疗。计量数据行t检验;计数资料行卡方检验。结果:两组手术情况比较结果显示,试验组和观察组在药物治疗有效率、手术切除腺体量、术中出血量、术后满意度、术后痊愈时间方面基本相同,无统计学差异(P>0.05);并发症率比较无统计学差异(P>0.05);试验组不良反应发生率明显低于观察组,两者比较有统计学差异(P<0.05)。结论:小剂量泼尼松联合手术治疗肉芽肿性乳腺炎效果满意,安全性好。Objective:To observe the clinical efficacy and safety of low-dose prednisone combined with operation for the treatment of granulomatous mastitis.Methods:90 patients with granulomatous mastitis were randomly divided into test group and control group.There were 45 patients in each group.Patients in test group were given oral prednisone with the initial dose of 0.4 mg·kg^-1·d^-1 for 4 weeks.From the 5th week,the dose was reduced 2.5 mg·d^-1 every week till to 5 mg·d^-1.And then prednisone was stopped after 5 mg·d^-1 for 2 weeks.The administration regimen in control group was the same as that of the test group except that the initial dose was 0.75 mg·kg^-1·d^-1 and the dose was reduced 5 mg·d^-1 every week from the 5th week.All the patients accepted complete clearance of focal lesion after 6-8 weeks of hormone therapy.If the size of the mass reduced quickly,surgery would initiate when the diameter of the mass was less than 2 cm.T-test and Chi-square test were adopted to analyze measurement data and qualitative data respectively.Results:There were no significant differences between two groups in the effective rate of medication,weight of gland ablated in the surgery,bleeding volume during the surgery,postoperative satisfaction,healing time and complications after operation(P>0.05).The incidence of adverse drug reactions was significantly lower in test group than that in control group(P<0.05).Conclusion:Low dose prednisone combined with operation was effective and safe in the treatment of granulomatous mastitis.

关 键 词：肉芽肿性乳腺炎 手术 泼尼松 安全性 疗效 

分 类 号：R969.4[医药卫生—药理学] R977.1[医药卫生—药学]