清热化痰散结方联合地塞米松棕榈酸酯注射液封闭治疗浆细胞性乳腺炎临床研究

Clinical efficacy of Qingre Huatan Sanjie Formula combined with block treatment of dexamethasone palmitate injection for plasma cell mastitis

目的 观察清热化痰散结方联合地塞米松棕榈酸酯注射液封闭治疗浆细胞性乳腺炎(PCM)的临床疗效。方法 将98例PCM患者按照随机数字表法分为2组,对照组48例予手术治疗,治疗组50例予清热化痰散结方联合地塞米松棕榈酸酯注射液封闭治疗,2组均治疗4周。比较2组疗效;比较2组治疗前后乳腺肿块最大直径、疼痛VAS、炎症指标、免疫因子变化;比较2组乳房美容优良率;比较2组复发情况和不良反应发生情况。结果 治疗组总有效率94.0%(47/50),对照组总有效率75.0%(36/48),治疗组疗效优于对照组(P<0.05)。2组治疗后乳腺肿块最大直径、疼痛视觉模拟评分(VAS)均较本组治疗前降低(P<0.05),治疗后治疗组乳腺肿块最大直径、疼痛VAS均低于对照组(P<0.05)。2组治疗后白细胞介素6(IL-6)、IL-1β、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)均较本组治疗前降低(P<0.05),治疗后治疗组IL-6、IL-1β、TNF-α、CRP均低于对照组(P<0.05)。2组治疗后血清免疫因子免疫球蛋白(Ig)A、IgG、IgM水平均较本组治疗前降低(P<0.05),治疗后治疗组血清免疫因子IgA、IgG、IgM水平均低于对照组(P<0.05)。治疗组复发率4.9%(2/41),对照组复发率18.2%(4/22),治疗组复发率低于对照组(P<0.05)。治疗组不良反应反生率4.0%(2/50),对照组不良反应发生率2.1%(1/48),2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 清热化痰散结方联合地塞米松棕榈酸酯注射液封闭治疗PCM,能缩小乳房肿块,减轻乳房疼痛,降低炎症因子和免疫因子水平,减少复发率。

Objective To observe the Clinical efficacy of Qingre Huatan Sanjie Formula combined with block treatment of dexamethasone palmitate injection for plasma cell mastitis(PCM).Methods Totally 98 PCM patients were randomly assigned to receive either operative treatment(the control group,n=48)or Qingre Huatan Sanjie Formula combined with block treatment of dexamethasone palmitate injection(the treatment group,n=50).Treated for 4 weeks,the aim was to compare maximum diameter of breast mass,visual analogue scale(VAS),inflammatory index,immune factors,breast beauty excellent rate,recurrence,adverse reactions.The curative effect was assessed.Results After treatment,the overall effective rate was higher in the treatment group compared with the control group(94.0%[47/50]vs 75.0%[36/48]),P<0.05).The maximum diameter of breast mass,VAS in groups were decreased,which were lower in the treatment group than in the control group(P<0.05).The interleukine-6(IL-6),interleukin-1beta(IL-1β),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)in groups were decreased,which were decreased in the treatment group relevant to the control group(P<0.05).The immunoglobulin(Ig)A,IgG,IgM in groups were decreased,the reduction in the treatment group was more common(P<0.05).The recurrence rate in the treatment groupt was lower han that in the control group((4.9%(2/41)vs 18.2%4/22,P<0.05).The incidence of adverse reactions in the treatment group was comparable to the control group(4.0%[2/50]vs 2.1%[1/48],P>0.05).Conclusion For PCM patients,Qingre Huatan Sanjie Formula combined with block treatment of dexamethasone palmitate injection can reduce breast lumps,relieve breast pain,decrease the levels of inflammatory factors and immune factors,and reduce the recurrence rate.