中医治疗浆细胞性乳腺炎评述

Progress on Traditional Chinese Medicine in Treatment of Plasma Cell Mastitis

在浆细胞性乳腺炎的肿块期或脓肿形成之前,内服中药可促进肿块及脓肿消散,配合中药外敷则相得益彰。若患者失治误治,病情迁延至脓肿期或即将破溃,采用中医清创术配合祛腐药线引流,脓清后垫棉绑缚。中医辨证论治的思路贯穿本病治疗的各个方面,对于皮瓣内卷、肤色瘀黑、水肿增厚、创面苍白的"阴性皮瓣",则不宜急于收口,治疗应刮除水肿肉芽及坏死皮缘,使其成为创面红活、血色鲜红的"阳性皮瓣"后,方可收口。对于瘘管期患者,虽然中医手术扩创配合术后换药是治疗本病的主要手段,但内服中药可起到良好的辅助作用。对于抵触手术治疗的患者,采用疏肝、健脾、补肾分期辨证配合中药外敷治疗本病,可基本摒弃手术切除的治疗方法。虽然中医治疗浆细胞性乳腺炎具有一定优势,但还需要在以下方面突破:①个体化诊治与规范化诊治相结合,优化外治方法,改进术式,兼顾美容效果;②明确并统一中医外治法的诊疗操作规范;③改进研究方法,例如建立浆细胞性乳腺炎中医诊疗数据库;④拓展研究范围,关注中医疗法对患者生存质量改善作用等。希望随着研究的不断深入,能使中医对浆细胞性乳腺炎的治疗更加系统化和规范化。

In the lump stage or abscess formation of plasma cell mastitis,oral administration of traditional Chinese medicine can promote the dissipation of masses and abscesses,and the external application of traditional Chinese medicine complements each other.If the patient loses treatment and is mistreated,the condition is postponed to the abscess stage or is about to collapse.The traditional Chinese medicine debridement is combined with the phlegm line to drain,and the pus clears the cotton pad.The idea of TCM syndrome differentiation and treatment also runs through all aspects of the treatment of this disease.For the "negative flap" of flap involution,dark complexion,thickening of edema,and pale wound surface,it is not advisable to close the mouth.The treatment should scrape the edema granulation and necrotic skin.The edge,so that it becomes a "positive flap" with red wounds and bright red blood,can be closed.For patients with fistula,although the expansion of TCM surgery and postoperative dressing change is the main means of treating this disease,oral administration of Chinese medicine can play a good supporting role.For patients who are resistant to surgical treatment,the treatment of this disease can be basically abandoned by using Shugan,Jianpi,Bushen methods with syndrome differentiation and external application of traditional Chinese medicine.Although Chinese medicine has certain advantages in the treatment of plasma cell mastitis,it also needs to break through in the following aspects:①individualized diagnosis and treatment combined with standardized diagnosis and treatment,optimization of external treatment methods,improvement of surgical style,and consideration of cosmetic effects;②clear and unified Chinese medicine The standard of diagnosis and treatment of the treatment;③improve the research methods,such as the establishment of a database of traditional Chinese medicine diagnosis and treatment of plasma cell mastitis;④to expand the scope of research,pay attention to the effect of Chinese medicine on the quality of life of patients.It is hoped that with the deepening of research,TCM can make the treatment of plasma cell mastitis more systematic and standardized.