本文選題：漿細胞性乳腺炎 + 活血解毒化痰法��； 參考：《安徽中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：1目的(1)觀察漿細胞性乳腺炎患者的Hs-CRP、PRL及細胞因子IL-1β、IL-6、TNF-α的變化,研究活血解毒化痰法對上述指標的干預(yù)作用,并探討中醫(yī)活血解毒化痰法治療本病的機制。(2)觀察活血解毒化痰法治療漿細胞性乳腺炎的臨床療效。2方法選擇42例漿細胞性乳腺炎患者隨機分為治療組和對照組,治療組24例予以活血解毒化痰法聯(lián)合中醫(yī)外治法治療;對照組18例予以抗生素及激素治療聯(lián)合中醫(yī)外治法治療。(1)療效評估:觀察治療前后中醫(yī)證候評分及臨床療效。(2)測定血清中超敏C-反應(yīng)蛋白(Hs-CRP)、催乳素(PRL)水平,治療前、治療2周后各測一次。(3)采用酶聯(lián)免疫吸附法(ELISA)檢測細胞因子IL-1β、IL-6、TNF-α的水平,治療前、治療2周后各測一次。3結(jié)果(1)臨床療效評估:①中醫(yī)證候積分:與治療前比較,2組患者治療后的中醫(yī)證候積分均有明顯下降,差異有顯著性統(tǒng)計學(xué)意義(p0.01),治療后2組間比較,治療組優(yōu)于對照組,差異有顯著性統(tǒng)計學(xué)意義(p0.01)。②臨床療效:中藥活血解毒化痰法聯(lián)合中醫(yī)外治法治療漿細胞性乳腺炎臨床療效的總有效率為91.67%,西藥聯(lián)合中醫(yī)外治法治療漿細胞性乳腺炎的總有效率為83.33%,經(jīng)非參數(shù)檢驗,p0.05,無統(tǒng)計學(xué)意義。(2)實驗室指標評估:①與治療前相比,2組患者治療后Hs-CRP、PRL水平均有明顯下降,差異有顯著性統(tǒng)計學(xué)意義(p0.01),2組患者治療后Hs-CRP、PRL均值比較,p0.05,差異無統(tǒng)計學(xué)意義。②與治療前相比,2組患者治療后IL-1β、IL-6、TNF-α水平均有明顯下降,差異有顯著性統(tǒng)計學(xué)意義(p0.01),2組患者治療后TNF-α均值比較,p0.05,差異有統(tǒng)計學(xué)意義,2組患者治療后IL-1β,IL-6均值比較,p0.05,差異無統(tǒng)計學(xué)意義。③漿細胞性乳腺炎患者在膿腫期細胞因子IL-1β、IL-6、TNF-α的水平顯著高于炎性腫塊期IL-1β、IL-6、TNF-α的水平,差異具有顯著性統(tǒng)計學(xué)意義(p0.01)。4結(jié)論(1)漿細胞性乳腺炎患者血清Hs-CRP值可作為觀察本病病情變化的參考值之一。(2)漿細胞性乳腺炎患者血清PRL的水平升高與本病的發(fā)病存在相關(guān)性。(3)漿細胞性乳腺炎患者血清細胞因子IL-1β、IL-6、TNF-α的水平在膿腫期明顯高于炎性腫塊期,患者血清細胞因子IL-1β、IL-6、TNF-α的水平可能與炎癥反應(yīng)的程度有關(guān)。(4)中醫(yī)活血解毒化痰法擬方可減輕漿細胞性乳腺炎患者的臨床癥狀,其機理可能與其降低患者血清IL-1β、IL-6、TNF-α水平有關(guān)。
[Abstract]:Objective 1) to observe the changes of Hs-CRPU PRL and cytokine IL-1 尾 -IL-6 TNF- 偽 in patients with plasma cell mastitis, and to study the effect of activating blood circulation and detoxification and resolving phlegm on the above indexes. To explore the mechanism of activating blood circulation and detoxifying and removing phlegm in treating this disease. (2) to observe the clinical curative effect of activating blood circulation and detoxifying phlegm in treating plasma cell mastitis. Methods 42 patients with plasma cell mastitis were randomly divided into treatment group and control group. In the treatment group, 24 cases were treated by activating blood circulation and detoxifying phlegm combined with external treatment of traditional Chinese medicine. In the control group, 18 cases were treated with antibiotics and hormone combined with external therapy of traditional Chinese medicine. Evaluation of curative effect: observe the score of TCM syndrome and clinical efficacy before and after treatment. Determine the serum level of Hs-CRPN, prolactin, PRL, before and after treatment, and determine the serum levels of Hs-CRPL, prolactin, and prolactin, before and after treatment. After 2 weeks of treatment, the levels of cytokine IL-1 尾 -IL-6 and TNF- 偽 were detected by Elisa. After 2 weeks of treatment, the scores of TCM syndromes in group 2 were significantly decreased compared with those before treatment, and the difference was statistically significant (P 0.01). After treatment, the scores of TCM syndromes in group 2 were significantly lower than those before treatment, and there was a significant difference between the two groups after treatment. The treatment group was superior to the control group. The total effective rate of traditional Chinese medicine for activating blood circulation and detoxification and removing phlegm was 91.67 in the treatment of plasmacytic mastitis, while that of western medicine combined with external treatment of traditional Chinese medicine was 91.67 in the treatment of plasmacytic mastitis, and the total effective rate was 91.67 in the treatment of plasmacytic mastitis by activating blood circulation and detoxifying phlegm. The total effective rate of adenositis was 83.33. After nonparametric test, there was no statistical significance. There was significant difference between the two groups (P < 0.05). There was no significant difference in the level of IL-1 尾 -IL-6TNF- 偽 between the two groups after treatment, and there was no significant difference between the two groups before and after treatment, and there was no significant difference between the two groups in the level of IL-1 尾 -IL-6 and TNF- 偽 after treatment, and there was no significant difference between the two groups before and after treatment. There was significant difference in the mean value of TNF- 偽 between the two groups after treatment. There was a significant difference in the mean value of IL-1 尾 -IL-6 between the two groups (p 0.05). There was no significant difference between the two groups in the cell of abscess stage. 3. The plasma cell mastitis patients were in the abscess stage. The level of IL-6 TNF- 偽 in IL-1 尾 was significantly higher than that in IL-1 尾-6 TNF- 偽 in inflammatory tumor stage, and the level of TNF- 偽 in TNF- 偽 was significantly higher than that in inflammatory tumor. Conclusion the serum Hs-CRP level in patients with plasma cell mastitis can be regarded as one of the reference values to observe the change of the disease. The serum PRL level of the patients with plasma cell mastitis is higher than that of the patients with plasma cell mastitis and the pathogenesis of the disease. The level of serum cytokine, IL-1 尾, IL-6, TNF- 偽 in patients with plasma cell mastitis was significantly higher than that in patients with inflammatory mass at abscess stage. The level of serum cytokine IL-1 尾, IL-6, TNF- 偽 may be related to the degree of inflammation. 4) the method of activating blood circulation and detoxifying and resolving phlegm can relieve the clinical symptoms of patients with plasma cell mastitis, and its mechanism may be related to the decrease of serum IL-1 尾 -IL-6 TNF- 偽 level.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R655.8

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