超聲介導(dǎo)復(fù)方黃柏液治療粉刺性乳癰的臨床研究
發(fā)布時(shí)間：2018-09-11 19:33
【摘要】：背景:粉刺性乳癰在西醫(yī)學(xué)上稱之為"漿細(xì)胞性乳腺炎",具有病程長、不易治療、容易反復(fù)發(fā)作、預(yù)后不佳的特點(diǎn),給患者的生活和工作帶來了極大的不便,給患者的生理和心理造成了極大的創(chuàng)傷,就目前國內(nèi)外的研究表明,該病并沒有一種特效性的治療方法。目的:本研究提出了運(yùn)用超聲介導(dǎo)復(fù)方黃柏液靶向遞送技術(shù)治療腫塊期粉刺性乳癰,以進(jìn)一步了解超聲介導(dǎo)藥物靶向遞送技術(shù)治療腫塊期粉刺性乳癰的有效性和安全性,為醫(yī)學(xué)界治療腫塊期粉刺性乳癰提供新方法和新思路,以提高臨床療效。方法:將40例粉刺性乳癰患者隨機(jī)均分成兩組,分別為超聲組(即治療組)和西藥組(即對照組)。超聲組(20例):①將2個(gè)空白的耦合劑貼片擠干,分別加入2.5ml的復(fù)方黃柏液,將貼片置于兩個(gè)電極上,再固定在治療儀的2個(gè)治療頭上待用;②觸摸乳房腫塊,確定可捫及腫塊的最長徑的兩端,做好標(biāo)記;③清潔病人乳房,待皮膚干燥后,將治療頭用繃帶或膠帶固定在皮膚上;④接通電源后,按病人所能耐受的參數(shù)進(jìn)行調(diào)整(一般不需要調(diào)整),時(shí)間為30min,按開始鍵進(jìn)行治療;⑤30min后取下治療頭,貼片仍需貼于原處保留3-4小時(shí),促使藥物充分被吸收。該治療每日2次,3周為一療程。西藥組(20例):20例采用西藥保守治療,在本次實(shí)驗(yàn)中使用抗生素+地塞米松的組合,第一周:0.4%替硝唑200ml+注射用頭孢拉定1g+生理鹽水250ml+地塞米松磷酸鈉,頭孢拉定使用前行該藥的皮試,顯示陰性反應(yīng)后使用;地塞米松磷酸鈉前三天使用量為10mg/天,后四天5mg/天。所有藥物進(jìn)行靜脈滴注,每天一次,連續(xù)滴注1周。第二周:頭孢拉定膠囊口服,持續(xù)服用一周,每天3次,每次0.5g;地塞米松片口服,持續(xù)服用一周,每天1次,每次1.5mg。第三周:頭孢拉定膠囊口服,持續(xù)服用一周,每天3次,每次0.5g。3周為一療程。觀察記錄超聲組患者的乳房疼痛程度分級、乳房腫塊大小分級、癥狀體征積分在治療前、治療3周后的數(shù)據(jù);與此同時(shí),觀察記錄西藥組乳房疼痛程度分級、乳房腫塊大小分級、癥狀體征積分在治療前、治療3周后的數(shù)據(jù)。利用SPSS21.0軟件將兩組數(shù)據(jù)分別進(jìn)行組內(nèi)及組間的數(shù)據(jù)比較。結(jié)果:1、乳房疼痛程度分級、腫塊大小分級、癥狀體征積分的比較:治療3周后,超聲組的疼痛程度分級、腫塊大小分級、癥狀體征積分較治療前明顯降低,均有p0.01,說明超聲組治療前后在統(tǒng)計(jì)學(xué)上有明顯差異;西藥組治療3周后,乳疼痛程度分級、腫塊大小分級、癥狀體征積分較治療前降低顯著,均有p0.01,說明西藥組治療前后在統(tǒng)計(jì)學(xué)上有明顯差異。超聲組和西藥組的乳房疼痛程度分級、乳房腫塊大小分級、癥狀體征積分這三個(gè)方面,在經(jīng)過3周治療后相比較,均有p0.05,差異有統(tǒng)計(jì)學(xué)的意義。2、臨床療效的比較:經(jīng)過3周的治療后,超聲組共20例,治愈6例,占30%;顯效10例,占50%;有效3例,占15%;總有效率19例,占95%;西藥組共20例,治愈2例,占10%;顯效6例,占30%;有效9例,占45%);總有效17例,占85%。對超聲組和西藥組兩組治療3周后的療效數(shù)據(jù)采取秩和檢驗(yàn)進(jìn)行分析統(tǒng)計(jì),p0.05,說明兩組的有效率差異具有明顯的統(tǒng)計(jì)學(xué)意義。結(jié)論:超聲介導(dǎo)復(fù)方黃柏液靶向遞送技術(shù)治療腫塊期粉刺性乳癰能有效減輕此病的臨床癥狀和體征,有助于提高臨床治愈率,獲得良好的治療效果,十分值得進(jìn)行推行使用。
[Abstract]:BACKGROUND: Acne mammary carbuncle is called "plasma cell mastitis" in Western medicine. It has the characteristics of long course, difficult treatment, easy recurrence and poor prognosis. It brings great inconvenience to the life and work of patients, and causes great trauma to the physiology and psychology of patients. Objective: To investigate the efficacy and safety of ultrasound-mediated drug delivery in the treatment of acne mastitis and to provide a new method for the treatment of acne mastitis. Methods: 40 cases of acne mammary carbuncle were randomly divided into two groups: the ultrasonic group (treatment group) and the western medicine group (control group). The ultrasonic group (20 cases): 1. Two blank coupling patches were extruded and dried, and 2.5ml compound Phellodendron solution was added, and the patches were placed on two electrodes, and then fixed on the therapeutic apparatus. 2 treatment head to be used; 2 touch the breast mass to determine the longest diameter of the two ends of the mass, marking; 3 clean the patient's breast, after the skin is dry, the treatment head with bandage or adhesive tape fixed on the skin; 4 switch on the power supply, according to the patient can tolerate the parameters (generally do not need to adjust), time is 30 minutes, press _30 minutes later, remove the treatment head, the patch still need to stick on the original place to retain 3-4 hours, to promote the full absorption of the drug. The treatment twice a day, three weeks for a course of treatment. Western medicine group (20 cases): 20 cases were treated conservatively with Western medicine, in