| 摘要: |
| 目的 比较阳和汤加味联合雕刻式切除术或传统区段扩大切除术两种手术方式治疗肿块期阳虚寒凝证肉芽肿性乳腺炎(GM)的临床疗效。方法:选取2021 年9 月—2023 年9 月河南中医药大学第一附属医院收治的肿块期阳虚寒凝证GM 患者134 例。±据手术方式不同，分为观察组(阳和汤加味+雕刻式切除术)和对照组(阳和汤加味+传统区段扩大切除术)两组，每组各67 例。比较两组术前经阳和汤加味治疗前后患者乳房肿块最大直径、中医证候积分变化，并以术后6 个月作为随访终点，比较切口愈合状况、复发率及痊愈率，对其中痊愈患者进行乳房外形评分、乳房敏感度评分。结果:观察组与对照组治疗后乳房肿块最大直径与中医证候积分较治疗前均有改善(P>0.05)；术后两组患者切口愈合状况、痊愈率及复发率比较均无统计学差异(P<0.05)；观察组痊愈患者在乳房外形满意等级、乳房外形评分及乳房敏感度评分方面均优于对照组痊愈患者(P<0.05)。结论:术前应用阳和汤加味可使炎性肿块局限化，改善肿块期中医证候，为手术创造条件。阳和汤加味联合雕刻式切除术能更好地保留肿块期阳虚寒凝证GM 患者的乳房外形并维护乳房敏感度。 |
| 关键词: 肉芽肿性乳腺炎 肿块期 阳和汤 雕刻式切除术 区段扩大切除术 |
| DOI：10.3969/j.issn.1007-6948.2025.01.009 |
| 投稿时间：2024-05-02 |
| 基金项目:国家中医药管理局全国名老中医药专家传承工作室建设项目(2100601-CZ0175)；2021 年河南省卫健委国家中医临床研究基地科研专项(2021JDZY018)；2022 年河南省卫健委国家中医临床研究基地科研专项(2022JDZX086) |
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| Observation of curative of Yanghe decoction combined with sculptural excision on mass -type granulomatous mastitis |
| YUAN Jiang-shan,CHENG Zi-ye,WANG Bei-bei |
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| Abstract: |
| Objective To compare the clinical effect of granulomatous mastitis (GM) treated by modified Yanghe decoction combined with carving resection or traditional segmental extended resection. Methods 134 GM patients with Yang deficiency and cold coagulation syndrome from September 2021 to September 2023 in the First Affiliated Hospital of Henan University of Chinese Medicine were analyzed retrospectively. According to the different clinical operation methods, the patients were divided into observation group (modified Yanghe decoction +carving resection) and control group (modified Yanghe decoction +traditional segmental extended resection), 67 cases in each group. The changes of breast mass diameter and traditional Chinese medicine (TCM)syndrome scores of the patients in the two groups before and after the treatment were compared. The wound healing status, recurrence rate and recovery rate were compared at the end of the follow-up period of 6 months after the operation, and the recovered patients were scored by breast shape score and breast sensitivity score. Results The diameter of breast mass and the scores of TCM syndrome were improved between the observation group and the control group (P<0.05); There was no statistical difference in the wound healing status, healing rate and recurrence rate between the two groups(P>0.05); The observation group was better than the control group in breast shape satisfaction, breast shape score and breast sensitivity score (P<0.05). Conclusion Preoperative application of modified Yanghe decoction can localize inflammatory mass,improve TCM syndromes in mass stage, and create conditions for operation. modified Yanghe decoction combined with carving resection can better preserve the breast shape and maintain breast sensitivity of GM patients with Yang deficiency and cold coagulation syndrome in mass stage. |
| Key words: Granulomatous mastitis mass stage Yanghe decoction carving resection segmental section extended resection |
