消痈乳康汤联合中医换药对肉芽肿性乳腺炎临床疗效及Treg/Th17免疫平衡机制的影响  

Therapeutic Effects of Xiaoyong Rukang Decoction Combined with Herbal Dressing Change on Granulomatous Mastitis and Its Influence on Treg/Th17 Immune Balance Mechanism

作　　者：唐众 凌洁 黄维芳 TANG Zhong;LING Jie;HUANG Weifang(The First Hospital of Hunan University of Chinese Medicine,Changsha 410008,China)

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410008

出　　处：《西部中医药》2023年第10期145-149,共5页Western Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81473680);湖南省教育厅科学研究项目(19C1395)。

摘　　要：目的:观察消痈乳康汤联合中医换药治疗肉芽肿性乳腺炎(granulomatous mastitis,GM)的临床疗效及对调节性T细胞(regulatory T cell,Treg)/辅助性T细胞17(T helper cell 17,Th17)免疫平衡机制以及免疫相关指标的影响。方法:选取实施乳腺导管切除术后GM患者97例,按照完全随机原则分为观察组(48例)及对照组(48例)。对照组术后予西医常规治疗,观察组在对照组基础上加服消痈乳康汤治疗,共治疗4周。比较两组临床症状、疼痛评分、QLQ-C30评分,外周血Treg细胞、白细胞介素10(interleukin-10,IL-10)、转化生长因子β_(1)(trans forming growth factor-β_(1),TGF-β_(1))水平,Treg/Th17比值及免疫相关指标,并统计其临床疗效、复发率及不良反应率。结果:治疗后观察组乳房包块最大直径、乳房皮肤评分、疼痛评分及外周血Treg细胞、Treg/Th17比值、IL-10、TGF-β_(1)、IgG、IgA水平均明显低于治疗前与对照组治疗后(P<0.05);QLQ-C30总评分及各维度评分均明显高于治疗前与对照组治疗后(P<0.05)。观察组治疗总有效率[95.83%(46/49)]明显高于对照组[75.51%(37/48)](P<0.05),观察组不良反应发生率[6.25%(3/48)]低于对照组[16.33%(8/49)](P<0.05),且随访复发率低于对照组(P<0.05)。结论:消痈乳康汤联合中医换药治疗GM安全有效,能够明显缓解临床症状,加速疾病康复,改善患者生活质量,还可能是通过调控Treg/Th17免疫平衡机制治疗GM,并能够提升患者免疫功能,同时降低疾病复发风险。Objective:To observe clinical effects of Xiaoyong Rukang decoction combined with herbal dressing changing in the treatment of granulomatous mastitis(GM),and its impacts on Treg/Th17 immune balance mechanism and immune-related indexes.Methods:A total of 97 GM patients after breast duct resection were selected and randomly divided into 48 cases in observation group and 48 cases in control group according to the principle of complete randomness.The control group accepted conventional therapy of Western medicine after the surgery,and the observation group took Xiaoyong Rukang decoction,for four weeks.To compare clinical symptoms,VAS,QLQ-C30 scores,the levels of Treg cells,IL-10,TGF-β_(1) in peripheral blood,Treg/Th17 ratio and immune-related indexes between both groups,to perform statistical analysis of clinical efficacy,the recurrence rate and the incidence of adverse reaction.Results:After the treatment,the observation group was lower than before the treatment and the control group after the treatment clearly in maximum diameter of breast mass,breast skin scores,VAS,Treg cells in peripheral blood,Treg/Th17 ratio,the levels of IL-10,TGF-β_(1),IgG and IgA(P<0.05);QLQ-C30 scores and different dimensional scores were apparently higher than these before the treatment and these of the control group after the treatment(P<0.05).Total effective rate of the treatment in the observation group was[95.83%(46/49)],evidently higher than[75.71%(37/48)]of the control group(P<0.05),the incidence of adverse reaction of the observation group was[6.25%(3/48)],lower than[16.33%(8/49)]of the control group and follow-up recurrence rate lower than that of the control group(P<0.05).Conclusion:Xiaoyong Rukang decoction and herbal dressing changing is safe and effective in the treatment of GM,it could noticeably relieve clinical symptoms,accelerate the recovery,improve the patients'quality of life.It could treat GM possibly through regulating Treg/Th17 immune balance mechanism,lifting the patients'immunologic function while reducing the ris

关 键 词：乳腺炎 肉芽肿性 消痈乳康汤 浆细胞性乳腺炎 Treg/Th17免疫平衡机制 免疫指标 

分 类 号：R339.23[医药卫生—人体生理学]