清热败毒饮加减治疗肉芽肿性小叶性乳腺炎术后患者临床研究  

Clinical efficacy of modified Qingre Baidu Decoction on postoperative patients with granulomatous lobular mastitis

作　　者：郭洁荣 热孜亚·萨吾尔 蒋可心 孙霃平[1] 刘胜[1] 秦悦农[1] GUO Jierong;SAWUER Reziya;JIANG Kexin;SUN Chenping;LIU Sheng;QIN Yuenong(Department of Breast of Integrative Medicine,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032)

机构地区：[1]上海中医药大学附属龙华医院中西医结合乳腺科,上海200032

出　　处：《河北中医》2024年第3期428-432,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：上海市科技计划项目(编号:20Z21900300);上海申康医院发展中心重大疾病多中心临床研究项目(编号:SHDC2020CR1050B)。

摘　　要：目的观察清热败毒饮加减治疗肉芽肿性小叶性乳腺炎(GLM)术后患者的临床疗效。方法将120例GLM患者分为2组,暴露组75例,术后应用清热败毒饮加减治疗,3个月≤服药时间≤6个月;非暴露组45例,术后应用清热败毒饮加减治疗,1个月≤服药时间<3个月。比较2组疗效;比较2组愈后乳房外形恢复情况;疗程结束后随访3个月,比较2组复发情况,并分析患者年龄、体质量指数(BMI)、中药治疗时间、哺乳史、积乳史、口服避孕药史、外伤史、乳头凹陷、乳头溢液、伴下肢红斑结节史、过敏史与复发的相关性。治疗期间进行用药安全评估。结果暴露组总有效率100%(75/75),非暴露组总有效率100%(45/45),2组疗效比较差异无统计学意义(P>0.05)。暴露组乳房外形优秀率高于非暴露组(P<0.05)。暴露组复发率1.33%(1/75),非暴露组复发率13.33%(6/45),暴露组复发率低于非暴露组(P<0.05)。术后清热败毒饮加减治疗时间、口服避孕药史、过敏史可能与GLM复发相关(P<0.05)。术后清热败毒饮加减治疗≥3个月对GLM的复发为保护因素(P<0.05)。2组术后口服中药治疗期间,安全性指标检查均在正常范围,具有临床安全性。结论GLM术后患者应用清热败毒饮加减治疗,服药时间≥3个月可提高疗效,一定程度上保护乳房外形,降低复发率,临床安全有效。Objective To explore the clinical efficacy of modified Qingre Baidu Decoction on postoperative patients with granulomatous lobular mastitis(GLM).Methods Totally 120 GLM patients were randomly divided into the exposure group(n=75)and the non-exposure group(n=45).After surgery,all patients were treated with modified Qingre Baidu Decoction.The treatment time of the exposure group and the non-exposure group was no less than 3 months and less than 3 months,respectively.The clinical efficacy,recovery of postoperative breast appearance,and the recurrence rate of 3-month follow-up were compared between groups.The correlation between age,body mass index(BMI),the length of traditional Chinese medicine(TCM)treatment,the history of breast feeding,milk stasis,oral contraceptives,wound healing,nipples depression,nipple discharge,limb erythema nodosum,allergic diseases,with the recurrence was analyzed.The medication safety was assessed.Results The difference was not statistically significant in the incidence of thrombocytopenia between the exposure group and the non-exposure group(100%[75/75]vs 100%[45/45],[P>0.05],respectively).The breast appearance in the exposure group was significantly better than that of the non-exposure group(P<0.05).The recurrence rate in the exposure group was significantly lower than that in the non-exposure group(1.33%[1/75]vs 13.33%[6/45],[P<0.05],respectively).After treatment,usage time of modified Qingre Baidu Decoction,history of oral contraceptives,allergic diseases might be risk factors for GLM recurrence(P<0.05).Usage time of modified Qingre Baidu Decoction≥3 months was an independent protective factor for GLM recurrence(P<0.05).The safety indexes of the both groups were in reference range,indicating clinical safety.Conclusion For postoperative patients with granulomatous lobular mastitis,usage time of modified Qingre Baidu Decoction≥3 months can significantly improve the treatment effect,protect the breast shape and reduce the recurrence rate of disease to a certain extent,which is safe an

关 键 词：肉芽肿性小叶性乳腺炎 清热败毒饮 

分 类 号：R655.81[医药卫生—外科学] R289.5[医药卫生—临床医学]