土黄连液乳管镜冲洗治疗乳腺导管扩张伴炎症临床观察

Clinical Study on the Treatment of Inflammatory Nipple Discharge with Local TCM Drug Perfusion

目的:研究乳管镜下乳头溢液导管腔内结构、病变性状,探索治疗炎症性乳头溢液的新方法。方法:应用乳管镜对乳头溢液患者进行检查,选择其中152例诊断为导管扩张及导管炎症的良性病变患者,随机分3组,治疗组53例经病变乳孔冲洗土黄连液2mL,对照1组48例冲洗庆大霉素80000U,对照2组51例冲洗0.9%生理盐水2mL治疗,每周1次,连续8次,随访3个月后乳管镜复查,观察疗效。结果:冲洗治疗后随访3个月,治疗组50例停止溢液,总有效率94.34%。对照1组总有效率81.25%,对照两组总有效率23.53%。经统计学分析,土黄连液组疗效优于庆大霉素和生理盐水对照组,差异有显著性(P<0.05)。结论:土黄连液乳管镜冲洗治疗乳腺导管扩张伴炎症性乳头溢液操作简便、无损伤、无不良反应、无并发症,临床疗效好,避免了对炎症性乳头溢液行手术切除带来的组织创伤和精神负担,为临床提供了一种新的治疗手段。

Objective ：To observe the intraductal structure and lesion nature of the nipple discharge under mammary ductoscope and to explore a new therapeutic method of inflammatory nipple discharge. Methods ： 152 eases with nipple discharge examined by mammary ductoseope,53 cases diagnosed as mammary duct ectasia or inflammation were selected and treated with TCM（ Tuhuan- glian） ;48 cases diagnosed as mammary duct ectasia or inflammation were selected and treated with gentamycin ;and 51 cases diagnosed as mammary duct ectasia or inflammation were selected and treated with Sodium Chloride for 8 times （ perfused every 1 week as one times ）. Results：All the patients were followed up for 3 months ,50 cases got healed with TCM. The results indicated that the therapeutic effect of TCM （Tuhuanglian） （94. 34% ）was better than that of the contrast group with gentamycin and Sodium Chloride（ P 〈 O. 05 ） ;Moreover ,50 cases with TCM were found with less inflammation and exudation, smooth surface and disap- pearance of congestion. Conclusion：Treating inflammatory nipple discharge with TCM （Tuhuanglian） local drug perfusion is clinically effective with simple, atraumatie and uncomplicated maniptlation. It can prevent tissue trauma and mental burden of the patient caused by operative intervention, providing a new therapeutic measure in clinic.