温阳通络法联合小切口引流术治疗粉刺性乳痈患者的疗效观察  

Clinical Efficacy of Warming Yang and Dredging Collaterals Combined with Small Incision Drainage in Treating Comedogenic Mastitis of Yang Deficiency and Phlegm Coagulation

作　　者：李梦婷 薛晓红[2] 张馨月[2] 李思雨 沙珊焱 季亚婕[2] LI Meng-ting;XUE Xiao-hong;ZHANG Xin-yue;LI Si-yu;SHA Shan-yan;JI Ya-jie(Surgical Department,Shanghai Municipal Hospital of Traditional Chinese Medicine,Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071;Breast Department,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200083)

机构地区：[1]上海中医药大学附属市中医医院外一科,上海200071 [2]上海中医药大学附属岳阳中西医结合医院乳腺科,上海200083

出　　处：《世界中西医结合杂志》2024年第2期341-346,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：上海中医药大学附属岳阳中西医结合医院科研项目(2019YYQ24)。

摘　　要：目的 观察温阳通络法联合小切口引流术治疗阳虚痰凝证型粉刺性乳痈患者的临床疗效。方法 选取2018年1月1日—2020年3月31日期间就诊于上海岳阳中西医结合医院乳腺病科的粉刺性乳痈患者114例作为研究对象,按随机数字表法分为对照组和治疗组,每组各57例。对照组予手术治疗,治疗组予温阳通络加减方联合小切口引流术。治疗4个月后观察比较两组患者临床疗效,治疗前后乳房外形、SF健康调查简表积分、血清炎症指标[白介素-6(Interleukin-6,IL-6)、白介素-8(Interleukin-8,IL-8)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]及血清免疫指标[免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白G(Immunoglobulin G,IgG)、免疫球蛋白M(Immunoglobulin M,IgM)];治疗6个月后比较两组患者复发情况。结果 治疗后治疗组临床总有效率96.49%(55/57)明显高于对照组78.95%(45/57),差异有统计学意义(P<0.05)。治疗后两组患者乳房外形JCRT评分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组乳房外形JCRT评分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者SF-36健康简表评分均较治疗前升高,差异有统计学意义(P<0.05);且治疗组SF-36健康简表评分明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清炎症IL-6、IL-8、TNF-α指标均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血清炎症IL-6、IL-8、TNF-α指标明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清免疫IgA、IgG、IgM指标均较治疗前升高,差异有统计学意义(P<0.05);且治疗组血清免疫IgA、IgG、IgM指标明显高于对照组,差异有统计学意义(P<0.05)。6个月后,对两组治疗有效患者进行随访,其中对照组复发9例,复发率为20%(9/45),治疗组复发3例,复发率为5.45%(3/55),两组患者复发率比较,差异有统计学意义(P<0.05)。结论 温阳通络法加减联合小�Objective To observe the clinical efficacy of warming Yang and dredging collaterals combined with small incision drainage for patients with comedogenic mammary carbuncles characterized by yang deficiency and phlegm coagulation.Methods A total of 114 patients with comedogenic mastitis treated in the Breast Department,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine from January 1,2018,to March 31,2020 were recruited.They were randomly divided into a control group and a treatment group by a random number table,with 57 in each group.The control group underwent surgical treatment,while the treatment group was treated with warming Yang and dredging collaterals combined with small incision drainage.After four months of treatment,clinical efficacy,changes in breast appearance,Short Form Health Survey(SF-36)scores,serum inflammatory markers[interleukin-6(IL-6),interleukin-8(IL-8),and tumor necrosis factor-alpha(TNF-α)],and serum immune markers[immunoglobulin A(IgA),immunoglobulin G(IgG),and immunoglobulin M(IgM)]were compared between the two groups.Recurrence was also compared after six months of treatment.Results The total effective rate of the treatment group was 96.49%(55/57),higher than the 78.95%(45/57)of the control group(P<0.05).After treatment,both groups showed improvements in breast appearance[Joint Center for Radiation Therapy(JCRT)score]and increased SF-36 scores,with the treatment group exhibiting more significant improvements(P<0.05).Serum inflammatory and immune markers improved in both groups,and the treatment group had a more pronounced reduction in inflammatory markers and an increase in immune markers than the control group(P<0.05).The follow-up at six months revealed a lower recurrence rate in the treatment group(5.45%,or 3/55)compared with the control group(20%,or 9/45)(P<0.05).Conclusion Warming Yang and dredging collaterals combined with small incision drainage significantly improved the clinical outcomes in patients with comedogenic mastitis characterized by yang deficiency

关 键 词：温阳通络法 小切口引流术 阳虚痰凝证 非哺乳期乳腺炎 粉刺性乳痈 乳房外形评分 生活质量量表 

分 类 号：R655.8[医药卫生—外科学]