消乳散结汤配合外科手术治疗非哺乳期乳腺炎临床研究

Clinical Study on Xiaoru Sanjie Decoction Combined with Surgery for Non-Puerperal Mastitis

目的:观察消乳散结汤配合外科手术治疗非哺乳期乳腺炎(NPM)肝经郁热证的临床疗效。方法:选取96例NPM肝经郁热证患者,以随机数字表法分为治疗组与对照组各48例。2组均行外科手术治疗,对照组术后给予注射用头孢呋辛钠治疗,治疗组在对照组基础上给予消乳散结汤治疗。2组均随访6个月。比较2组临床疗效、中医证候积分、炎症指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)]水平及复发率。结果:术后15 d,治疗组总有效率97.92%,与对照组95.83%比较,差异无统计学意义(P>0.05)。治疗组治愈率54.17%,高于对照组31.25%,差异有统计学意义(P<0.05)。2组中医证候积分均较术后1 d降低,治疗组中医证候积分低于对照组,差异均有统计学意义(P<0.05)。2组血清IL-6、TNF-α、CRP水平均较术后1 d降低,治疗组血清IL-6、TNF-α、CRP水平均低于对照组,差异均有统计学意义(P<0.05)。随访3个月,治疗组无复发,对照组复发率2.17%,2组比较,差异无统计学意义(P>0.05)。随访6个月,治疗组复发率2.13%,低于对照组13.04%,差异有统计学意义(P<0.05)。结论:在外科手术基础上加用消乳散结汤治疗NPM肝经郁热证,可有效缓解症状,减轻炎症反应,降低复发率。

Objective:To observe the clinical effect of Xiaoru Sanjie Decoction combined with surgery for non-puerperal mastitis(NPM)with stagnated heat in the liver meridian syndrome.Methods:A total of 96 cases of NPM patients with stagnated heat in the liver meridian syndrome were selected and divided into the treatment group and the control group according to the random number table method,with 48 cases in each group.Both groups were given surgery;after surgery,the control group was treated with Cefuroxime Sodium for Injection,and the treatment group was additionally treated with Xiaoru Sanjie Decoction based on the treatment of the control group.Both groups were followed up for 6 months.The clinical effects,as well as traditional Chinese medicine(TCM)syndrome scores,levels of inflammatory indicators[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and C-protein reaction(CRP)],and recurrence rates were compared between the two groups.Results:The total effective rate of 15 days after surgery was 97.92%in the treatment group and 95.83%in the control group,and the comparison showed no significance in the difference(P>0.05).The cure rate was 54.17%in the treatment group,higher than that of 31.25%in the control group,the difference being significant(P<0.05).The TCM syndrome scores in the two groups were decreased when compared with those 1 day after surgery,and the score in the treatment group was lower than that in the control group,differences being significant(P<0.05).The levels of IL-6,TNF-α,and CRP in serum in the two groups were decreased when compared with those 1 day after surgery,and the levels of IL-6,TNF-α,and CRP in serum in the treatment group were lower than those in the control group,differences being significant(P<0.05).During the 3 months of follow-up,there was no recurrence in the treatment group,and the recurrence rate was 2.17%in the control group,there being no significance in the difference(P>0.05).During the 6 months of follow-up,the recurrence rate was 2.13%in the treatment group,lower than that of 13.04%in the control group,the difference being significant(P<0.05).Conclusion:In the treatment of NPM with stagnated heat in the liver meridian syndrome,the additional application of Xiaoru Sanjie Decoction based on surgery can effectively relieve symptoms and inflammatory responses,and reduce recurrence rates.