拔毒生肌散治疗非哺乳期乳腺炎脓肿窦道脓腐临床观察(1)
摘要 目的：初步观察拔毒生肌散治疗非哺乳期乳腺炎脓腐，促进创面愈合的临床功效与可能机制。方法：选取非哺乳期乳腺炎脓肿期、窦道期患者20例，分为观察组与对照组，每组10例，观察组将拔毒生肌散均匀洒向并覆盖创面脓腐，以黄芩油纱条覆盖，对照组仅以黄芩油纱条覆盖创面；创面敷药隔日1次，敷药7次为1个疗程。治疗前后进行肿块大小、创面脓腐积分与创周皮肤状况评估，测定创面肉芽IL-6，并进行肝肾功能及尿汞临床安全性测定。结果：观察组的肿块范围评分、创面脓腐评分、创周皮肤状况评分，从治疗第6次起，显著低于对照组(P<0.05)，其中创周温度从治疗第2次起即显著低于对照组。治疗后观察组脓腐周围肉芽组织中IL-6含量及病理免疫组化表达显著低于对照组(P<0.05)。且观察组患者血常规、肝肾功能及尿汞测定均在正常值范围，与对照组比较，差异无统计学意义。结论：拔毒生肌散对非哺乳期乳腺炎患者创面具有良好的提脓去腐功效，显著改善炎性反应而促进愈合，临床使用2周安全，未见不良反应，有一定推广运用价值。
关键词 拔毒生肌散；非哺乳期乳腺炎；脓腐；白细胞介素-6；临床安全性
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AbstractObjective：TopreliminarilyobservetheclinicalefficacyandpossiblemechanismofthetherapeuticeffectofBaduShengjiPowderinthetreatmentofnon-lactatingmastitisthrougheliminatingpusandnecrotictissues.Methods：Atotalof20patientswithnon-lactationmastitiswereselectedinstageofabscess，sinusanddividedintothetreatmentandthecontrolgroupwith10casesineachgroup.Inthetreatmentgroup，BaduShengjiPowderwasevenlyspreadandcoveredthepusareaofthewound，alongwithradixscutellariaeoilgauzetocoverthesurface，whereas，inthecontrolgroup，thewoundareaswereonlycoveredwithradixscutellariaeoilgauze.Thewoundsweretreatedeveryotherday7timesfor1treatment.Thesizeofthetumormass，thescoreoftheinthewoundandtheskinconditionaroundthewoundwereassessedbeforeandaftertreatment.IL-6contentsinthewoundgranulationweremeasuredaswellastheclinicalsafetyindicesofthehepatorenalfunctionsandthelevelofurinemercury.Results：Thescoresofbreastmassrange，thepusandnecrotictissuesandtheskinconditionsbeyondwoundinthetreatmentgroupweresignificantlylowerthanthoseinthecontrolgroupsincethesixthevaluation(P<0.05)，amongwhich，theskintemperaturesofthewoundareawerelowerthanthoseofcontrolgroupsincethesecondevaluation.ThecontentsofIL-6aswellastheirexpressionsbyhistopathologicimmunohistochemistryintheperipheralgranulationtissueofthetreatmentgroupweresignificantlylowerthanthoseinthecontrolgroupaftertreatment(P<0.05).Thebloodroutine，hepatoralfunctionandurinemercuryofthepatientsafter14daysofclinicaluseinthetreatmentgroupwereallnormalandwithoutsignificantdifferencesascomparedwiththeresultsofcontrolgroup.Conclusion：BaduShengjiPowdersignificantlyamelioratedinflammationandpromotedwoundhealingonthepatientswithnon-lactationmastitisthroughitsgoodefficaciesofeliminatingpusandnarcotictissues.Noclinicaladverseeventshappenedwithin2weeksofclinicalapplication.Thereshouldbecertainvaluesforpopularizationandapplication.
KeyWordsBaduShengjiPowder；Non-lactatingmastitis；Pusandslough；IL-6；Clinicalsafety
中圖分类号：R242文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.06.017, http://www.100md.com(曹思涵唐甜邵心怡王聪冯泽宇朱智媛陈绪姚昶)
关键词 拔毒生肌散；非哺乳期乳腺炎；脓腐；白细胞介素-6；临床安全性
, http://www.100md.com
AbstractObjective：TopreliminarilyobservetheclinicalefficacyandpossiblemechanismofthetherapeuticeffectofBaduShengjiPowderinthetreatmentofnon-lactatingmastitisthrougheliminatingpusandnecrotictissues.Methods：Atotalof20patientswithnon-lactationmastitiswereselectedinstageofabscess，sinusanddividedintothetreatmentandthecontrolgroupwith10casesineachgroup.Inthetreatmentgroup，BaduShengjiPowderwasevenlyspreadandcoveredthepusareaofthewound，alongwithradixscutellariaeoilgauzetocoverthesurface，whereas，inthecontrolgroup，thewoundareaswereonlycoveredwithradixscutellariaeoilgauze.Thewoundsweretreatedeveryotherday7timesfor1treatment.Thesizeofthetumormass，thescoreoftheinthewoundandtheskinconditionaroundthewoundwereassessedbeforeandaftertreatment.IL-6contentsinthewoundgranulationweremeasuredaswellastheclinicalsafetyindicesofthehepatorenalfunctionsandthelevelofurinemercury.Results：Thescoresofbreastmassrange，thepusandnecrotictissuesandtheskinconditionsbeyondwoundinthetreatmentgroupweresignificantlylowerthanthoseinthecontrolgroupsincethesixthevaluation(P<0.05)，amongwhich，theskintemperaturesofthewoundareawerelowerthanthoseofcontrolgroupsincethesecondevaluation.ThecontentsofIL-6aswellastheirexpressionsbyhistopathologicimmunohistochemistryintheperipheralgranulationtissueofthetreatmentgroupweresignificantlylowerthanthoseinthecontrolgroupaftertreatment(P<0.05).Thebloodroutine，hepatoralfunctionandurinemercuryofthepatientsafter14daysofclinicaluseinthetreatmentgroupwereallnormalandwithoutsignificantdifferencesascomparedwiththeresultsofcontrolgroup.Conclusion：BaduShengjiPowdersignificantlyamelioratedinflammationandpromotedwoundhealingonthepatientswithnon-lactationmastitisthroughitsgoodefficaciesofeliminatingpusandnarcotictissues.Noclinicaladverseeventshappenedwithin2weeksofclinicalapplication.Thereshouldbecertainvaluesforpopularizationandapplication.
KeyWordsBaduShengjiPowder；Non-lactatingmastitis；Pusandslough；IL-6；Clinicalsafety
中圖分类号：R242文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.06.017, http://www.100md.com(曹思涵唐甜邵心怡王聪冯泽宇朱智媛陈绪姚昶)