肉芽肿性乳腺炎中医药治疗的研究进展  

Research progress in the treatment of granulomatous mastitis with traditional Chinese medicine

作　　者：郭鱼波 张董晓[1] 赵文洁[1] 黄巧[1] 周玉 付娜[1] 东浩[1] GUO Yubo;ZHANG Dongxiao;ZHAO Wenjie;HUANG Qiao;ZHOU Yu;FU Na;DONG Hao(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010

出　　处：《中华中医药杂志》2024年第6期3018-3022,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京市属医院科研培育计划项目(No.PZ2022009,No.PZ2018022,No.PZ2021011);首都医科大学2023年教育教学改革研究课题(No.2023JYY304);2023年本科生科研特训项目(No.XSKY2023)。

摘　　要：肉芽肿性乳腺炎是以乳腺小叶为中心、非干酪样坏死性肉芽肿为主要病理特征的慢性炎症性疾病。近年来发病趋势逐年上升,多有近期妊娠生育史或异常泌乳史,临床表现为肿块、疼痛、溃疡、脓肿、窦道、瘘管,病情复杂,缠绵难愈,病程长,易复发。不同分期肉芽肿性乳腺炎表现不同的病理特点。文章综述了肉芽肿性乳腺炎的中医论治理论主张从“痰郁”理论、伏邪理论、痈疽思想、疮疡思想论治等。西医治法包括抗生素、皮质类固醇激素和免疫抑制剂、手术等。临床研究发现肉芽肿性乳腺炎通过中西医结合法或中医内外治相结合法均可取得一定的疗效。基础研究通过将人肉芽肿性乳腺炎病变组织与弗氏佐剂混合进行大鼠乳房注射接种,建立了肉芽肿性乳腺炎大鼠模型,有助于本病治疗及机制研究的进一步开展。Granulomatous mastitis is a chronic inflammatory disease with breast lobule as the center and non caseous necrotizing granuloma as the main pathological feature.The incidence trend of granulomatous mastitis is increasing year by year.Most patients have a recent history of pregnancy and childbirth or abnormal lactation.The clinical manifestations of granulomatous mastitis are mass,pain,ulcer,abscess,sinus and fistula.Granulomatous mastitis is a complicated disease with long course and high recurrence rate.Granulomatous mastitis in different stages has different pathological characteristics.This paper summarizes the traditional Chinese medicine theory of treating granulomatous mastitis,which advocates the theory of ‘phlegm depression',the theory of hidden pathogen,the thought of carbuncle,and the thought of sores and ulcers.Western medicine treatment includes antibiotics,corticosteroids,immunosuppressants,surgery,etc..Clinical studies have found that granulomatous mastitis could achieve a certain effect through the combination of traditional Chinese and Western medicine or the combination of internal and external treatment of traditional Chinese medicine.In the basic research,the granulomatous mastitis rat model was established by injecting the pathological tissue of human granulomatous mastitis and Freund's adjuvant into the breast of rats,which is helpful for further research on the treatment and mechanism.

关 键 词：肉芽肿性乳腺炎 综述 研究进展 肉芽肿性小叶性乳腺炎 中医外科 

分 类 号：R269[医药卫生—中西医结合]