疏肝理气、化瘀通络法治疗肿块期肉芽肿性乳腺炎疗效观察  

Observation on the curative effect of method for soothing the liver and regulating Qi, removing blood stasis and dredging collaterals on granulomatous mastitis at mass stage

作　　者：王月[1] 周亮[1] 孙涛[1] 刘丽芳[1] WANG Yue;ZHOU Liang;SUN Tao;Liu Lifang(The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410007,Hunan,China)

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《现代中西医结合杂志》2021年第23期2550-2554,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：2019湖南省教育厅科学研究项目(19C1390)。

摘　　要：目的观察疏肝理气、化瘀通络法治疗肿块期肉芽肿性乳腺炎(GM)的临床疗效。方法选择2016年9月—2019年8月湖南中医药大学第一附属医院收治的86例肿块期GM患者,随机分为2组各43例,对照组给予常规保守方案(醋酸波尼松+甲氨蝶呤)治疗,观察组在此基础上辅以自拟疏肝理气、化瘀通络汤治疗,2组均治疗8周。比较2组临床疗效,治疗前后症状、体征评分,Ki-67抗原水平及病情复发情况。结果观察组总有效率为79.1%(34/43),显著高于对照组的51.2%(22/43),差异有统计学意义(P<0.05)。治疗后2组乳房疼痛评分、皮肤变化评分均显著降低(P均<0.05),且观察组均显著低于对照组(P均<0.05);治疗后2组乳房肿块评分均显著升高(P均<0.05),且观察组乳房肿块评分显著高于对照组(P<0.05)。观察组治疗后Ki-67抗原高表达率为4.7%(2/43),显著低于对照组的18.6%(8/43),差异有统计学意义(P<0.05)。随访6个月,观察组复发率为5.9%(2/34),显著低于对照组的18.2%(4/22),差异有统计学意义(P<0.05)。结论对肿块期GM辅以疏肝理气、化瘀通络汤治疗可提高治疗效果,有助于改善临床症状,降低炎性细胞增殖活性,抑制病情复发。Objective It is to observe the clinical effects of method for soothing the liver and regulating Qi,removing blood stasis and dredging collaterals on granulomatous mastitis at mass stage.Methods Eighty-six patients with mass stage granulomatous mastitis admitted to the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from September 2016 to August 2019 were selected and randomly divided into two groups,with 43 cases in each group.The control group was given a conventional conservative treatment regimen(prednisolone acetate+methotrexate),and the observation group was supplemented with self-made decoction for soothing the liver and regulating Qi,removing blood stasis and dredging collaterals based on the control group,both groups were treated for 8 weeks.The efficacy,changes in the scores of symptoms and signs,the levels of Ki-67 antigen before and after treatment,and recurrence of the disease were compared between the two groups.Results The total effective rate of the observation group was 79.1%(34/43),which was higher than 51.2%(22/43)of the control group,the difference was significant(P<0.05).After treatment,the scores of breast pain and skin change of the two groups were significantly reduced(P<0.05),and the observation group was significantly lower than the control group(P<0.05).After treatment,the breast mass scores of the two groups were significantly improved(P<0.05),and the breast mass scores of the observation group were significantly higher than those of the control group(P<0.05).After treatment,the high expression rate of Ki-67 antigen in the observation group was 4.7%(2/43),which was significantly lower than 18.6%(8/43)in the control group,the difference was statistically significant(P<0.05);the recurrence rate in the observation group was 5.9%(2/34),which was significantly lower than 18.2%(4/22)in the control group after follow-up for 6 months,the difference was statistically significant(P<0.05).Conclusion The assistant therapy with decoction for soothing the liver and regul

关 键 词：疏肝理气 化瘀通络 肉芽肿性乳腺炎 

分 类 号：R655.8[医药卫生—外科学]