瓜蒌牛蒡汤联合小针刀疗法治疗急性化脓性乳腺炎临床研究
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摘要
目的:观察瓜蒌牛蒡汤联合小针刀疗法治疗急性化脓性乳腺炎的临床疗效。方法:选取2017年5月至2018年9月在本院就诊的急性化脓性乳腺炎患者78例,按照随机数字表法分为对照组和观察组各39例。对照组采用小针刀疗法治疗,观察组在对照组治疗的基础上采用瓜蒌牛蒡汤治疗。比较两组患者临床疗效、恢复情况、治疗前后中医症状积分及相关炎性因子[血清C反应蛋白(c-reactive protein,CRP)、肿瘤坏死因子-α(tumor necrosis factor,TNF-α)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、白细胞计数(white blood cell count,WBC)]及并发症发生情况。结果:对照组有效率为76. 92%,观察组有效率为94. 87%,两组有效率比较,差异有统计学意义(P <0. 05);观察组体温复常时间、脓腔消失时间、乳房肿痛消失时间、住院时间较对照组短(P <0. 05);治疗后两组主症、次症积分较治疗前明显降低(P <0. 05),且观察组较对照组低(P <0. 05);治疗后两组血清CRP、TNF-α、WBC、ESR较治疗前明显下降,且观察组上述指标水平较对照组低(P <0. 05);对照组并发症发生率为12. 82%,观察组并发症发生率为7. 69%,两组并发症发生率比较,差异无统计学意义(P> 0. 05)。结论:瓜蒌牛蒡汤联合小针刀疗法可显著减轻急性化脓性乳腺炎患者的炎症反应。
Objective: To observe the clinical curative effect of Trichosanthes and Fructus Arctii Decoction in combination with small ocular knife therapy on acute suppurative mastitis. Methods: A total of 78 cases of acute suppurative mastitis treated in our hospital were selected and divided into the control group and the observation group according to random number table method,with 39 cases in each group. The control group was treated with small ocular knife therapy,while the observation group was treated with Trichosanthes and Fructus Arctii Decoction on the basis of the control group. The clinical efficacies,recovery,TCM symptom scores and related inflammatory factors including serum C-reactive protein(CRP),tumor necrosis factor alpha(TNF-α),and erythrocyte sedimentation rate(ESR),white blood cell count(WBC) and complications were compared between the two groups before and after the treatment. Results: The effective rate was 76. 92% in the control group and 94. 87% in the observation group. There was a significant difference between the two groups(P < 0. 05). The recovery time of body temperature,the disappearance time of abscess cavity,the disappearance time of breast swelling and pain,and the hospitalization time in the observation group were shorter than those in the control group(P < 0. 05). The scores of main and secondary symptoms in the two groups were significantly lower after the treatment than those before the treatment,and the observation group was lower than the control group(P < 0. 05). After the treatment,the levels of CRP,TNF-α,WBC and ESR in serum of the two groups were significantly lower than those before the treatment,and the above indexes of the observation group were lower than those of the control group(P < 0. 05). The incidence of complications in the control group was 12. 82%,while that in the observation group was7. 69%. There was no significant difference in the incidence of complications between the two groups(P > 0. 05). Conclusion:Trichosanthes and Fructus Arctii Decoction in combination with small ocular knife therapy can significantly alleviate the inflammatory reaction in patients with acute suppurative mastitis.
Objective: To observe the clinical curative effect of Trichosanthes and Fructus Arctii Decoction in combination with small ocular knife therapy on acute suppurative mastitis. Methods: A total of 78 cases of acute suppurative mastitis treated in our hospital were selected and divided into the control group and the observation group according to random number table method,with 39 cases in each group. The control group was treated with small ocular knife therapy,while the observation group was treated with Trichosanthes and Fructus Arctii Decoction on the basis of the control group. The clinical efficacies,recovery,TCM symptom scores and related inflammatory factors including serum C-reactive protein(CRP),tumor necrosis factor alpha(TNF-α),and erythrocyte sedimentation rate(ESR),white blood cell count(WBC) and complications were compared between the two groups before and after the treatment. Results: The effective rate was 76. 92% in the control group and 94. 87% in the observation group. There was a significant difference between the two groups(P < 0. 05). The recovery time of body temperature,the disappearance time of abscess cavity,the disappearance time of breast swelling and pain,and the hospitalization time in the observation group were shorter than those in the control group(P < 0. 05). The scores of main and secondary symptoms in the two groups were significantly lower after the treatment than those before the treatment,and the observation group was lower than the control group(P < 0. 05). After the treatment,the levels of CRP,TNF-α,WBC and ESR in serum of the two groups were significantly lower than those before the treatment,and the above indexes of the observation group were lower than those of the control group(P < 0. 05). The incidence of complications in the control group was 12. 82%,while that in the observation group was7. 69%. There was no significant difference in the incidence of complications between the two groups(P > 0. 05). Conclusion:Trichosanthes and Fructus Arctii Decoction in combination with small ocular knife therapy can significantly alleviate the inflammatory reaction in patients with acute suppurative mastitis.
