| Objective:A clinical controlled study was conducted to observe and compare the symptoms and signs,inflammatory indexes and immune indexes of patients with early and middle stage granulomatous mastitis（GLM）treated by heat-clearing and detoxification method;at the same time,the inhibitory effect of antipyretic and detoxifying drugs on dandelion honeysuckle against common pathogenic bacteria of GLM was studied in vitro.The study clears heat-clearing and detoxifying method to the treatment effect of GLM,and explores the mechanism of heat-clearing and detoxification in the treatment of GLM from three aspects of inflammation,immunity and infection,so as to provide ideas for clinical treatment of traditional Chinese medicine.Methods:1.Clinical randomized controlled study:130 patients with early and middle stage GLM were randomly divided into control group and treatment group.The control group was treated with an intravenous injection of levofloxacin.The treatment group was treated with Chinese herbs based on the treatment of the control group,and the early stage GLM was treated with heat-clearing and detoxifying traditional Chinese medicine couple（dandelion,honeysuckle）+Gualou Niubang Decoction.The middle stage was treated with dandelion,honeysuckle+Tou-nong-san.The treatment period is 7days.Observed and recorded the TCM syndrome scores and clinical efficacy of the two groups before and after treatment,and recorded the level of white blood cell,C-reactive protein,CD4+and CD8+T lymphocyte pathological immunohistochemical expression.2.Experimental study on bacteriostasis in vitro:Corynebacterium and Staphylococcus aureus obtained from pus or tissue culture of GLM patients were used as test strains.The minimal inhibitory concentration（MIC）of dandelion-honeysuckle decoction on Corynebacterium and Staphylococcus aureus was determined by microbroth dilution method（MIC）,to objectively evaluate the inhibitory effect of heat-clearing and detoxifying traditional Chinese Medicine pair dandelion-honeysuckle on common pathogenic bacteria of GLM.Results:1.Clinical study results:Compared with the control group,the treatment group had a significant improvement in reducing the maximum tumor diameter,reducing local skin conditions,reducing pain,and reducing the number of new tumors（P<0.05）.After treatment,the treatment group of TCM symptoms total score（14.06±4.58）was significantly lower than the control group（17.14±4.76）,P<0.05.In the reduction of blood inflammation indicators（WBC,CRP）,the treatment group was significantly better than the control group（P<0.05）.In immune indicators,the treatment group of CD4+T cells positive expression rate is lower than the control group,and the treatment group of CD8+T cells were higher than that of control group（P<0.05）.Compared with the control group（64.62%）,the effective rate（81.54%）of the treatment group was significantly improved（P<0.05）.2.The results of bacteriostatic experiment in vitro:The water decoction of heat-clearing and detoxifying traditional Chinese Medicine couple dandelion-honeysuckle had different inhibitory effects on the common pathogenic bacteria of GLM,in which the MIC against Corynebacterium and Staphylococcus aureus were 1000 mg·mL-1and 500 mg·mL-1,respectively.Conclusion:1.The method of heat-clearing and detoxifying is effective in the treatment of granulomatous mastitis,which plays an important role in inflammation,immunity and infection.It can reduce the swelling heat and pain of breast mass in patients with GLM,make the mass shrink or even disappear gradually,relieve clinical symptoms,reduce the total score of TCM symptoms,improve clinical efficiency,effectively reduce blood inflammatory indexes,regulate immune function,and have different degree of inhibition on GLM Common pathogenic bacteria. |
