| Objective:To monitor the clinical efficacy and safety of Cortex phellodendri compound fluid in the treatment of non-puerperal mastitis after abscess operation,and analyze the changes of IL-6,IL-10,MMP-2,MMP-9 indexes,so as to provide medical ideas for the treatment of non-puerperal mastitis abscess after surgery.Methods:60 inpatients treated in the Department of Vascular Breast surgery of the first affiliated Hospital of Anhui University of traditional Chinese Medicine from October 2021 to September 2022 were randomly divided into treatment group(30 cases treated with Cortex phellodendri compound fluid)and 2 cases with shedding.30 cases in the control group(ornidazole)and 4 cases fell off.Both groups were given basic traditional Chinese medicine and surgical treatment,cortex phellodendri compound fluid VSD negative pressure irrigation after operation,and ornidazole VSD negative pressure irrigation after operation in the control group.On the 7th,14 th and 30 th day after operation,the local symptom scores of the two groups were recorded in detail,including the extent of redness and swelling,the degree of pain,the nature of exudate and the growth of granulation(on the 7th day after surgery),and the changes of IL-6,IL-10,MMP-2 and MMP-9 in pathological tissue or granulation tissue were detected before and 7 days after operation.Six months later,the healing patients were followed up,the recurrence and scar were recorded,and the SPSS27.0 software was used for statistical analysis.Results:1.There was no significant difference in age,height,weight,course of disease,size of abscess,direction of breast disease and skin rupture between the two groups before treatment(P>0.05),suggesting that the two groups were comparable.2.The scores of local symptoms of wounds in the two groups were as follows:1)the range of redness and swelling and the degree of pain:there was no difference between the two groups on the 7th day after operation(P>0.05).The scores of the treatment group were better than those of the control group on the 14 th and 30 th day after operation(P<0.05).In the group,the scores on the 14 th and 30 th day after operation were improved compared with those on the 7th day after operation(P<0.05).2)Properties of exudate:The quality scores of exudate in the treatment group were better than those in the control group on the 7th and 14 th day after surgery(P<0.05),but there was no significant difference between the two groups on the 30 th day after surgery(P>0.05),and symptoms in both groups were improved(P<0.05).3)Compared with the granulation growth on the 7th day after operation,the score of the treatment group was better than that of the control group(P> 0.05).3.1)There was no significant difference in the levels of IL-6,IL-10,MMP-2 and MMP-9 in granulation tissue between the two groups before treatment,but there was no significant difference between the two groups.2)Compared with those before treatment,the level of IL-6 in the treatment group and the control group decreased on the 7th day after operation,while the levels of IL-10,MMP-2 and MMP-9 increased.3)After 7 days of treatment,the level of IL-6 in the treatment group was significantly lower than that in the control group,the level of IL-10 in the treatment group was higher than that in the control group,and the level of MMP-2 in the control group was higher than that in the treatment group,and the level of MMP-9 in the control group was higher than that in the treatment group.4.Evaluation of the total postoperative curative effect of the two groups:after 30 days of treatment,the overall effective rate of the treatment group was 96.4%,including 7 cases(25%),15 cases(53.6%),5 cases(17.9%)and 1 case(3.5%).The effective rate in the control group was 88.5%,including 12 cases(42.9%),11 cases(39.3%)and 3 cases(11.7%).The rank sum test showed that the effective rate of the treatment group was higher than that of the control group.5.Comparison of the conditions of the two groups of prescriptions,27 of the 28 patients in the treatment group were cured,accounting for 96.4%,1 case relapsed,accounting for3.6%,while 23 of the 26 cases in the control group were cured,accounting for 88.4%,accounting for 11.6%.There was no significant difference in recurrence between the two groups(P>0.05).6.Comparison of postoperative scars between the two groups,among the 28 patients in the treatment group,there were 3 cases of unobvious scar(10.7%),16 cases of slight scar(57.1%),8 cases of obvious scar(28.6%)and 1 case of thick scar(3.6%).Among the 26 cases in the control group,the breast scar was not obvious in 0 cases(0%),slight scar in12 cases(46.2%),obvious scar in 9 cases(34.6%),and thick scar in 5 cases(19.2%).The obvious degree of scar in the treatment group was lower than that in the control group(P<0.05).7.During the total treatment,no patients in the two groups showed any discomfort.Conclusion:1.Cortex phellodendri compound fluid is effective in the treatment of non-lactation mastitis abscess after surgery,which can significantly relieve postoperative symptoms of redness,swelling and pain of patients,and has certain curative effect on removing wound pus,promoting granulation regeneration and reducing healing time.2.Cortex phellodendri compound fluid can inhibit inflammatory response,promote wound healing process,reduce wound scar hyperplasia,and improve wound healing quality by regulating IL-6,IL-10 and other cytokines.3.Cortex phellodendri compound fluid can promote epithelial tissue growth and shorten healing time by regulating the production of MMP-2,MMP-9 and other cytokines on wound surface. |
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