this experiment using antibiotics + dexamethasone combination, the first week: 0.4% tinidazole 200 ml + injection head. Sporadine 1 G + normal saline 250ml + dexamethasone sodium phosphate, Cefradine before the use of the drug skin test, showed negative reaction after use; dexamethasone sodium phosphate dosage of 10 mg / day before the first three days, 5 mg / day after four days. All drugs intravenous drip once a day, continuous drip for 1 week. Second week: Cefradine capsule oral, continued to take one day 3 weeks, 3 times a day, 0.5 g each time; oral dexamethasone tablets, continued to take one week, once a day, 1.5 mg each time. 3 weeks: oral cefradine capsules, continued to take one week, three times a day, each time 0.5 G. At the same time, observe and record the data of breast pain degree classification, breast mass size classification, symptoms and signs integral before treatment and after 3 weeks of treatment in western medicine group. Sign score comparison: 3 weeks after treatment, the ultrasonic group pain degree classification, tumor size classification, symptoms and signs scores were significantly lower than before treatment, all p0.01, indicating that the ultrasonic group before and after treatment in a statistically significant difference; Western medicine group after 3 weeks of treatment, breast pain degree classification, tumor size classification, symptoms and signs scores were significantly lower than before treatment. There were significant differences in the degree of breast pain, the size of breast mass and the score of symptoms and signs between the ultrasound group and the western medicine group. After treatment, there were 20 cases in ultrasound group, 6 cases were cured, accounting for 30%; 10 cases were markedly effective, accounting for 50%; 3 cases were effective, accounting for 15%; 19 cases were effective, accounting for 95%; 20 cases in western medicine group, 2 cases were cured, accounting for 10%; 6 cases were markedly effective, accounting for 30%; 9 cases were effective, accounting for 45%; 17 cases were effective, accounting for 85%. Rank sum test was used to analyze the curative effect data of ultrasound group and Western medicine group after 3 weeks treatment, p0.05. Conclusion: Ultrasound-guided targeted delivery of compound Phellodendron Cortex Phellodendri solution can effectively alleviate the clinical symptoms and signs of acne mammary carbuncle in mass stage, help to improve the clinical cure rate and obtain good therapeutic effect, which is worth promoting.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R269
本文編號：2237661
[Abstract]:BACKGROUND: Acne mammary carbuncle is called "plasma cell mastitis" in Western medicine. It has the characteristics of long course, difficult treatment, easy recurrence and poor prognosis. It brings great inconvenience to the life and work of patients, and causes great trauma to the physiology and psychology of patients. Objective: To investigate the efficacy and safety of ultrasound-mediated drug delivery in the treatment of acne mastitis and to provide a new method for the treatment of acne mastitis. Methods: 40 cases of acne mammary carbuncle were randomly divided into two groups: the ultrasonic group (treatment group) and the western medicine group (control group). The ultrasonic group (20 cases): 1. Two blank coupling patches were extruded and dried, and 2.5ml compound Phellodendron solution was added, and the patches were placed on two electrodes, and then fixed on the therapeutic apparatus. 