从脏腑风湿理论治疗肉芽肿性乳腺炎探讨

Approach to treatment of granulomatous mastitis based on theory of visceral rheumatism

肉芽肿性小叶性乳腺炎是一种以乳腺小叶为中心的肉芽肿性病变。结合仝小林“脏腑风湿”理论,认为部分肉芽肿性乳腺炎是一类“乳房风湿病”,属脏腑风湿范畴;并从脏腑风湿的角度阐述部分肉芽肿性乳腺炎的病因病机、治疗原则等,提出风寒湿内侵是病因,产后体虚、寒湿内伏是病机,痰湿瘀互结是关键,化热溃破是进展。应以扶正祛邪为大法、分肿块期、脓肿期及溃后期三个不同阶段论治。为肉芽肿性乳腺炎提供新的辨证治疗思路。

Granulomatous lobular mastitis is a granulomatous lesion centered on thymus lobule.Combined with Tong xiaolin's theory of"visceral rheumatism",partial granulomatous mastitis is considered as a type of"breast rheumatism",and it belongs to the category of visceral rheumatism.The etiology,pathogenesis and therapeutic principles of partial granulomatous mastitis can be explained from visceral rheumatism,which provides a new approach of differential treatment for granulomatous mastitis.It should be put forward that wind-cold-damp from vivo is etiology,postpartum physical weakness with cold-damp lying latently in the vivo is pathogenesis,phlegm accumulating with damp and blood-stasis is key,heat-transformation with ulceration is progression;strengthening healthy qi to eliminate pathogens should be taken as main therapeutic principle,and the treatment should be made according to three different stages,i.e.tumor mass stage,abscess stage and ulceration late stage.