九华膏治疗溃后期非哺乳期乳腺炎临床研究

Clinical study of Jiuhua Ointment in the treatment of the late stage of ulceration of non-lactating mastitis

目的总结观察九华膏治疗溃后期非哺乳期乳腺炎的疗效及机制。方法将78例非哺乳期乳腺炎溃后或小切口排脓后,随机分为观察组和对照组,每组39例。对照组常规消毒清洗后橡皮膜引流,观察组在对照组的基础上使用九华膏填充窦道。观察两组的疗效、换药的次数、窦道的深度、愈合的时间、生活质量评分及毒副反应,采用酶联免疫法检测治疗前及治疗结束后患者肉芽组织细胞因子白细胞介素(interleukin,IL)-4、IL-10、IL-17、IL-22及血管内皮生长因子(vascular endothelial growth factor,VEGF)含量。结果观察组总有效率100%,对照组总有效率92.3%,观察组优于对照组(P<0.05);两组均可缩小靶肿块大小、缩短窦道深度、降低患者SF-36评分(P<0.05),且观察组优于对照组(P<0.05);观察组还可延长换药的间隔时间、减少换药的次数(P<0.05);治疗后,两组肉芽组织IL-4、IL-10、VEGF含量均上升(P<0.05),IL-17、IL-22含量均下降(P<0.05),且观察组优于对照组(P<0.05);两组均未出现明显毒副作用。结论九华膏对溃后期非哺乳期乳腺炎具有很好的疗效,能够改善窦道周围炎性反应,治愈或缩小病灶,防止窦道的产生,促进窦道愈合,改善患者生活质量。

Objective To summarize and observe the curative effect and mechanism of Jiuhua Ointment in treating the late stage of ulceration of non-lactating mastitis.Methods After ulceration or drainage of pus through small incision,78 cases of nonlactating mastitis were randomly divided into observation group and control group,with 39 cases in each group.The rubber membrane drainage was performed after routine disinfection and cleaning in the control group.On the basis of the control group,the observation group was used Jiuhua Ointment to fill the sinus tract.The curative effect,frequency of dressing change,depth of sinus tract,healing time,quality of life score and toxic and side effects of the two groups were observed.The content levels of granulation tissue cytokines interleukin(IL)-4,IL-10,IL-17,IL-22 and vascular endothelial growth factor(VEGF)were measured by enzyme-linked immunoassay before and after treatment.Results The total effective rate was 100%in the observation group and92.3%in the control group,and the curative effect in the observation group was better than that in the control group(P<0.05).The size of target mass,the depth of sinus tract and the SF-36 score were reduced in both groups(P<0.05),and the observation group was better than the control group(P<0.05).The observation group could also prolong the interval time of dressing change and reduce the number of dressing change(P<0.05);after treatment,the content of IL-4,IL-10 and VEGF in granulation tissue increased(P<0.05),while the content of IL-17 and IL-22 decreased(P<0.05)in both groups,and the observation group was better than the control group(P<0.05).There were no obvious toxic and side effects in the two groups.Conclusion Jiuhua Ointment has a good curative effect on the late stage of ulceration of non-lactating mastitis,which can improve the inflammatory reaction around the sinus tract,cure or shrink the lesion,prevent the formation of the sinus tract,promote the healing of the sinus tract,and improve the patient’s quality of life.