基于伏邪理论治疗肉芽肿性乳腺炎临证探讨

Discussion on the clinical management of granulomatous mastitis based on theory of latent pathogens

肉芽肿性乳腺炎是一种病程较长、多发生于女性非哺乳期、病因未明、具有非特异性的乳腺良性炎症性疾病,易误诊误治,近年来发病率呈逐渐上升趋势。中医学将其归属于"不乳儿乳痈""乳漏"等范畴,中医药对该病的诊治有一定疗效。本文探讨基于"伏邪理论"治疗肉芽肿性乳腺炎。治疗时辨证分期论治:急性期清热化痰散结以透邪,亚急性期温阳通络化痰以祛邪,慢性期益气通络化痰以除邪,同时配合适时手术的治疗理念,使隐匿潜藏之伏邪消散,则邪祛正安,为本病临床治疗提供了新思路。

Granulomatous mastitis is a nonspecific benign inflammatory breast disease with a long disease course,mostly occurring in women during the non-lactation period.The etiology is unknown,and it is easy to be misdiagnosed and treated in a wrong way.In recent years,its incidence has been on the rise.In traditional Chinese medicine,granulomatous mastitis falls into the category of“nonpuerperal mammary carbuncles”and“mammary fistula”,and TCM has achieved a certain curative effect in the diagnosis and treatment of this disease.This paper discusses the treatment of granulomatous mastitis based on the“theory of latent pathogens”.Syndrome differentiation and stage-based treatment is put forward:In the acute phase,clear heat and dissolve phlegm to dissipate pathogens;In the subacute phase,warm yang and unblock collaterals to dissipate pathogens;In the chronic phase,nourish qi,unblock collaterals and dissipate phlegm to dispel pathogens.Moreover,in combination with the therapeutic concept of timely surgical operations,the latent pathogens would scatter and be removed.This paper offers new treatment ideas for the clinical treatment of this disease.