| Background:Granulomatous lobular mastitis(GLM)is a type of clinical manifestation that is easily confused with plasma cell mastitis.It is specifically manifested as a breast mass that occurs in the lobules of the breast,and it occurs in young and middle-aged women,especially Non-lactating mastitis of a pregnant woman with a history of breastfeeding.At present,there is no unified understanding of the pathophysiology of GLM.The main theories include that the disease is considered to be an autoimmune disease,hypersensitivity reaction or bacterial infectious disease.Although the final diagnosis depends on pathology,the trauma caused by thick needle biopsy is also the same.Factors for GLM progression are not applicable.In addition,there is no unified consensus on treatment.The main foreign research materials are surgery,hormone shock therapy and anti-tuberculosis drug treatment.There is no uniform treatment standard at home and abroad.Although surgery is the best way to cure the disease,The influence of the shape is also great.Finding a reasonable treatment is urgent.Domestic research shows that Chinese medicine treatment of this disease has the advantages of small side effects and good breast shape retention,especially oral Chinese medicine combined with traditional Chinese medicine therapy such as debridement and thread hanging,which stands out among many traditional Chinese medicine treatments,according to Wu Shangxian’s "Li Yue Pian Wen","the principle of external treatment,namely the principle of internal treatment,the Medicine of external treatment,namely the Medicine of internal treatment," this study proposes the treatment method of external treatment combined with debridement by tolituo purulent decoction,further optimize the safety and effectiveness of traditional Chinese medicine treatment.Reaserch Purposes:The main purpose of this study was to explore the therapeutic effect of TuoLiTouNong Decoction combined with external treatment on liver stagnation and sputum coagulation granulomatous lobular mastitis through a prospective cohort study in order to provide accurate evidence-based medicine for clinical treatment.evidence.Research methods:Select 43 female patients admitted to our hospital from April 2019 to January 2020,who were diagnosed with granulomatous lobular mastitis with pus.The treatment group:externally applied TuoLiTouNong decoction to prepare granules for prescription of Dongzhimen Hospital of Traditional Chinese Medicine,clean wounds,remove necrotic tissue,cut off excessively grown granulation,soak sterile gauze with normal saline,and make drainage strips for wound packing.The drug externally applied drainage strips and lumps,and the drug drainage strips were gradually withdrawn from the inside to ensure that deep wounds heal first to avoid false healing,and then covered with sterile gauze.Change the dressing once a day.Control group:Drainage strips made of physiological saline were used for wound packing,and drug drainage strips were gradually withdrawn from the inside to ensure that deep wounds healed first to avoid false healing,and then covered with sterile gauze.Change the dressing once a day.The treatment course of the two groups was set to 1 month.During the treatment period,if the standard of secondary surgery was reached,or the wound and sinus were completely healed,the treatment time was stopped,and the treatment was stopped.Results:1.Baseline data analysis:There were no significant differences in age,pregnancy and delivery history,lactation history,prolactin level,local symptoms and systemic symptoms among the control groups(p<0.05).2.Analysis of efficacy indicators(1)Comparison of treatment effects in the groupAfter treatment,the mass of the control group,the treatment group,and the patient’s VAS pain scores were reduced to varying degrees(P<0.05,a statistical difference).The aesthetic evaluation scores were increased to varying degrees(P<0.05).0.05,with statistical difference).(2)Comparison of treatment effects between groupsAccording to the comparison of the tumor area difference,VAS pain score,and aesthetic evaluation difference between the treatment group and the control group,it can be seen that the effect of external treatment of Torrey’s pustule on the tumor area and breast shape of patients is better than that of simple incision and drainage(P<0.05).In addition,the treatment time in the treatment group was significantly shorter than that in the control group,which proved that the treatment with Tori Tuan Pu Decoction could accelerate the patient’s symptom relief.(3)Effectiveness analysisIn the control group,21 patients improved 16(76.2%)and failed to recover 5(23.8%).In the treatment group 22 patients,improved 22(100%)and failed(0%).After statistical analysis,treatment The treatment effect was better in the group than in the control group.3.Conclusions:Tori Tonbo Decoction combined with incision and drainage external treatment can significantly shorten the perioperative period compared with simple external treatment,and has certain advantages in reducing the mass area and protecting the shape of the breast,but it is more simple There is no obvious difference in incision and drainage. |
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