引文
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[17]WANG W,LI Z,MENG Q,et al.Chronic Calcium Channel Inhibitor Verapamil Antagonizes TNF-α-Mediated Inflammatory Reaction and Protects Against Inflammatory Arthritis in Mice[J].Inflammation,2016,39(5):1624-1634.
[18]ZAREIFAR S,FARAHMAND FAR M R,GOLFESHAN F,et al.Changes in Platelet Count and Mean Platelet Volume During Infectious and Inflammatory Disease and Their Correlation With ESR and CRP[J].J Clin Lab Anals,2014,28(3):245-248.
[19]向艳霞,肖凌云,张菊,等.黄芪多糖治疗神经系统疾病的作用及其机制研究进展[J].中国医院药学杂志,2016,36(8):687-691.
[20]李玉凤.乳痈消联合芒硝外敷对急性乳腺炎患者血清WBC、ESR及hs-CRP水平的影响[J].北方药学,2017,14(9):88-89.
[2]CHENG L,REDDY V,SOLMOS G,et al.Mastitis,a Radiographic,Clinical,and Histopathologic Review[J].Breast J,2015,21(4):403-409.
[3]侯聪,吕钢.瓜蒌牛蒡汤治疗急性乳腺炎的临床观察[J].四川中医,2015,33(11):122-123.
[4]林毅.现代中医乳房病学[M].北京:人民卫生出版社,2003:136.
[5]吴在德,吴肇汉.外科学[M].7版.北京:人民卫生出版社,2008:328.
[6]ALBASRI A M.Profile of benign breast diseases in western Saudi Arabia:An 8-year histopathological review of 603 cases[J].Saudi Med J,2014,35(12):1517-1520.
[7]汪唐顺,滕占庆,陈晓晓,等.小切口引流联合中药外用治疗急性化脓性乳腺炎[J].中国中西医结合外科杂志,2017,23(3):297-300.
[8]吕佳奇,杨靖靖,贡旭楠,等.妊娠期急性化脓性乳腺炎合并重症感染的临床疗效观察[J].中国妇幼保健,2014,29(15):2404-2405.
[9]王理德,李景新,黄黎,等.小针刀治疗颈肩肌筋膜疼痛综合征临床观察[J].辽宁中医药大学学报,2014,16(9):196-198.
[10]李丽,赵海军,徐瑾,等.中西医结合治疗急性乳腺炎疗效观察[J].现代中西医结合杂志,2014,17(1):69-71.
[11]刘志.小针刀疗法联合中药治疗急性化脓性乳腺炎的效果观察[J].深圳中西医结合杂志,2017,27(5):46-47.
[12]王剑,马瑞莲.中西医结合治疗急性乳腺炎69例临床观察[J].中医药导报,2014,20(4):128-129.
[13]许小清,沈石连,庞则英,等.加减瓜蒌牛蒡汤配合排乳法治疗哺乳期乳腺炎临床研究[J].中医临床研究,2016,8(3):73-75.
[14]罗强,林敏,徐宁,等.化脓性乳腺炎病原菌分型对比分析[J].广东医学,2016,37(15):2308-2310.
[15]朱雪琼,米海霞,林祥,等.瓜蒌牛蒡汤合阳和汤联合中药外敷对哺乳期急性乳腺炎早期患者IL-6、CRP水平的影响研究[J].中华中医药学刊,2017,35(4):819-821.
[16]沈胡刚,彭志坚,朱怡平,等.散清消通法对早期哺乳期急性乳腺炎患者血WBC、CRP、PCT的影响[J].中国中医急症,2017,26(9):1671-1673.
[17]WANG W,LI Z,MENG Q,et al.Chronic Calcium Channel Inhibitor Verapamil Antagonizes TNF-α-Mediated Inflammatory Reaction and Protects Against Inflammatory Arthritis in Mice[J].Inflammation,2016,39(5):1624-1634.
[18]ZAREIFAR S,FARAHMAND FAR M R,GOLFESHAN F,et al.Changes in Platelet Count and Mean Platelet Volume During Infectious and Inflammatory Disease and Their Correlation With ESR and CRP[J].J Clin Lab Anals,2014,28(3):245-248.
[19]向艳霞,肖凌云,张菊,等.黄芪多糖治疗神经系统疾病的作用及其机制研究进展[J].中国医院药学杂志,2016,36(8):687-691.
[20]李玉凤.乳痈消联合芒硝外敷对急性乳腺炎患者血清WBC、ESR及hs-CRP水平的影响[J].北方药学,2017,14(9):88-89.