| Objective:The purpose of this study was to retrospectively analyze the general data and life quality measurement scale of 402 female patients with granulomatous lobular mastitis admitted to the breast clinic and inpatient department of the first affiliated hospital of hunan university of Chinese medicine,summarize the epidemiological characteristics of this disease,and explore the distribution characteristics of TCM syndromes and quality of life.Methods:Granulomatous mastitis and "granulomatous lobular mastitis","Chinese medicine","card type","distribution" and "syndrome" and "epidemiology" subject combine China hownet,ten thousand data,VIP information science and technology of China in 2009-2019,10 years of core journals published on granulomatous lobular mastitis of periodical literature.Patients with granulomatous lobular mastitis admitted to the outpatient and inpatient departments of the department of mammary gland,the first affiliated hospital of hunan university of traditional Chinese medicine from January 2019 to March 2020 were collected,and the case information collection form and quality of life scale were filled in according to the unified requirements through outpatient service,telephone and Internet.Through data processing and statistical analysis of the literature cases and the cases in our hospital,the regularity of the incidence of granulomatous lobular mastitis was summarized,the quality of life of the newly diagnosed and discontinued patients in our hospital was compared,and the distribution characteristics of TCM syndromes and the correlation between common TCM syndromes and symptoms and signs were explored.Results:1.General pathogenesis: a total of 1144 cases of granulomatous lobular mastitis were reported by searching Chinese literature on the distribution of TCM syndromes from 2009 to 2019.The incidence was concentrated in spring and summer(55.12%).79.37% of the patients had a history of breastfeeding.17.28% had a history of acute mastitis or milk deposition;7.37% had a history of hyperprolactinemia.5.00% had a history of breast trauma on the affected side;2.93% have a history of long-term use of contraceptives and sex hormone drugs;2.08% have a long history of psychiatric use.From January 2019 to March 2020,a total of 402 valid questionnaires were collected in our hospital,and it was found that the disease mostly occurred in women of child-bearing age between 30 and 39 years old(79.10%).The incidence was concentrated in spring and summer(62.94%).The number of urban patients was higher(73.38%).Most of the patients had a history of pregnancy and lactation,and 2-5 years after gestation was the peak period of onset(55.47%),and 71.39% of the patients had onset after stopping lactation for half a year or more.Common past history: history of milk and milk deposition(55.47%);History of acute mastitis(28.61%);Congenital inverted nipple or poor nipple morphology(39.55%);Breast trauma history within 1 month before onset(20.15%);Oral history of estrogen or contraceptives(16.67%);Abortion history within 6 months before onset(6.97%);History of idiopathic hyperprolactinemia(2.74%);History of pituitary adenoma(1.49%);Oral history of antipsychotics or antidepressants(1.24%).Other factors: spicy diet of 65.17% patients,8.21% patients often eat foods that promote milk secretion,8.46% patients often eat foods with high hormone content such as propolis,royal jelly,etc.The BMI of 28.86% of the patients was in the overweight range;A few patients had a history of smoking(2.99%)and drinking(9.95%).19.90% of the patients had a week or more of mental depression before onset,and44.28% of the patients had one or more negative sexual events in the 1month before onset.2.Clinical features: the majority of unilateral breast diseases(95.66%)were reported in the literature,and all quadrants could be affected.The upper and outer quadrants were the most common(47.62%).The most common symptoms were breast pain(82.59%)and breast abscess(78.11%)in 402 patients in our hospital.3.The characteristics of TCM syndrome type distribution: the literature of TCM syndrome type of frequency from high to low in turn for toxic heat flourishing/fire poison flaming syndrome(29.24%),liver depression Tan Ning syndrome(23.06%),liver depression,hot/liver fire/liver meridian muggy syndrome(14.44%),are false and(10.44%),Yang deficiency Tan Ning certificate(6.35%),liver depression,phlegm heat syndrome(5.83%),Yin and Yang(4.96%),toxic heat sepsis(1.74%),alternating knot/transresistance phlegm and blood stasis phlegm and blood stasis syndrome(1.04%),phlegm dampness syndromes(0.78%),followed by pixu(spleen deficient)inhibitor for the wet heat syndrome(0.70%),liver The syndrome of dampness and heat(0.43%),liver stagnation and blood stasis(0.35%),spleen deficiency and dampness and stagnation(0.17%),Yang deficiency and cold coagulation,phlegm stasis and heat transfer,upper heat and lower cold,liver stagnation and spleen deficiency,combined wet and blood stasis,liver stagnation and spleen deficiency(0.08%).The TCM syndromes of 299 newly diagnosed patients with granulomatous lobulolobulomastitis in our hospital were liver classics stasis syndrome(43.81%),phlegm dampness stagnation syndrome(19.06%),heat toxicity syndrome(14.72%),phlegm heat stasis syndrome(11.04%),liver stagnation and spleen deficiency syndrome(10.03%),and positive deficiency and toxicity syndrome(1.34%).Through factor analysis of symptoms and signs,it was found that the disease location mainly involved liver,spleen and stomach.The disease involves heat,dryness,fluid deficit,Yang and kang,Yin deficiency,qi deficiency,Yang deficiency,phlegm and dampness,qi stagnation and blood stasis,which basically accord with the above six syndromes.Logistic analysis suggested that there was a positive correlation between benign depression and irritability(r=1.87,P<0.05),lesion skin temperature(r=1.298,P<0.05)and lesion skin red(r=0.949,P<0.05).Red skin(r=3.601,P<0.05),nodular erythema of the extremities(r=3.358,P<0.05),and sleep(r=2.095,P<0.05)were positively correlated with incandescent heat toxicity.4.Quality of life: in the cases of our hospital,the quality of life of the patients who stopped taking medicine was significantly improved compared with the patients who were newly diagnosed,and there were significant differences in physiological status,social/family status,emotional status,functional status and additional attention(P<0.05).The differences were statistically significant.Conclusion:1.The peak period of granulomatous mastitis is 30-39 years old,which is concentrated in 2-5 years after delivery.Most of the patients have lactation history,history of milk deposition,history of acute mastitis,and history of nipple depression or poor nipple morphology.2.From the literature cases,it can be seen that the primary diagnosis of granulomatous mastitis patients are mainly the symptoms of heat toxicity,liver stagnation and phlegm,and liver depression.The cases collected from our hospital showed that the liver meridian heat stasis,phlegm dampness stagnation and heat toxicity were dominant.Liver,spleen and stomach were the main disease sites involved in the first diagnosis of granulomatous lobular mastitis.The disease is heat,dryness,jin deficit,Yang kang,Yin deficiency,qi deficiency,Yang deficiency,phlegm dampness,qi stagnation,blood stasis.Good depression and irritability,high lesion skin temperature and red lesion skin can significantly improve the diagnosis probability of liver meridian stasis syndrome.The red color of skin can obviously increase the diagnostic probability of incandescent heat toxin syndrome.3.The improved quality of life of breast cancer to determine FACT-B scale have examined the reliability and validity of tip can be used for determination of granulomatous mastitis of the patient’s quality of life,and was prompted to set a group of patients with drug withdrawal in scale score,physiological status,social/family status,emotional state,functional status and additional attention aspects have improved markedly. |
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