红花逍遥片联合曲氨耐德治疗肉芽肿乳腺炎的研究

Clinical study on the control of granulomatous mastitis with Honghua Xiaoyao tablet and triamcinolone

目的通过口服红花逍遥片联合炎症肿块内注射曲氨耐德治疗肉芽肿乳腺炎,分析控制炎症表现的临床及影像学相关指标,探讨红花逍遥片在中西医结合治疗肉芽肿乳腺炎中的价值。方法选取2015年3月—2018年3月石家庄市第四医院住院治疗的肉芽肿乳腺炎患者266例作为研究对象。按随机数字表法分为研究组和对照组,每组133例。对照组仅予以炎症肿块内注射曲氨耐德注射液50 mg,2次/周,连续1个月;研究组在对照组的基础上,口服红花逍遥片1.56 g,3次/d,连续治疗1个月。比较两组治疗后疼痛评分、下肢红斑、肿块体积、彩超影像学回声变化、彩超血流变化、穿刺脓血情况、C反应蛋白下降情况等相关指标变化。结果治疗后研究组疼痛评分与对照组比较,差异有统计学意义(P<0.05);研究组治疗后下肢红斑消退时间、肿块体积缩小程度与对照组比较,差异有统计学意义(P<0.05),研究组低于对照组;研究组治疗后炎症肿块彩超影像学回声均匀程度、炎症肿块彩超血流信号减少程度与对照组比较,差异有统计学意义(P<0.05),研究组优于对照组;研究组治疗后炎症肿块穿刺抽出的脓血黏稠度、C反应蛋白水平与对照组比较,差异有统计学意义(P<0.05),研究组低于对照组。结论红花逍遥片口服联合炎症肿块内注射曲氨耐德治疗肉芽肿乳腺炎,控制临床炎症的各项指标研究组均优于对照组,表明红花逍遥片在中西医结合治疗肉芽肿乳腺炎时,其疏肝理气、降解乳络瘀血、痰核、湿热的功效可以大大提高西医治疗功能,值得临床推广。

Objective In the treatment of granulomatous mastitis,Honghua Xiaoyao tablet was given orally combined with triamcinolone acetonide injection in inflammatory mass,and the clinical and imaging indexes of controlling inflammation were analyzed to explore the value of Honghua Xiaoyao tablet in the treatment of granulomatous mastitis with the combination of traditional Chinese and Western medicine.Methods A total of 266 cases of granulomatous mastitis were selected and randomly divided into study group(133 cases)and control group(133 cases)according to the random number table.The control group was given triamcinolone acetonide injection(50 mg)twice a week for one month.On the basis of the control group,the study group took Honghua Xiaoyao tablet(1.56 g)three times a day for one month.After treatment,the changes of pain score,erythema of lower extremity,volume of mass,echo change of color Doppler ultrasonography,blood flow changes of color Doppler ultrasonography,puncture pus,decrease of C-reactive protein,and other related indicators were compared.Results After treatment,the pain score of the study group was significantly lower than that of the control group(P<0.05);the time of erythema subsidence and the reduction of mass volume in the study group were significantly lower than those in the control group(P<0.05);the homogeneity of color Doppler echo and the reduction of color Doppler flow signal in inflammatory masses in the study group were better than those in the control group(P<0.05);the purulent blood viscosity and C-reactive protein extracted by puncture of inflammatory mass were significantly lower than those of control group(P<0.05).Conclusion Honghua Xiaoyao Tablet combined with intratumoral injection of triamcinolone acetonide in the treatment of granulomatous mastitis is superior to the control group in controlling clinical inflammation.It shows that Honghua Xiaoyao Tablet has the effects of soothing liver and regulating qi,degrading blood stasis in breast collaterals,phlegm nucleus and dampness-heat in the treatment of granulomatous mastitis,which can greatly improve the therapeutic function of Western medicine and is worthy of clinical promotion.