肝胃同治法联合激素治疗非哺乳期乳腺炎急性肿块期的临床疗效

Clinical Efficacy of Method of Liver and Stomach Combined with Hormone in Treatment of Non-puerperal Mastitis in Acute Tumor Stage

目的:观察肝胃同治法联合激素治疗非哺乳期乳腺炎急性肿块期的临床疗效。方法:选取2019年1月—2020年12月南通市中医院乳腺外科收治的非哺乳期乳腺炎急性肿块期患者90例,按随机数字表法分为A组、B组与C组,A组31例,B组29例,C组30例。其中A组予口服醋酸泼尼松及疏肝散结汤,B组予口服醋酸泼尼松,C组予口服疏肝散结汤,均治疗8周。观察患者临床症状体征积分(肿块大小、肤色、肤温、疼痛)、总有效率、炎性因子[白细胞计数(WBC)、C反应蛋白(CRP)、白细胞介素(IL)-2、IL-4、IL-6]、免疫球蛋白(IgA、IgM、IgG)。结果:三组治疗前临床症状体征积分、炎性指标、免疫指标差异无统计学意义(P>0.05),治疗后三组各项指标均较治疗前显著降低(P<0.05),且治疗后A组各指标低于B组(P<0.05),肿块大小积分与C组无明显差异(P>0.05),其余各指标均低于C组(P<0.05),B组肿块大小积分高于C组,其余指标均低于C组(P<0.05),总有效率与C组无明显差异(P>0.05)。A组与B组不良反应发生率差异无统计学意义,但均高于C组,差异有统计学意义(P<0.05)。结论:肝胃同治法联合激素能有效缩小非哺乳期乳腺炎患者肿块,控制炎症,调节自身免疫,临床疗效显著,安全有效。

Objective To observe the clinical efficacy of the treatment from liver and stomach simultaneously combined with hormone in the treatment of non-puerperal mastitis patients in acute tumor stage.Methods 90 patients with non-puerperal mastitis in acute tumor stage were selected and divided into groups A,B and C according to the random number table,which 31 cases in group A,29 cases in group B,and 30 cases in group C.Group A was given oral prednisone acetate and Shugan Sanjie decoction,group B was given oral prednisone acetate,and group C was given oral Shugan Sanjie decoction,all of which were treated for 8weeks.The clinical symptoms and signs scores(tumor size,skin color,skin temperature,pain),total effective rate,inflammatory factors(WBC,CRP,IL-6,IL-2,IL-4)and immunoglobulin(IgA,IgM,IgG)were observed.Results There was no significant difference in the scores of clinical symptoms and signs,inflammation indexes and immune indexes in three groups before treatment(P>0.05),and all indexes in three groups significantly reduced after treatment(P<0.05).The indexes in group A were lower than those in group B after treatment(P>0.05),and the tumor size is equivalent to that of group C(P>0.05).The other indicators are lower than those of group C(P<0.05),and the tumor size of group B is higher than that of group C.The rest of the indicators are lower than those of group C(P<0.05),and the total effective rate is equivalent to that of group C(P>0.05).Adverse reactions in group A were similar to group B(P>0.05),and higher than group C(P<0.05).Conclusion The treatment from liver and stomach simultaneously combined with hormone can effectively reduce the tumor of patients with non-puerperal mastitis,control inflammation and regulate autoimmunity.The clinical effect is significant,safe and effective.