摘要
目的采用前瞻性随机对照研究,评价在"异病同治"思想指导下以清消法结合拖线疗法治疗浆细胞性乳腺炎(PCM)和肉芽肿性乳腺炎(GM)的临床应用疗效,形成成熟规范的诊疗操作方案。方法纳入上海中医药大学附属龙华医院浦东分院收治的浆细胞性乳腺炎患者124例,肉芽肿性乳腺炎患者162例,组内随机分为试验组和对照组,清消法结合拖线疗法作为试验组,中医手术切开扩创法结合中药作为对照组,围手术期及术后随访,观察疗效及相关评价指标。结果PCM试验组与对照组比较,创面愈合时间,第3、6、9个月的痊愈以及复发人数组间比较差异无统计学意义(P>0.05);PCM试验组第7天局部创面情况明显优于对照组(P<0.05),第7、14天时疼痛缓解也好于对照组(P<0.05);PCM试验组术后乳房美容指数及住院费用较对照组明显更具优势(P<0.05)。GM试验组与对照组比较,创面愈合时间,第3、6个月的痊愈以及复发人数组间比较差异无统计学意义(P>0.05);GM试验组第1天局部创面情况明显优于对照组(P<0.05),第3、14天时疼痛缓解好于对照组(P<0.05);GM试验组术后乳房美容指数及住院费用较对照组明显更具优势(P<0.05);GM试验组术后第9个月痊愈人数高于对照组。结论清消法结合拖线疗法标准化的方案治疗PCM和GM是安全有效的,保证高痊愈率和低复发率的同时,兼有减少疼痛、保护乳房外观、经济适用等特点,是值得向基层临床推广的规范性中医综合治疗方案。
Objective Prospective randomized controlled study was used to evaluate the curative effect of Qingxiao therapy combined with dragline therapy,which was practiced in the treatment of plasma cell mastitis and granulomatous mastitis.We are looking forward to forming a standard treatment plan and will recommend it to basic medical institutions.Methods 124 plasma cell mastitis and 162 granulomatous mastitis were divided into two groups each randomly.Patients in positive group were treated by Qingxiao therapy combined with dragline therapy,and the patients in negative group were treated by past experienced plan.Severel curative related index were observed before and after the operation,to evaluate effect of Qingxiao therapy combined with dragline therapy.Standard treatment plan for plasma cell mastitis and granulomatous mastitis will be formed and recommended to community hospitals.Results There was no difference in wound healing time,healing rate and recurrence rate in the 3 rd,6 th and 9 th month between the two groups(P>0.05).After treatment,the local wound condition of plasma cell mastitis in the positive group was better than that in the negative group 7 days after the operation(P<0.05).7 and 14 days after the operation,plasma cell mastitis in the positive group were less painful than the negative group(P<0.05).The breast appearance inthe positive group was better than the negative group 1 month after the operation(P<0.05).Medical expenses of the positive group was less than the negative group(P<0.05).There was no difference in wound healing time,recovery rate and recurrence rate between the two groups(P>0.05).After treatment,the local wound condition of granulomatous mastitis in the positive group was worse than that in the negative group only 1 day after the operation(P<0.05).3 and 14 days after the operation,granulomatous,mastitis in the positive group were less painful than the negative group(P<0.05).The breast appearance inthe positive group was better than the negative group in 3 and 6 months after the operation(P<0.05).The recovery rate of the positive group was higher than the negative group in 9 months after the operation(P<0.05).Conclusion It is proved that the standardscheme about plasma cell mastitis and granulomatous mastitis treated by Qingxiao therapy combined with dragline therapy is effective fully.It should be recommended to community hospitals wildly.
作者
郑金洲
宋晓耘
王玉
李锋
王瑞
刘胜
周细秋
ZHENG Jinzhou;SONG Xiaoyun;WANG Yu;LI Feng;WANG Rui;LIU Sheng;ZHOU Xiqiu(Longhua Affiliated Hospital of Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《辽宁中医药大学学报》
CAS
2021年第7期165-169,共5页
Journal of Liaoning University of Traditional Chinese Medicine
基金
上海市进一步加快中医药事业发展三年行动计划[ZY(2018-2020)-ZYBZ-01]
上海市中西医临床协作试点项目(ZXYXZ-201909)
上海市浦东新区卫生健康委员会联合公关项目(PW2019D-7)
关键词
浆细胞性乳腺炎
肉芽肿性乳腺炎
清消法
拖线疗法
plasma cell mastitis
granulomatous mastitis
Qingxiao therapy
dragline therapy
作者简介
郑金洲(1981-),男,江苏盐城人,主治医师,博士,研究方向:外科(甲乳外科方向);通讯作者:周细秋(1970-),男,湖北武汉人,主任医师,硕士,研究方向:外科(甲乳外科方向)。
