肉芽肿性乳腺炎半阴半阳证证治  

Treatment of Granulomatous Mastitis with Half-Yin and Half-Yang Syndrome

作　　者：李志鲲 程旭锋[2] 张文可 赵慧朵[2] Zhikun Li;Xufeng Cheng;Wenke Zhang;Huiduo Zhao(First Clinical Medical College,Henan University of Chinese Medicine,Zhengzhou,Henan,China;Breast Surgery,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan,China)

机构地区：[1]河南中医药大学第一临床医学院,河南郑州450046 [2]河南中医药大学第一附属医院胸外科,河南郑州450000

出　　处：《Chinese Medicine and Natural Products》2023年第3期102-107,共6页中医学报（英文）

基　　金：supported by the National Distinguished Veteran TCM Expert Professor Wanlin Wang Inheritance Workshop Construction Project{National Chinese Medicine People Education Letter[2019]No.41(CZ0175)};Health Commission of Henan Province National TCM Clinical Research Base Scientific Research Special Project(2021JDZY018);Health Commission of Henan Province National TCM Clinical Research Base Reward Project(2022JDZX086)。

摘　　要：肉芽肿性乳腺炎是一种难治性慢性乳腺炎,属于中医外科“粉刺性乳痛”“疮病”范畴。该病按阴阳辨证可分为:阴证、阳证与半阴半阳证。其中阴证与阳证的相关理论和治法,在中医外科学中较为完善;而半阴半阳证则缺乏具体的理论阐述和治疗体系,具有特殊性和复杂性,成为该病的疑难证候,限制了该病临床疗效的提高。肉芽肿性乳腺炎半阴半阳证的核心病机为“营卫延塞,阴阳不通”;临床特征为局部阴证与阳证并见,病情缠绵难愈;辨证上应“重局部,轻全身”;治疗上应以“驱阴化阳”为总治则,温托升浮,解毒化延;用药推崇“寒温并用,以温为主;重升轻降,托脓敛毒”。最终恢复机体营卫气血的正常运行与阴阳平衡,达到治愈目的。Granulomatous mastitis(GM)is a refractory chronic mastitis,which belongs to the category of“acne mammary abscess”and“ulcer”in Traditional Chinese External Medicine.According to yin-yang syndrome differentiation,the disease can be divided into yin syndrome,yang syndrome,and half-yin and half-yang syndrome.Among them,the theories and treatment of yin syndrome and yang syndrome are relatively comprehensive in Traditional Chinese External Medicine.However,the half-yin and half-yang syndrome lacks a specific theoretical elaboration and treatment system,which is a special and complex syndrome of the disease,limiting the improvement of the clinical efficacy of the disease.The core pathogenesis of GM with half-yin and halfyang syndrome is“obstruction of nutritive and defensive phases,and yin-yang obstruction.”The clinical features are local yin syndrome complicated with yang syndrome,and the disease is lingering and difficult to cure.For syndrome differentiation,it is advisable to“attach more importance to the local while less importance to the whole body.”The treatment should be based on the general principle of“eliminating yin and transforming yang.”For the use of herbs,it is recommended to adopt the methods of“the combination of the herbs in cold and warm nature,mainly with herbs in warm nature,attaching more importance to use the herbs with the function of ascending and less to descending.”Finally,restore the normal circulation of qi and blood as well as the balance of yin and yang to achieve the purpose of treatment.

关 键 词：肉芽肿性乳腺炎 粉刺性乳痛 半阴半阳证 驱阴化阳 冲和膏 活络效灵丹 内托生肌散 

分 类 号：R269[医药卫生—中西医结合]