浆细胞性乳腺炎瘘管期治疗经验总结  

Summary of experience in the treatment of plasma cell mastitis at fistula stage

作　　者：尹剑云[1] Yin Jianyun(Department of Thyroid Breast Surgery,Kunshan Hospital of Traditional Chinese Medicine,Kunshan 215300 China)

机构地区：[1]昆山市中医医院甲状腺乳腺外科,昆山215300

出　　处：《中医外治杂志》2024年第1期36-40,共5页Journal of External Therapy of Traditional Chinese Medicine

摘　　要：浆细胞性乳腺炎反复破溃形成窦道、瘘管迁延难愈,成为乳腺病领域论治的难点。笔者认为乳房的生理特点、浆细胞性乳腺炎前期治疗过程中手术及药毒、治疗过程中情绪状态等,导致乳房络脉瘀腐阻滞、正气虚弱余邪留恋是瘘管形成的病机所在。临证根据窦道深度、内壁情况以及分泌物的质地选用相应的外治法;结合整体症候,临床辨证分为气血不足、痰瘀阻络,肾阳不足、痰湿阻络,络脉虚寒、痰瘀阻络,肝郁肾虚、痰瘀热阻四型进行论治。两法合用,邪正兼顾,相得益彰,值得临床借鉴。Plasma cell mastitis,with its recurrent ulcerations leading to the formation of sinus tracts and fistulas that are difficult to heal,poses a significant challenge in the field of breast disease management.The author believes that the physiological characteristics of the breast,the surgery and drug toxicity during the early treatment of plasma cell mastitis,and the emotional state during the treatment process contribute to the stagnation and obstruction of the breast's collateral vessels,as well as a weakened body's resistance with lingering pathogenic factors,which are the underlying mechanisms for the formation of fistulas.In clinical practice,appropriate external treatment methods are selected based on the depth of the sinus tracts,the condition of the inner walls,and the texture of the secretions;combined with the overall symptoms,clinical syndrome differentiation is categorized into four types:qi and blood deficiency with phlegm and blood stasis obstructing the collaterals,kidney yang deficiency with phlegm and dampness obstructing the collaterals,collateral vessel deficiency and cold with phlegm and blood stasis obstructing the collaterals,and liver depression and kidney deficiency with phlegm and blood stasis obstructing the collaterals due to heat.The combination of these two approaches,addressing both the pathogenic factors and the body's resistance,complements each other and is worth emulating in clinical practice.

关 键 词：浆细胞性乳腺炎 瘘管形成 中医药周期疗法 

分 类 号：R269[医药卫生—中西医结合]