微创灌洗配合口服中药治疗浆细胞性乳腺炎的临床研究

Minimally invasive lavage and oral administration of traditional Chinese medicine for plasma cell mastitis

目的探讨微创灌洗配合口服中药治疗浆细胞性乳腺炎的临床效果。方法±据纳入、排除标准,选取2018年11月至2019年9月在宁夏回族自治区人民医院就诊的100例浆细胞性乳腺炎患者资料进行回顾性研究,其中采用微创灌洗配合口服中药治疗者50例(联合治疗组),仅用口服中药治疗者50例(口服中药组)。分析2组间疗效、中医证候量表评分、医院焦虑和抑郁量表评分及治疗时间的差异。中医证候量表评分为偏态分布定量资料,用M(P 25~P 75)表示。2组患者总有效率比较采用x^(2)检验,医院焦虑和抑郁量表评分及治疗时间比较均采用独立样本t检验,中医证候量表评分比较采用非参数检验;组内患者治疗前、后医院焦虑和抑郁量表评分比较采用配对样本t检验,中医证候量表评分比较采用符号秩和检验。结果联合治疗组患者治疗总有效率达96%(48/50),明显优于单纯口服中药患者的56%(28/50)(x^(2)=21.930,P<0.001)。联合治疗组患者中医证候量表评分由19.0(18.0~24.3)分下降至1.0(1.0~7.0)分(Z=-6.179,P<0.001),口服中药组患者中医证候量表评分由18.0(16.0~23.2)分下降至12.0(9.7~21.2)分(Z=-6.103,P<0.001);联合治疗组患者治疗后的中医证候量表评分明显低于口服中药组(Z=-5.704,P<0.001)。在医院焦虑和抑郁量表评分方面,联合治疗组患者焦虑评分由(14.4±2.2)分降至(5.4±2.4)分(t=23.862,P<0.001),口服中药组患者焦虑评分由(13.5±2.5)分降至(8.2±3.5)分(t=15.499,P<0.001);联合治疗组患者抑郁评分由(12.7±2.2)分降至(4.9±2.4)分(t=28.055,P<0.001),而口服中药组患者抑郁评分由(12.5±1.7)分降至(7.5±2.6)分(t=16.390,P<0.001)。联合治疗组患者治疗后的焦虑、抑郁评分均明显低于口服中药组(t=4.110,P<0.001;t=4.850,P<0.001)。联合治疗组患者治疗时间为(14.2±2.3)d,明显短于口服中药组的(22.6±3.0)d(t=8.420,P<0.001)。结论微创灌洗配合口服中药治疗浆细胞性乳腺炎效果优于口服中药,并可有效缓解患者的焦虑、抑郁状况,缩短治疗时间,减轻患者痛苦。

Objective To explore the clinical efficacy of minimally invasive lavage and oral administration of traditional Chinese medicine(TCM)in the treatment of plasma cell mastitis.Methods Based on the inclusion and exclusion criteria,a retrospective study was conducted on clinical data of 100 patients with plasma cell mastitis in the People’s Hospital of Ningxia Hui Autonomous Region from November 2018 to September 2019.Among them,50 patients were treated with minimally invasive lavage and oral administration of TCM(combined therapy group),and 50 patients were treated with oral administration of TCM only(oral therapy group).The clinical efficacy,score in TCM syndrome scale,score in the Hospital Anxiety and Depression Scale and treatment time were compared between two groups.TCM syndrome score were skewed distributed data,expressed as M(P25-P75).The clinical efficacy was compared byx^(2) test between two groups,the anxiety and depression scores and treatment time by independent-samples t test,TCM syndrome score by non-parametric test.The anxiety and depression scores of the same group were compared by paired-samples t test before and after treatment,TCM syndrome score by Wilcoxon signed rank test.Results The total effective rate in combined therapy group was 96%(48/50),significantly higher than 56%(28/50)in oral therapy group(x^(2)=21.930,P<0.001).The TCM syndrome score was decreased from 19.0(18.0-24.3)to 1.0(1.0-7.0)in combined therapy group(Z=-6.179,P<0.001),from 18.0(16.0-23.2)to 12.0(9.7-21.2)in oral therapy group(Z=-6.103,P<0.001).After treatment,the TCM syndrome score in combined therapy group was significantly lower than that in oral therapy group(Z=-5.704,P<0.001).The anxiety score was decreased from 14.4±2.2 to 5.4±2.4(t=23.862,P<0.001)in combined therapy group,from 13.5±2.5 to 8.2±3.5(t=15.499,P<0.001)in oral therapy group.The depression score was decreased from 12.7±2.2 to 4.9±2.4(t=28.055,P<0.001)in combined therapy group,from 12.5±1.7 to 7.5±2.6(t=16.390,P<0.001)in oral therapy group.The anxiety and depression scores in combined therapy group were significantly lower than those in oral therapy group(t=4.110,P<0.001;t=4.850,P<0.001).The treatment time in combined therapy group was(14.2±2.3)d,significantly shorter than(22.6±3.0)d in oral therapy group(t=8.420,P<0.001).Conclusion Compared with oral administration of TCM,minimally invasive lavage combined with oral administration of TCM has a better efficacy in the treatment of plasma cell mastitis,and it can effectively relieve the anxiety and depression of patients,shorten the treatment time and relieve the pain.