| Non-puerperal mastitis(NPM)is a group of refractory aseptic inflammatory diseases with a long course,mostly plasma cell mastitis and granulomatous mastitis,with complex and varied clinical manifestations.The first symptom was a lump in the breast,followed by an abscess that ruptures and forms a sinus tract that is difficult to heal.In particular,the rupture phase has a greater impact on the physical and psychological health of patients,the current treatment is mostly based on surgery,debridement and dressing or incision and drainage.Prof.Zhang Xiaojun found that the combination of the external application of medicinal slag and oral Chinese medicine is effective in promoting healing of rupture and dissipation of lumps.The treatment is simple,less damaging to the shape of the breast,less painful to the patient,and highly acceptable,reflecting the unique and irreplaceable advantages of TCM diagnosis and treatment.This study was conducted to observe the efficacy and safety of the external application of Wentong Xiaoyong Prescription combined with oral Chinese medicine in the treatment of non-lactating mastitis during the rupture stage,to summarize the treatment experience of Professor Zhang Xiaojun,and to provide a safe and reliable solution for the treatment of non-lactating mastitis with the combination of internal and external treatment in Chinese medicine.There are two parts:a literature review and a clinical study.1.Literature reviewFirstly,a comprehensive overview of Western medical research on non-lactating mastitis is presented.The etiology and pathogenesis of NPM have not been clearly defined.At present,the research mainly focuses on immune abnormalities,bacterial infections,abnormal lipid metabolism,hormone disorders and other aspects.Through the previous clinical experience,the occurrence of NPM may be related to the abnormal increase of prolactin level.Western medicine treatment is mainly surgery,the postoperative breast shape damage to the patient’s psychological trauma.Antibiotics,hormones,immune preparations,etc.,drug treatment,with poor efficacy and different degrees of side effects.Followed by the historical development of the Chinese medical name.The doctors have different understandings of the etiology and pathogenesis of the disease,and the treatment also has its own characteristics.Tutor Zhang Xiaojun thinks that the disease is asthenia in origin and asthenia in superficiality.Patients due to congenital deficiency or acquired loss.The spleen can not transport water wet,condensed into phlegm.Sputum accumulation in the milk duct appeared as a breast mass.Therefore,Tuutor Zhang Xiaojun proposed that sputum is the key pathological factor,spleen deficiency and phlegm turbidity is the basic etiology.The original combination of oral Chinese medicine with external application of internal and external combination therapy.2.Clinical researchObjective:To verify the clinical efficacy and safety of the combination of external application of Wentong Xiaoyong Prescription combined with oral Chinese medicine in the treatment of ruptured non-lactating mastitis.Methods:A total of 23 cases of patients with non-lactating mastitis during the rupture period who met the criteria for nadir discharge were completed in this study and were divided into 11 cases in the observation group and 12 cases in the control group using the envelope method.In the observation group,the external application of Wentong Xiaoyong Prescription was combined with the oral Xiaoyong Sanjie formula,while in the control group,the oral administration of Xiaoyong Sanjie formula was given.The area of lesion breakdown,healing rate,mass size,shrinkage rate,pain score,skin color,exudate volume,lactogen,anxiety and depression status and safety indexes were recorded before treatment,at 1,2 and 4 months of treatment,respectively.Results:1)Observed indicators improved significantly in both groups after 4 months of treatment compared to the previous ones(P<0.05).2)The number of healed cases of rupture in the observation group was 10(90.9%)and the number of healed cases in the control group was 11(91.7%)in 4 months of treatment,and there was no significant difference between the two groups(P>0.05).The number of healed masses in the observation group was 8(72.7%)and the number of healed masses in the control group was 8(66.7%),with no significant difference between the two groups(P>0.05).3)After 1 month of treatment,the rupture healing rate was 61.56%±35.04%in the observation group and 27.99%±30.18%in the control group,with a significant difference between the two groups(P=0.022).The mass shrinkage rate in the observation group(41.93%±22.36%)and the control group(20.67%±24.33%)was significantly different between the two groups(P=0.041).4)One patient in the observation group developed the skin rash after external application of medicinal slag,and the symptoms were reduced after symptomatic treatment and did not affect the subsequent treatment.Conclusions:1)External application of the Wentong Xiaoyong Prescription was combined with the oral Xiaoyong Sanjie formula and the oral Xiaoyong Sanjie formula alone both have effects on promoting healing of rupture,dissipation of lumps,relief of breast pain,reduction of exudate volume,lowering of lactogen levels,and improvement of anxiety and depression in non-lactating mastitis patients.2)Combined with the external application of Wentong Xiaoyong Prescription,the treatment is effective and safe in promoting the early healing of the rupture and reduction of masses,and can be promoted for clinical use. |
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