2 treatment head to be used; 2 touch the breast mass to determine the longest diameter of the two ends of the mass, marking; 3 clean the patient's breast, after the skin is dry, the treatment head with bandage or adhesive tape fixed on the skin; 4 switch on the power supply, according to the patient can tolerate the parameters (generally do not need to adjust), time is 30 minutes, press _30 minutes later, remove the treatment head, the patch still need to stick on the original place to retain 3-4 hours, to promote the full absorption of the drug. The treatment twice a day, three weeks for a course of treatment. Western medicine group (20 cases): 20 cases were treated conservatively with Western medicine, in this experiment using antibiotics + dexamethasone combination, the first week: 0.4% tinidazole 200 ml + injection head. Sporadine 1 G + normal saline 250ml + dexamethasone sodium phosphate, Cefradine before the use of the drug skin test, showed negative reaction after use; dexamethasone sodium phosphate dosage of 10 mg / day before the first three days, 5 mg / day after four days. All drugs intravenous drip once a day, continuous drip for 1 week. Second week: Cefradine capsule oral, continued to take one day 3 weeks, 3 times a day, 0.5 g each time; oral dexamethasone tablets, continued to take one week, once a day, 1.5 mg each time. 3 weeks: oral cefradine capsules, continued to take one week, three times a day, each time 0.5 G. At the same time, observe and record the data of breast pain degree classification, breast mass size classification, symptoms and signs integral before treatment and after 3 weeks of treatment in western medicine group. Sign score comparison: 3 weeks after treatment, the ultrasonic group pain degree classification, tumor size classification, symptoms and signs scores were significantly lower than before treatment, all p0.01, indicating that the ultrasonic group before and after treatment in a statistically significant difference; Western medicine group after 3 weeks of treatment, breast pain degree classification, tumor size classification, symptoms and signs scores were significantly lower than before treatment. There were significant differences in the degree of breast pain, the size of breast mass and the score of symptoms and signs between the ultrasound group and the western medicine group. After treatment, there were 20 cases in ultrasound group, 6 cases were cured, accounting for 30%; 10 cases were markedly effective, accounting for 50%; 3 cases were effective, accounting for 15%; 19 cases were effective, accounting for 95%; 20 cases in western medicine group, 2 cases were cured, accounting for 10%; 6 cases were markedly effective, accounting for 30%; 9 cases were effective, accounting for 45%; 17 cases were effective, accounting for 85%. Rank sum test was used to analyze the curative effect data of ultrasound group and Western medicine group after 3 weeks treatment, p0.05. Conclusion: Ultrasound-guided targeted delivery of compound Phellodendron Cortex Phellodendri solution can effectively alleviate the clinical symptoms and signs of acne mammary carbuncle in mass stage, help to improve the clinical cure rate and obtain good therapeutic effect, which is worth promoting.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R269
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