中西医结合治疗非哺乳期乳腺炎脓肿期肝胃郁热证的临床疗效观察  

Clinical observation of integrated traditional and western medicine in the treatment of abscess stage nonpuerperal mastitis with liver and stomach stagnation heat syndrome

作　　者：俞金李 丁晓雯 乔楠 宋倩[1] 方勇 YU Jin-li;DING Xiao-wen;QIAO Nan(Ultrasonography Department,Affiliated Traditional Chinese Medicine Hospital of Nantong University,Nantong Hospital Affiliated of Nanjing University of Chinese Medicine,Nantong(226001),China)

机构地区：[1]南通大学附属南通中医院,南京中医药大学南通附属医院超声科,江苏南通226001 [2]南通大学附属南通中医院,南京中医药大学南通附属医院普外科,江苏南通226001 [3]南通大学附属南通中医院,南京中医药大学南通附属医院中医外科,江苏南通226001

出　　处：《中国中西医结合外科杂志》2024年第1期65-70,共6页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：江苏省中医药科技计划发展项目重点项目(ZD202231);江苏省中医药科技发展委托专项(2022WTZX08);南通市社会民生科技计划项目(MSZ2022029)。

摘　　要：目的:观察超声引导下微创置管引流术联合疏肝散结汤治疗非哺乳期乳腺炎脓肿期肝胃郁热证的临床疗效。方法:选取2021年1月-2023年5月南通市中医院乳腺外科收治的非哺乳期乳腺炎脓肿期肝胃郁热证患者63例,按随机数字表法分为A组、B组与C组,A组23例,B组与C组各20例。A组、C组行超声引导下微创置管引流术,B组行脓肿切开引流术,A组行超声引导下微创置管引流术后1周予疏肝散结汤口服4周。观察患者临床症状体征(术后疼痛评分、疤痕长度、乳房外形评分)、疗效指标(手术时间、拔管时间、复发率)、实验室指标[白细胞计数(WBC)、C反应蛋白(CRP)、血沉(ESR)、肝素结合蛋白(HBP)]。结果:3组治疗前实验室指标WBC、CRP、ESR、HBP差异无统计学意义(P <0.05),治疗后3组各项指标均较治疗前显著降低(P <0.05),且A组各指标低于B组、C组(P <0.05);手术时间、复发率3组差异无统计学意义(P <0.05),术后疼痛评分、疤痕长度、乳房外形评分、拔管时间A组、C组均低于B组(P <0.05),A组与C组无明显差异(P <0.05)。3组不良反应发生率差异无统计学意义(P <0.05)。结论:超声引导下微创置管引流术联合疏肝散结汤治疗非哺乳期乳腺炎脓肿期肝胃郁热证,能够有效控制局部炎症,具有创伤小、切口美观、术后恢复快的特点,临床疗效显著,安全有效。Objective To observe the clinical effect of ultrasound-guided minimally invasive catheter drainage combined with Shugan Sanjie Decoction in the treatment of non-puerperal mastitis abscess stage with liver and stomach stagnation heat syndrome.Methods 63 patients with non lactating mastitis and abscess stage liver and stomach heat stagnation syndrome admitted to the Breast Surgery Department of Nantong Traditional Chinese Medicine Hospital from January 2021 to May 2023 were selected,then they were randomly divided into group A,group B and group C according to the method of random number table.23 cases were in group A,20 cases in group B and 20 cases in group C.Group A and group C were treated with ultrasound-guided minimally invasive catheter drainage,while group B was treated with abscess incision and drainage.Group A was treated with Shugan Sanjie Decoction for 4 weeks after operation for one week.The clinical symptoms and signs of the patients(postoperative pain score,scar length,breast shape score),efficacy indicators(operation time,extubation time,recurrence rate),laboratory indicators(WBC,CRP,ESR,HBP)were observed.Results There was no statistically significant difference in the laboratory indexes before treatment among the three groups(P>0.05).After treatment,the indexes of the three groups were significantly lower than those before treatment(P<0.05),and the indexes of Group A were lower than those of Group B and C(P<0.05).There was no statistically significant difference in operation time and recurrence rate among the three groups(P>0.05).Postoperative pain score,scar length,breast shape score and extubation time in Group A and C were lower than those in Group B(P<0.05),and Group A is equivalent to Group C(P>0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P<0.05).Conclusion The ultrasound-guided minimally invasive catheter drainage combined with Shugan Sanjie Decoction can effectively control local inflammation in the abscess stage of non-p

关 键 词：非哺乳期乳腺炎 脓肿期 中西医结合 微创置管引流术 临床疗效 

分 类 号：R655.8[医药卫生—外科学] R269[医药卫生—临床医学]