發(fā)布時(shí)間：2018-08-26 18:53

【摘要】：研究目的:觀察加減透膿散聯(lián)合乳房按摩手法治療肉芽腫性小葉乳腺炎(腫塊期)的臨床療效,驗(yàn)證加減透膿散的有效性,同時(shí)為肉芽腫性小葉乳腺炎臨床干預(yù)手段的選擇提供試驗(yàn)數(shù)據(jù),并指導(dǎo)臨床實(shí)踐。研究方法:遵循西醫(yī)肉芽腫性小葉乳腺炎及中醫(yī)乳癰的相關(guān)診斷標(biāo)準(zhǔn),在江蘇省中醫(yī)院名醫(yī)堂門診,按照自愿、知情同意原則,納入年齡在20～50歲之間(包括20、50歲)的肉芽腫性小葉乳腺炎(腫塊期)患者30例,將30名患者按照不同治療方法分為2組;治療組:加減透膿散聯(lián)合乳房按摩手法18例,采用以加減透膿散為基本方,聯(lián)合乳房按摩手法治療;對(duì)照組12例,采用口服甲強(qiáng)龍20mg/d,緩解后每1-2周減量至16mg,12mg,8mg,4mg治療。兩組均以2周為一個(gè)療程,觀察2個(gè)療程后癥狀體征變化,C-反應(yīng)蛋白水平改變及治愈后半年隨訪的復(fù)發(fā)情況。療效參考《中醫(yī)病證診斷療效標(biāo)準(zhǔn)》、《中藥新藥臨床研究指導(dǎo)原則》(2002版)、"乳癰中醫(yī)臨床路徑"自擬"肉芽腫性小葉乳腺炎(腫塊期)療效評(píng)價(jià)量化積分表"評(píng)分衡量,采用SPSS19.0對(duì)評(píng)分情況進(jìn)行處理,P≤0.05表示結(jié)果有統(tǒng)計(jì)學(xué)意義。研究結(jié)果:加減透膿散聯(lián)合乳房按摩手法治療組臨床愈顯率、改善療效積分方面與口服甲強(qiáng)龍的對(duì)照組對(duì)比,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);兩組在改善炎性指標(biāo)C-反應(yīng)蛋白的比較具有顯著統(tǒng)計(jì)學(xué)意義(P≤0.05),治療組優(yōu)于對(duì)照組;兩組在降低復(fù)發(fā)率方面具有顯著統(tǒng)計(jì)學(xué)意義,治療組優(yōu)于對(duì)照組(P≤0.05)。研究結(jié)論:(1)加減透膿散聯(lián)合乳房按摩手法和口服甲強(qiáng)龍都是治療肉芽腫性小葉乳腺炎(腫塊期)的有效方法,均能顯著改善臨床癥狀體征積分;(2)加減透膿散聯(lián)合乳房按摩手法在降低炎性指標(biāo)C-反應(yīng)蛋白方面有明顯效果;(3)加減透膿散聯(lián)合乳房按摩手法能夠明顯降低肉芽腫性小葉乳腺炎(腫塊期)患者的復(fù)發(fā)率,避免停用類固醇激素時(shí)帶來(lái)的高復(fù)發(fā)率,值得推廣應(yīng)用。
[Abstract]:Objective: to observe the clinical effect of the treatment of granulomatous lobule mastitis (mass stage) by adding and reducing permeation purulent powder combined with masseuse manipulation, and to verify the effectiveness of adding and reducing permeable purulent powder. It also provides experimental data for the selection of clinical intervention methods for granulomatous lobule mastitis and instructs clinical practice. Methods: according to the diagnostic criteria of granulomatous lobule mastitis and breast carbuncle in Jiangsu Provincial traditional Chinese Medicine Hospital, according to the principle of voluntary and informed consent, Thirty patients with granulomatous lobule mastitis (mass stage) aged between 20 and 50 (including 20 to 50 years old) were enrolled. The patients in the control group were treated with 20 mg / d of methylketenolone every 1-2 weeks after remission and reduced to 16 mg / 1 12 mg / g ~ (8 mg / d) per week after remission, and 12 cases were treated with breast massage manipulation in combination with the basic prescription of adding and reducing permeation of pus powder (P < 0.05), while the control group (n = 12) was treated with 4 mg / d. Two weeks were used as a course of treatment to observe the changes of symptoms and signs and the changes of C-reactive protein level after two courses of treatment and the recurrence after half a year follow up. The therapeutic effect was evaluated by "criteria for the diagnosis of TCM Disease and Syndrome", "guiding principles of Clinical Research of New drugs of traditional Chinese Medicine" (2002 Edition), "Clinical Pathway of Breast Carbuncle" and "quantitative integral Table for Evaluation of curative effect of granulomatous lobule mastitis (tumor stage)". It was statistically significant to use SPSS19.0 to deal with the score (P 鈮，

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