《外科十法》辨治肉芽肿性乳腺炎  

Differentiation and Treatment of Granulomatous Mastitis in Ten Therapies of External Medicine

作　　者：周笛 刘丽芳[2] 罗君 柳佳璐 龙俊瑶 ZHOU Di;LIU Li-fang;LUO Jun;LIU Jia-lu;LONG Jun-yao(Hunan University of Chinese Medicine,Changsha,Hunan,China,410208;The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan,China,410007)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《河南中医》2021年第5期702-705,共4页Henan Traditional Chinese Medicine

基　　金：湖南省教育厅科学研究项目重点项目(19A383);湖南省卫生健康委员会课题项目(20200754);湖南省高等学校“双一流”学科建设项目{湘教通[2018]469号}。

摘　　要：程钟龄《外科十法》将肉芽肿性乳腺炎按阳毒、阴毒、半阴半阳之毒进行论治,属阳毒者,成脓前,使用远志膏外敷肿处,脓成后及时切开将脓腐放尽。躯干及四肢之脓肿,皆可用刀法,而头面及耳前后之脓肿,则宜用砭法。切开引流之后,不论脓液多少,均安放引流条于创口。属阴毒者,宜以温为主,可用万全膏遍敷肿处,同时配合中药内服。属半阴半阳者,多有成脓不畅之虞,在成脓前,可将清热之远志膏及温阳之万全膏交替使用,从而达到温阳而不助邪,清热而不留虞之效。若肿块局部少量成脓,可用艾灸法促其成脓,或者配合内服温阳中药促阴毒消散,肿块化脓。脓成肉腐后,再视局部情况运用刀针砭石法或开口除脓法切开排脓。若切开排脓后腔内颜色灰暗,腔面肉芽难以生长,可将海浮散敷于腔内,以达瘀肉自脱,新肉自生之效。In Ten Therapies of External Medicine,Cheng Zhong-ling divides granulomatous mastitis into three types:Yang toxin,yin toxin,half yin and half yang toxin.If it belongs to yang toxin,Senega Ointment is used to apply to the swelling area before the pus is formed.After the pus is formed,it is cut in time to release the pus.For pus in the body and limbs,acupotomy can be used,while for pus in the head,face and ears,the stone needling is appropriate.After incision and drainage,no matter how much pus there is,the drainage strip should be placed at the wound.If it belongs to yin toxin,warming method should be used.Wanquan Ointment(万全膏,WQO)can be applied to the swelling area,and Chinese medicinals should be taken orally at the same time.For half yin and half yang toxin with unsmooth formation of pus,before the formation of pus,Senega Ointment for clearing away heat and WQO for warming yang can be used alternately so as to achieve the effect of warming yang without helping pathogens and clearing heat without leaving pathogens.If there is a small amount of pus in the local part of the swelling,moxibustion can be used to promote the formation of pus,or combined with yang-warming Chinese medicinals for oral administration to promote dissipation of yin and toxin and the formation of pus.After the pus becomes rotten flesh,depending on the local condition,the incision and drainage of pus will be performed by acupotomy or stone needling,or opening purulent method.If the color of the cavity is gray and the granulation on the cavity surface is difficult to grow after the incision and discharge of pus,Haifu Powder(海浮散,HFP)can be applied in the cavity to achieve the effect of removing the rotten flesh and generating new one.

关 键 词：肉芽肿性乳腺炎 中医外治法 程钟龄 《外科十法》 

分 类 号：R269.558[医药卫生—中西医结合]