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消痈方内服联合金黄膏外敷治疗外吹乳痈初期患者的临床疗效及对乳汁菌群的影响 被引量:7

Clinical efficacy of oral administration of Xiaoyong Prescription combined with external application of Jinhuang Ointment in the treatment of early stage of breast carbuncle during lactation and its effect on milk microflora
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摘要 目的观察消痈方内服联合金黄膏外敷治疗外吹乳痈初期患者的临床疗效及对乳汁菌群的影响。方法将81例外吹乳痈初期患者按1?2的比例随机分为对照组(27例)、治疗组(54例)。两组均外敷金黄膏,对照组在此基础上口服头孢地尼胶囊,治疗组则口服消痈方颗粒(随证加减)治疗。两组疗程均为3 d,观察临床疗效,比较乳痈症状体征量化积分、乳汁细菌阳性率及特定细菌数量的变化情况。结果(1)治疗组、对照组总有效率分别为90.7%、74.1%,治疗组的临床疗效优于对照组(P<0.05)。(2)治疗前后组内比较,两组乳痈症状体征量化总积分均降低(P<0.05);组间治疗后比较,治疗组乳痈症状体征量化总积分低于对照组(P<0.05)。(3)治疗前后组内比较,两组乳痈症状体征中乳房疼痛、皮肤发红、肿块大小、肿块数目、体温、中性粒细胞百分比(N%)、C反应蛋白(CRP)评分均较治疗前减少(P<0.05);组间治疗后比较,乳房肿块大小、肿块数目评分差值差异有统计学意义(P<0.05)。(4)治疗前后组内比较,两组乳汁细菌阳性率差异均无统计学意义(P>0.05);组间治疗后比较,治疗组乳汁细菌阳性率低于对照组(P<0.05)。(5)治疗前后组内比较,两组患者乳汁中链球菌、葡萄球菌、乳酸杆菌数量差异无统计学意义(P>0.05);组间治疗前后上述细菌数量的差值差异无统计学意义(P>0.05)。结论与口服头孢地尼联合金黄膏外敷比较,消痈方内服联合金黄膏外敷治疗外吹乳痈初期患者疗效满意,消散结块功效更为显著,且有利于降低乳汁细菌的阳性率。 Objective To observe the clinical efficacy of oral administration of Xiaoyong Prescription combined with external application of Jinhuang Ointment in the treatment of early stage of breast carbuncle during lactation and its effect on milk microflora.Methods A total of 81 patients with breast carbuncle during lactation at the initial stage were randomly divided into control group(n=27)and treatment group(n=54)according to the proportion of 1∶2.Both groups were treated with Jinhuang Ointment externally.The control group was also given cefdinir capsules orally,while the treatment group was given Xiaoyong Prescription orally in the form of granules(modified according to syndromes).The course of treatment in both groups was 3 days.The clinical efficacy was observed,and the changes of quantitative scores of symptoms and signs of breast carbuncle,the positive rate of milk bacteria and specific bacteria quantity were compared.Results(1)The total effective rate of the treatment group and the control group were 90.7%and 74.1%respectively,and the clinical efficacy of the treatment group was better than that of the control group(P<0.05).(2)The quantitative score of symptoms and signs of breast carbuncle in both groups decreased after treatment(P<0.05),and the quantitative score of breast carbuncle symptoms and signs in the treatment group was lower than that in the control group after treatment(P<0.05).(3)The scores of breast carbuncle symptoms and signs including breast pain,skin redness,size and quantity of lumps,body temperature,percentage of neutrophils(N%)and C-reactive protein(CRP)in the two groups were all lower than those before treatment(P<0.05).After treatment,the differences in the scores of size and quantity of breast lumps between the groups were statistically significant(P<0.05).(4)There was no significant difference in the positive rate of milk bacteria between the two groups before and after treatment(P>0.05).After treatment,the positive rate of milk bacteria in the treatment group was lower than that in the control group(P<0.05).(5)There was no significant difference in the number of streptococcus,staphylococcus and lactobacillus in the milk of the two groups before and after treatment(P>0.05).There was no significant difference in the number of the above bacteria between the two groups before and after treatment(P>0.05).Conclusion Compared with oral administration of cefdinir combined with external application of Jinhuang Ointment,oral administration of Xiaoyong Prescription combined with external application of Jinhuang Ointment has more satisfactory efficacy on patients with early stage of breast carbuncle during lactation in resolving lumps,and can better reduce the positive rate of bacteria in milk.
作者 林晓茹 陈红风 胡升芳 程亦勤 叶媚娜 王冰 吴晶晶 孟畑 殷玉莲 周悦 仲沅芫 LIN Xiaoru;CHEN Hongfeng;HU Shengfang;CHENG Yiqin;YE Meina;WANG Bing;WU Jingjing;MENG Tian;YIN Yulian;ZHOU Yue;ZHONG Yuanyuan(Breast Department of Traditional Chinese Medicine,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200030,China)
出处 《上海中医药杂志》 2020年第12期54-58,共5页 Shanghai Journal of Traditional Chinese Medicine
基金 上海市卫计委名老中医学术经验研究工作室建设项目(SHGZS-2017018) 上海中医药大学附属龙华医院中医优势病种培育建设项目(zybz-2017001)。
关键词 外吹乳痈 急性乳腺炎 哺乳期 初期 消痈方 金黄膏 乳汁菌群 中药抑菌 breast carbuncle during lactation acute mastitis lactation early stage Xiaoyong Prescription Jinhuang Ointment milk microflora TCM bacteriostatic
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