The Clinical Observation On Treatment Of "Latency Of Cold Dampness" Syndrome Granulomatous Mastitis Based On The Theory Of "Viscera Rheumatism"

Objective:To investigate the etiology,pathogenesis and treatment of granulomatous mastitis from the angle of "viscera rheumatism",and to observe the clinical effect of "warming yang and dispersing cold,invigorating spleen and removing blood stasis" to treat "latency of cold dampness" syndrome granulomatous mastitis(mass stage),which was caused by wind,cold and dampness invading spleen and stomach and occupying breast.The aim is to explore the best way to treat granulomatous mastitis in mass stage,to preserve breast shape to the greatest extent,and to provide new ideas for the treatment of granulomatous mastitis in the future.Methods:From June 2018 to October 2019,granulomatous mastitis patients in mass stage were selected from the breast surgery section for outpatients of the first affiliated hospital of Tianjin University of Traditional Chinese Medicine.According to the trial criteria and the random digital table method design the study,60 patients with granulomatous mastitis(mass stage)characterized by "latency of cold dampness" syndrome were divided into treatment group(30cases)and control group(30 cases).The treatment group took Wenyang Sankuai decoction combined with Huoxue Huayu ointment,the control group took Xiaojin pills combined with Huoxue Huayu ointment,the total course of treatment was 12 weeks.Collect the relevant clinical data of the subjects for summary,and through the self-made "latency of cold dampness" syndrome granulomatous mastitis(mass stage)patients with TCM syndrome grading scale measurement,observe and timely record the changes of breast mass diameter,pain,texture,accompanying symptom score,TCM syndrome score before treatment,6 weeks after treatment,12 weeks after treatment,and analyze the clinical efficacy.Results:(1)General data analysis A total of 60 subjects were collected in this study,age fluctuated between 25 and 38 years old,with an average onset age of 30.98±3.162 years old.This disease was mostly occuring in the postpartum 1.5-5 years,in 2-3 year is multiple.The shortest lactation time was 0 months, the longest was 26 months,the average 11.02 ± 4.866 months.The shortest course of disease was 3 days,the longest was 15 days,all most patients(80%)go to the hospital less than 10 days.Of the 60 subjects,11(18.3%)has a history of contraceptive use,25(41.67%)has a history of external breast collision,26(43.33%)has a history of milk accumulation,and 11(18.3%)has a history of mastitis,1(1.67%)had a history of breast surgery.(2)Pre-treatment baseline analysis By statistical analysis,there was no significant difference between the two groups in age,postpartum time,lactation time,the duration of the disease,and the history of previous related cases of breast(P>0.05),which was comparable.There was no statistical difference in breast mass diameter,pain,texture,accompanying symptom score,TCM syndrome score,blood routine,PRL between the two groups before treatment(P>0.05),which was comparable.(3)Analysis of results Analyzing the differences between the two groups before and after treatment for 12 weeks showed significant differences in breast mass diameter,pain,texture,accompanying symptom score,TCM syndrome score(P<0.05),indicating that both treatments were effective.After 12 weeks of treatment,the difference between the treatment group and the control group showed that the diameter,texture,accompanying symptom score and TCM syndrome score of breast mass were significantly different(P<0.05);There was significant difference in the effective rate of syndromes between the two groups(P<0.05);total effective rate:treatment group(90%)> control group(76.7%).All above indicated that the curative effect of the treatment group was better than that of the control group.After treatment,the laboratory indexes were reduced to normal,and the recurrence rate was 3.3%in both groups.Conclusions:(1)Wenyang Sankuai decoction combined with Huoxue Huayu ointment and Xiaojin pills combined with Huoxue Huayu ointment can have good effect to the diameter,pain,texture,accompanying symptom score,TCM syndrome score,blood routine and PRL of breast mass in "latency of cold dampness" syndrome granulomatous mastitis(mass stage).(2)Wenyang San block decoction combined with Huoxue Huayu ointment for the treatment of "latency of cold dampness" syndrome GM(mass stage)is better than Xiaojin pills combined with Huoxue ointment for the treatment of this disease.(3)By using the methods of warming yang and dispersing cold,invigorating spleen and removing blood stasis,the treatment of "latency of cold dampness" syndrome GM(mass stage)is effective,which indicates that the theory of "viscera rheumatism" is suitable for the treatment of syndrome differentiation in patients with "latency of cold dampness" syndrome GM(mass stage),which is worthy of clinical popularization and application.