摘要
目的:观察紫草阳和汤外敷联合地塞米松软膏治疗肿块期肉芽肿性小叶性乳腺炎的临床效果及对细胞焦亡相关蛋白的影响。方法:将40例肉芽肿性小叶性乳腺炎患者随机分为观察组20例和对照组20例。两组均给地塞米松软膏治疗,观察组在对照组基础上外敷紫草阳和汤治疗。比较两组乳腺肿块体积变化、乳房疼痛及成脓症状、病理组织学及免疫组织化学、细胞焦亡相关指标表达。结果:治疗后,观察组肿块体积差明显大于对照组,对照组为16.7±21.5,实验组为32.9±27.4,两组差异有统计学意义(P<0.05);观察组患者的客观缓解率(ORR=85%)明显高于治疗组(ORR=50%,P<0.05)。在成脓率及疼痛程度上,治疗2、3周后观察组乳房疼痛评分明显低于对照组(P<0.05);观察组成脓率为30%,对照组成脓率为20%,差异无统计学意义(P>0.05)。观察组caspase-1及GSDMD免疫组化表达水平均明显低于对照组(P<0.05);而在细胞焦亡相关指标表达方面,与对照组比较,观察组GSDMD、caspase-1、NLRP3表达明显降低(P<0.05)。结论:紫草阳和汤外敷联合地塞米松软膏治疗肿块期肉芽肿性小叶性乳腺炎疗效显著,可有效减轻乳房疼痛,缩小肿块体积,降低细胞焦亡相关性指标表达,具有良好的抗炎作用。
Objective:To observe the clinical effect of external application of Zi Cao Yang He Tang combined with dexa-methasone ointment in the treatment of granulomatous lobular mastitis in the mass stage and the effect on cellular pyroptosis-related proteins.Methods:Forty patients with granulomatous lobular mastitis were randomly divided into 20 cases in the observation group and 20 cases in the control group.Both groups were given dexamethasone ointment for treatment,and the observation group was treated with external application of Zi Cao Yang He Tang on the basis of the control group.Breast lump vol-ume changes,breast pain and pus symptoms,pathology and histology and immunohistochemistry,cellular death-related indicators expression were compared between the two groups.Results:After treatment,the difference in mass volume of the observation group was significantly greater than that of the control group(16.7±21.5 in the control group and 32.9±27.4 in the experimental group)and the difference between the two groups was statistically significant(P<0.05);the objective remission rate of the pa-tients in the observation group(ORR=85%)was significantly higher than that of the treatment group(ORR=50%,P<0.05).In terms of pus formation rate and pain level,the breast pain score of the observation group was significantly lower than that of the control group after two weeks or three weeks of treatment(P<0.05);the pus formation rate of the observation group was 30%,and the pus formation rate of the control group was 20%,and the difference was not statistically significant(P>0.05).The immu-nohistochemical expression levels of caspase-1 and GSDMD in the observation group were significantly lower than those in the con-trol group(P<0.05);and in terms of the expression of cellular pyroptosis-related indexes,the expression of GSDMD,cas-pase-1,and NLRP3 in the observation group was significantly lower compared with that in the control group(P<0.05).Conclu-sion:The efficacy of external application of Zi Cao Yang He Tang combined with dexamethasone ointment in treating granuloma-tous lobular mastitis in the mass stage is remarkable,which can effectively reduce breast pain,reduce the size of the mass,de-crease the expression of cellular pyroptosis-related indexes,and have a good anti-inflammatory effect.
作者
穆玉晶
汪唐顺
冯雪
孙萍
高爽
王玉坤
左禧萌
朱彦彦
马燕
史晓光
MU Yu-jing;WANG Tang-shun;FENG Xue;SUN Ping;GAO Shuang;WANG Yu-kun;ZUO Xi-meng;ZHU Yan-yan;MA Yan;SHI Xiao-guang(Dongzhimen Hospital Beijing University of Chinese Medicine,Beijing 100007,China)
出处
《海南医学院学报》
2023年第22期1703-1709,1717,共8页
Journal of Hainan Medical University
基金
湖北陈孝平科技发展基金会专项基金项目(CXPJJH12000002-2020010)
北京中医药大学教育科学研究课题(XJY21056)
北京中医药大学新教师启动基金项目(2022-BUCMXJKY010)。
关键词
紫草阳和汤
肉芽肿性小叶性乳腺炎
中医
外治
糖皮质激素
Zi Cao Yang He Tang
Granulomatous lobular mastitis
Traditional Chinese medicine
External treatment
glucocorticoid
