中药内服、外敷治疗浆细胞性乳腺炎(肿块期)的疗效观察及其对外周血CD3、CD20、CD68和炎性因子表达的影响  

Observation on Therapeutic Effect of Oral Administration and External Application of Chinese Medicine on Plasma Cell Mastitis(Mass Stage)and Influences on Peripheral Blood CD3,CD20,CD68 and Inflammatory Factors

作　　者：吴燕[1] 方珍[1] WU Yan;FANG Zhen(People’s Hospital of Lishui,Lishui,Zhejiang 323000)

机构地区：[1]丽水市人民医院,浙江丽水323000

出　　处：《中国中医药科技》2025年第2期202-206,共5页Chinese Journal of Traditional Medical Science and Technology

基　　金：浙江省医药卫生科技计划项目(2019KX553)。

摘　　要：目的:观察中药内服、外敷治疗浆细胞性乳腺炎(PCM)(肿块期)的临床疗效及其对外周血CD3、CD20、CD68和炎性因子水平的影响。方法:选择本院甲状腺乳腺外科2020年1月—2023年6月收治的女性PCM患者86例,按照随机数字表法分为观察组和对照组,每组43例;对照组予以甲泼尼龙片、奥美拉唑肠溶胶囊口服,并口服中药疏肝清热方,观察组在对照组治疗基础予以中药乳痈膏外敷,两组疗程均为4周。比较两组患者治疗前后中医症状评分、肿块大小、疼痛视觉模拟评分(VAS),并比较两组患者外周血CD3、CD20、CD68、白细胞介素(IL)-6、IL-1β、肿瘤坏死因子-α(TNF-α)含量,比较两组治疗总有效率和12个月复发率。结果:治疗后观察组总有效率高于对照组(P<0.05);观察组治疗后各项中医症状评分、肿块最大径、疼痛VAS评分均低于对照组(P<0.01);外周血CD3、CD20、CD68、IL-6、IL-1β、TNF-α含量均低于对照组(P<0.01),随访12个月复发率低于对照组(P<0.05)。结论:疏肝清热方内服联合乳痈膏外敷治疗肿块型PCM患者效果显著,可有效减轻炎症反应,抑制机体的免疫应答,改善中医症状,缩小肿块,减轻疼痛,降低复发率。Objective:To observe the clinical effect of traditional Chinese medicine oral administration and external application in the treatment of plasma cell mastitis(mass stage)and effects on CD3,CD20,CD68 and inflammatory factors in peripheral blood.Methods:86 female PCM patients who treated in the Thyroid and Breast Surgery Department of our hospital from January 2020 to June 2023 were randomly divided into an observation group and a control group,with 43 patients in each group;The control group received oral administration of Methylprednisolone tablets and Omeprazole enteric coated capsules,as well as oral administration of Shugan Qingre Decoction.The observation group received external application of traditional Chinese medicine Ruyong ointment on the basis of treatment in the control group,and both groups had a treatment course of 4 weeks.Compare the traditional Chinese medicine symptoms score,maximum diameter of the mass,and visual analog pain score(VAS)before and after treatment between two groups,and compare the peripheral blood CD3,CD20,CD68,IL-6,IL-1β、TNF-αbetween the two groups,compare the total effective rate and 12 month recurrence rate between the two groups.Results:After treatment,the total effective rate of observation group was higher than that of the control group(P<0.05).The scores of various Chinese medicine symptoms,maximum diameter of the mass,and pain VAS of the observation group were lower than those in control groups(P<0.01);Peripheral blood CD3,CD20,CD68,IL-6,IL-1βand TNF-αin the observation group were lower than those in control groups(P<0.05),and the recurrence rate at 12 months of the observation group was lower than that of the control group(P<0.05).Conclusion:The combination of internal administration of Shugan Qingre Decoction and external application of Ruyong ointment can effectively treating lump type PCM,alleviate inflammatory reactions,inhibit the immune response,improve Chinese medicine symptoms,reduce lumps,alleviate pain,reduce recurrence rate.

关 键 词：浆细胞性乳腺炎 肿块期 疏肝清热方 乳痈膏 CD3、CD20、CD68、IL-6 IL-1β TNF-α 

分 类 号：R73[医药卫生—肿瘤]