| ObjectivesWe have a prospective analysis of comparative study for the treatment of traditional Chinese medicine, surgical treatment, integrated traditional Chinese medicine external treatment combined with surgery group of granulomatous lobular mastitis patients, and to provide more reliable evidence-based medical basis for clinical decision making.MethodsCollected in September 1,2013 to November 1,2015 in the breast Department of Guangdong Provincial Hospital of traditional Chinese medicine hospital and clinic met the inclusion criteria of granulomatous lobular mastitis patients, according to the wishes of the patients included in the integrated traditional chinese medicine external treatment group had 30 people, surgery group, integrated traditional Chinese medicine external treatment combined with surgery group, the patients in each group had 32 people. A prospective cohort study was established to evaluate the efficacy, duration of treatment, breast shape, recurrence rate, and toxicity of the three treatments. End of the follow-up period was the end of the follow-up period.Results1. general information distribution:the inclusion criteria for patients with a total of 96 cases, mean age 32.29+4.54 years old, in 20-39 years old patients with multiple (92.6%);93 cases with family history (98.9%), including 81 cases of nursing history (86.2%), postpartum 1-5 years in 75 cases (79.8%);5 cases had a history of trauma (5.3%),4 cases had a history of mental illness and the use of psychotropic drugs (4.3%), family history of breast cancer history in 6 cases (6.4%);in other hospital,72 cases (76.6%),58 cases of antibiotics (61.7%),16 cases of those who use the hormone (17.0%),23 cases of abscess incision (24.5%),19 cases of Chinese medicine treatment (20.2%),4 cases of surgical treatment (4.3%).2. Comparison of the three groups at baseline:external treatment of traditional Chinese medicine group with an average age of 31.20±4.59 years, surgical treatment group, mean age 32.91±4.37 years;traditional Chinese medicine treatment group with an average age of 32.69±4.62 years, compared with three groups of age two two, there was no significant difference(P>0.05);traditional Chinese medicine group to our hospital the average duration of 60.80±43.99 days, surgical treatment group the average duration of 120.03±101.16 days, traditional Chinese medicine treatment group with average duration 94.53±78.59 days, compared with three groups of two two,surgical treatment group before the treatment duration is longer than the traditional Chinese medicine group, there was significant difference (Z=-2.293, P=0.022);the three group were more patients have coexisted, tumor, abscess and sinus tract, three groups in pain, fever, local nipple discharge, fever, limb erythema, lymph node enlargement symptom, two two comparison, no statistically significant difference(P>0.05);two two were compared between the three groups increased white blood cells,neutrophils increased, bacterial culture,no significant difference (P>0.05).3.efficacy evaluation:27 cases were cured (90.0%), improved in 3 cases (10.0%),2 cases of recurrence (7.4%);treatment group 29 cases were cured (90.6%), improved in 2 cases (6.3%),1 cases healed (3.1%),3 cases of recurrence (10.3%);traditional Chinese medicine combination surgical treatment of 29 cases were cured (90.6%), improved in 3 cases (9.4%),2 cases of recurrence (6.9%). To compare the effects of three groups of two two,no significant difference (P>0.05).Traditional Chinese medicine group the average treatment time was 40.48±6.79 days, surgical treatment group, the average treatment time was 29.07±10.14 days, TCM surgery group and the average treatment time was 25.52±9.85 days. The treatment time of three groups of two, TCM group treatment time was significantly longer than the surgical treatment group (Z=4.201,P=0.000) and external treatment of traditional Chinese medicine combined treatment group 5.357, P=0.000). External treatment of traditional Chinese medicine treatment group and treatment time is shorter than the surgical treatment group, but no significant difference (Z=-1.626,P=0.104). Traditional Chinese medicine group of 23 cases of breast shape excellent (76.7%),7 cases (23.3%), good breast appearance without general and poor;4 cases of breast surgery group (12.5%), the excellent shape of 17 good cases (53.1%),9 cases (28.1%), the general appearance of 2 breast (6.3% cases);traditional Chinese medicine excellent combination of surgical treatment in 5 cases of breast shape (15.6%),19 cases were good,6 cases (59.4%) and general (18.8%), poor in 2 cases (6.3%). Comparison of three groups of breast shape two two, integrated traditional Chinese medicine external treatment was significantly higher than that of breast shape excellent surgical treatment group (Z=-5.274,P=0.000) and external treatment of traditional Chinese medicine combined treatment group (Z=-4.953.P=0.000). Integrated traditional Chinese medicine external treatment and surgical breast shape excellent rate and good rate is higher than the surgical treatment group, but no significant difference (Z=-0.740 P=0.459)4. adverse reactions and adverse events:the three groups in the course of treatment and follow-up showed no serious side effects and adverse events.Conclusion1. Composite integrated traditional Chinese medicine external treatment and surgical treatment and integrated traditional Chinese medicine external treatment combined with surgery group, three groups of curative effect and recurrence rate had no significant difference. Although integrated traditional Chinese medicine external treatment for a long time, but can better maintain the breast shape, and no obvious adverse reaction, is worth popularizing in clinical therapy of Chinese medicine.2.Integrated traditional Chinese medicine external treatment combined with surgery group compared with surgery alone, has a certain relationship treatment time and improve the excellent rate of breast shape trend,but because of the small size of this study, have not yet found a statistically significant difference, pending further expand the sample size of the study. |
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