柴葵清消方联合手术治疗肉芽肿性小叶性乳腺炎手术时机回顾性研究  

Retrospective Study on the Optimal Surgical Timing for Treating Granulomatous Lobular Mastitis with Chaikui Qingxiao Recipe Combined with Local Lesion Resection

作　　者：张徐柳 孙霃平[1] 王烜晨 崔琳晗 刘胜[1] ZHANG Xu-liu;SUN Chen-ping;WANG Xuan-chen;CUI Lin-han;LIU Sheng(Breast Department of Integrated Traditional Chinese and Western 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：《中国中西医结合杂志》2025年第3期297-302,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：上海市卫生健康委员会基金项目(No.202240160);上海市科学技术委员会基金项目(No.20Z21900300)。

摘　　要：目的探索柴葵清消方配合局部病灶切除术治疗肉芽肿性小叶性乳腺炎的最佳手术时机。方法采用回顾性研究方法,从上海中医药大学附属龙华医院中西医结合乳腺科门诊及住院数据库中收集前期使用柴葵清消方治疗至疾病稳定期后采用局部病灶切除术根治的肉芽肿性小叶性乳腺炎患者,符合纳入标准187例。根据患者到达稳定期至手术的时间,分为稳定前期手术组(达到稳定期至手术时间30天)82例、稳定中期手术组(30天<达到稳定期至手术时间60天)56例、稳定后期手术组(达到稳定期至手术时间>60天)49例。分析三组术后伤口愈合情况及手术后2年内复发情况。结果与稳定前期手术组比较,稳定中期手术组、稳定后期手术组术后愈合时间缩短(P<0.05);稳定前期手术组、稳定中期手术组、稳定后期手术组三组患者的复发率分别为19.5%(16/82)、1.8%(1/56)、4.1%(2/49),差异有统计学意义(χ^(2)=14.143,P<0.01)。三组间多重比较,稳定前期手术组复发率大于稳定中期手术组(χ^(2)=9.680,P=0.002)。结论肉芽肿性乳腺炎患者前期使用柴葵清消方治疗至疾病稳定期,续服中药30~60天再行乳腺局部病灶切除术,为最佳的手术时机。Objective To investigate the optimal timing for surgery in the treatment of granulomatous lobular mastitis with Chaikui Qingxiao Recipe combined with local lesion resection.Methods A retrospective study was conducted by reviewing the outpatient and inpatient databases of the Breast Department of Integrated Traditional Chinese and Western Medicine at Longhua Hospital,Shanghai University of Traditional Chinese Medicine.A total of 187 patients with granulomatous lobular mastitis,who were initially treated with Chaikui Qingxiao Recipe until disease stabilization and then underwent local lesion resection for radical treatment,were included.Based on the time from stabilization to surgery,the patients were assigned into three groups,the earlystage surgical group(surgery within 30 days after stabilization),the mid-stage surgical group(surgery between 30 and 60 days after stabilization),and the late-stage surgical group(surgery more than 60 days after stabilization).The three groups consisted of 82,56 and 49 patients respectively.The postoperative wound healing and recurrence rates within 2 years were analyzed to determine the optimal surgical timing.Results Compared with the early-stage surgical group,the mid-stage and late-stage surgical groups had significantly shorter postoperative healing times(P<0.05).The recurrence rates in the early-stage,mid-stage,and late-stage surgical groups were 19.5%(16/82),1.8%(1/56),and 4.1%(2/49),respectively,with a statistically significant difference(χ^(2)=14.143,P<0.01).Multiple comparisons between the groups showed that the recurrence rate in the early-stage surgical group was higher than that in the mid-stage surgical group(χ^(2)=9.680,P=0.002).Conclusion For patients with granulomatous mastitis,the best surgical timing is after reaching a stable phase through the treatment with Chaikui Qingxiao Recipe,then continuing with Chinese herbal medicine for 30 to 60 days before performing local resection of the breast lesion.

关 键 词：柴葵清消方 局部病灶切除术 肉芽肿性小叶性乳腺炎 手术时机 中药复方 中西医结合 

分 类 号：R655.8[医药卫生—外科学]