疏肝消肿散治疗肝郁痰凝型肉芽肿性乳腺炎的临床疗效及对患者体液免疫指标和炎症指标水平的影响

Shugan Xiaozhong Powder for patients with granulomatous mastitis of liver depression and phlegm coagulation:curative effect observation and mechanism

目的观察疏肝消肿散治疗肝郁痰凝型肉芽肿性乳腺炎的临床疗效及对患者体液免疫功能、炎症指标的影响。方法将100例肝郁痰凝型肉芽肿性乳腺炎患者按照随机数字表法分为2组。对照组50例(最终完成46例)予注射用阿莫西林钠舒巴坦钠联合醋酸泼尼松片治疗,治疗组50例(最终完成48例)在对照组治疗基础上加疏肝消肿散治疗。2组均治疗3个月为1个疗程。比较2组临床疗效;比较2组治疗前后中医证候评分变化情况;体液免疫指标免疫球蛋白(Ig)A、IgG、IgM水平和炎症指标C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平变化。结果治疗组总有效率93.75%(45/48),对照组总有效率76.09%(35/46),治疗组疗效优于对照组(P<0.05)。治疗后2组中医证候各项评分及总分均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。治疗后2组IgA、IgG、IgM水平均高于本组治疗前(P<0.05),且治疗组均高于对照组(P<0.05)。治疗后2组血清IL-6、CRP、TNF-α水平均低于本组治疗前(P<0.05),且治疗组均低于对照组(P<0.05)。结论疏肝消肿散有助于缓解肝郁痰凝型肉芽肿性乳腺炎患者临床症状,提高临床疗效,可能与调节体液免疫功能、抑制炎性反应等因素有关。

Objective To observe the curative effect of Shugan Xiaozhong Powder for patients with granulomatous mastitis(GM)of liver depression and phlegm coagulation and its influence on humoral immune function and inflammation-related factors.Methods Totally 100 patients with GM(liver depression and phlegm coagulation)were randomly divided into 2 groups,50 cases(46 cases completed)in control group were given amoxicillin sodium and sulbactam sodium for injection combined with prednisone acetate tablets,and 50 cases(48 cases completed)in treatment group were additionally given Shugan Xiaozhong Powder on the basis of control group.Treated for 3 months,aiming to compare traditional Chinese medicine(TCM)syndrome score,humoral immune indexes such as immunoglobulin A(IgA),IgG,IgM,inflammation-related factors including C reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α);the curative effect was counted.Results The total response rates in treatment group and control group were 93.75%(45/48)and 76.09%(35/46),respectively.the curative effect being better in treatment group than control group(P<0.05).After treatment,TCM symptom scores in groups were decreased(P<0.05),which decreased notably in treatment group when compared with cortrol group(P<0.05);IgA,IgG,IgM in groups remarkably increased(P<0.05),improvement of which in treatment group were significantly better(P<0.05);Serum IL-6,CRP,TNF-αin groups were lower(P<0.05),which in treatment group were significantly decreased(P<0.05).Conclusion For patients with GM(liver depression and phlegm coagulation),Shugan Xiaozhong Powder can relieve clinical symptoms and improve clinical efficacy,which may be related toregulated humoral immune function and inhibited inflammatory response.