【摘要】 目的探讨活血化瘀方外敷联合糖皮质激素治疗肿块型肉芽肿性乳腺炎的疗效和安全性。方法前瞻性分析59例肿块型肉芽肿性乳腺炎患者治疗资料,根据术前治疗方法的不同随机分为活血化瘀外敷联合糖皮质激素组(观察组)30例和糖皮质激素组(对照组)29例。术前治疗8周后均序贯手术切除病灶,术后糖皮质激素单药治疗至停药。采用改良的实体瘤疗效评价标准(RICIST 1.1版)及手术切除范围评估疗效,比较2组治疗效果。结果中位随访时间为10个月(3～16个月)。疗效方面,术前治疗8周后,2组GM患者病灶范围小于治疗前,且观察组显著小于对照组(P<0.05);观察组客观缓解率(83.3%)优于对照组(69%)(P<0.05);术中在切除组织量、切除组织量占比上,观察组均低于对照组(P<0.05)。不良反应方面,术前、术后治疗期间2组均未发生重度不良反应;术前治疗期间,观察组出现2例局部皮肤接触性皮肤红斑,对照组出现1例脱发和失眠;术后治疗期间2组均观察到轻度-中度肥胖和月经紊乱。结论术前应用活血化瘀方外敷联合激素治疗肿块型肉芽肿性乳腺炎安全有效。更多还原

【Abstract】 Objective To investigate the efficacy and safety of the topical application of Chinese drugs for promoting blood circulation and removing blood stasis combined with glucocorticoid in the treatment of mass-type granulomatous mastitis.Methods The treatment data of 59 patients with mass-type granulomatous mastitis were prospectively analyzed.According to the different preoperative treatment methods,they were randomly divided into two groups:the external treatment group for promoting blood circulation and removing blood stasis in TCM combined with glucocorticoid (the observation group,n=30) and the glucocorticoid group (the control group,n=29).After 8 weeks of the preoperative treatment,the lesions were surgically removed sequentially,and glucocorticoid was used.The revised response evaluation criteria in solid tumours (RICIST,version 1.1) and the surgical resection scope were used to evaluate the efficacy,and the therapeutic effects of the two groups were compared.Results The median follow-up time was 10 months (3-16 months).In terms of efficacy,after 8 weeks of the preoperative treatment,the lesion size of the GM patients in both groups was smaller than before,and the observation group was significantly smaller than the control group (P<0.05).The objective remission rate of the observation group (83.3%) was better than that of the control group (69%) (P<0.05).The amount of tissue removed and the proportion of tissue removed during the surgery were lower in the observation group than those in the control group (P<0.05).In terms of adverse reactions,no severe adverse reactions were observed in both groups before and after treatment.During the preoperative treatment,there were 2 cases of local skin contact erythema in the observation group and 1 case of alopecia and insomnia in the control group.Mild to moderate obesity and menstrual disorders were observed in both groups during the postoperative treatment.Conclusion It is safe and effective to apply Chinese drugs externally for promoting blood circulation and removing blood stasis in combination with hormone in the treatment of mass-type granulomatous mastitis.更多还原