中药内服联合外用治疗肉芽肿性乳腺炎肿块期临床疗效观察

目的观察消化散联合加味阳和汤治疗肉芽肿性乳腺炎肿块期的临床疗效。方法将2018年6月至2019年12月我院收治的40例肉芽肿性乳腺炎肿块期患者随机分为观察组和对照组,每组20例。对照组予以醋酸泼尼松片,10 mg,日3次口服;观察组予以内外结合治疗,内服加味阳和汤,100 ml,日2次口服,外用消化散适量外敷,日2次,疗程4周。观察治疗前后患者乳房局部疼痛、局部皮肤颜色、局部肿块直径评分;判定治疗有效率,比较两组相关免疫及炎症因子水平变化。结果观察组总有效率为85%,对照组总有效率为75%,观察组高于对照组,但差异无统计学意义(P>0.05)。治疗4周后,观察组患者的乳房局部疼痛、局部皮肤颜色、局部肿块直径评分均显著低于对照组(P<0.05)。患者痊愈后6个月,观察组无复发病例,对照组5例复发,两组比较差异具有统计学意义(P<0.05)。观察组CRP、IL-2、IL-4水平均明显改善,且优于对照组,两组比较差异具有统计学意义(P<0.05)。结论消化散联合加味阳和汤治疗肉芽肿性乳腺炎肿块期临床疗效可靠。

Clinical observation of internal and external administration of Chinese medicines in the treatment of granulomatous mastitis at mass stage

Objective To observe the clinical efficacy of digestive powder combined with modified Yanghe Decoction in the treatment of granulomatous mastitis at mass stage.Methods Totally 40 patients with granulomatous mastitis were randomly divided into observation group and control group,with 20 cases in each group.Patients in the control group were given 10mg prednisone acetate tablets three times a day.Patients in the observation group were treated with combination of internal and external treatment,including orally taking 100 ml modified Yanghe Decoction twice a day,and external application of digestive powder twice a day,4 weeks as the treatment course.Before and after treatment,the scores of local breast pain,local skin color and local lump diameter were observed,the effective rate of treatment was judged,and the changes in related immune and inflammatory factors were compared.Results The total effective rate in observation group was slightly higher than that in control group,but the difference was not statistically significant(85%vs.75%,P>0.05).Four weeks after treatment,the scores of local breast pain,local skin color and local lump diameter in the observation group were significantly lower than those in the control group(P<0.05).Six months after the patients recovered,there was no recurrence case in the observation group,while 5 cases recurred in the control group(P<0.05).The levels of CRP,IL-2 and IL-4 in the observation group were significantly improved,which were better than those in the control group(P<0.05).Conclusion Digestive powder combined with modified Yanghe Decoction has reliable clinical efficacy in the treatment of granulomatous mastitis at mass stage.