摘要
目的探讨急性浆细胞性乳腺炎患者应用阳和汤联合透脓散的治疗效果及对炎性因子水平的影响。方法选择2019年5月至2020年5月滨州医学院烟台附属医院收治的120例急性浆细胞性乳腺炎患者,按随机数字表法分为对照组和联合组,每组60例。对照组采用西医治疗,联合组在对照组治疗的基础上给予阳和汤联合透脓散治疗,7 d为1个疗程,共4个疗程。比较两组患者治疗前、治疗1个月后症状体征积分及临床疗效;比较两组治疗前后白细胞介素(IL)-1β、IL-6和肿瘤坏死因子-α(TNF-α)水平。结果治疗1个月后两组患者乳房红肿、乳房肿块、乳房疼痛、乳房瘘管症状体征积分均明显降低,其中联合组上述四项症状体征积分均低于对照组,差异均有统计学意义(P<0.05)。联合组治疗后总有效率高于对照组[91.7%(55/60)比76.7%(46/60)],差异有统计学意义(χ^(2)=8.456,P<0.05)。治疗1个月后两组患者血清IL-1β、IL-6、TNF-α水平明显降低,并且联合组血清IL-1β、IL-6、TNF-α水平低于对照组[(3.24±0.92)ng/L比(3.81±1.02)ng/L、(1.12±0.42)ng/L比(1.41±0.35)ng/L、(32.27±19.03)ng/L比(43.04±21.58)ng/L],差异均有统计学意义(P<0.05)。治疗后两组患者肝肾功能未见异常,两组头痛头晕、恶心呕吐等不良反应发生情况比较差异无统计学意义(P>0.05)。结论阳和汤联合透脓散能够显著改善急性浆细胞性乳腺炎患者的临床症状,临床效果确切,其作用机制可能与降低IL-1β、IL-6、TNF-α水平,减轻炎性反应有关。
Objective To investigate the therapeutic effect of Yanghe decoction combined with Tounongpowder on patients with acute plasma cell mastitis and its influence on inflammatory factors.Methods A total of 120 patients with acute plasma cell mastitis admitted to Yantai Affiliated Hospital of Binzhou Medical College from May 2019 to May 2020 were selected,and divided into control group(60 cases)and combination group(60 cases).The control group was treated with western medicine,and the combination group was treated with Yanghe decoction and Tounongpowder on the basis of the control group.Seven days was 1 course and a total of 4 courses were continued.The scores of symptoms and signs and clinical effects of the two groups before treatment and 1 month after treatment were compared.The serum interleukin(IL)-1βand IL-6 were measured by radioimmunoassay,and tumor necrosis factor-α(TNF-α)was measured by enzyme-linked immunosorbent assay.Results After 1 month of treatment,the scores of breast swelling,breast lumps,breast pain,breast fistula symptoms and signs in the two groups were significantly decreased,the scores of above index in the combination group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The total effective rate in the combined group was higher than that in control group:91.7%(55/60)vs.76.7%(46/60),and the difference was statistically significant(χ2=8.456,P<0.05).After 1 month of treatment,the serum levels of IL-1β,IL-6 and TNF-αin the two groups were significantly reduced,and the serum levels of above 3 index in the combination group were significantly lower than those in the control group:(3.24±0.92)ng/L vs.(3.81±1.02)ng/L,(1.12±0.42)ng/L vs.(1.41±0.35)ng/L,(32.27±19.03)ng/L vs.(43.04±21.58)ng/L,and the differences were statistically significant(P<0.05).After treatment,the liver and kidney functions of the two groups were not abnormal,and the differences in adverse reactions such as headache,dizziness,nausea and vomiting were not statistically significant(P>0.05).Conclusions Yanghe decoction combined with Tounongpowder can significantly improve the clinical symptoms of patients with acute plasma cell mastitis,with a definite clinical effect.Its mechanism of action may be related to reducing the levels of IL-1β,IL-6,and TNF-αand reducing the inflammatory response.
作者
张宇
左安龙
李雷
都艳敏
孟杰
Zhang Yu;Zuo Anlong;Li Lei;Du Yanmin;Meng Jie(Department of Gastroenterology,Yantai Affiliated Hospital of Binzhou Medical College,Shandong Yantai 264100,China;Department of Traditional Chinese Medicine,Yantai Affiliated Hospital of Binzhou Medical College,Shandong Yantai 264100,China;Department of Thyroid and Breast Surgery,Yantai Affiliated Hospital of Binzhou Medical College,Shandong Yantai 264100,China)
出处
《中国医师进修杂志》
2021年第12期1140-1144,共5页
Chinese Journal of Postgraduates of Medicine
基金
山东省中医药科技发展计划项目(2019-0507)。
