| Research background: Granulomatous lobular mastitis(GLM)is a rare benign non-specific inflammatory breast disease that occurs in women of childbearing age.The lesion is in the lobules of the breast tissue,and the main lesions are characterized by small abscesses and lesions.Non-caseating necrosis is a rare chronic and complex breast disease.As the disease progresses,ulcers,fistulas,sinuses,etc.appear in the late stage.The disease is difficult to heal,the condition is complex,and it is easy to recur.Many breast surgeons lack accuracy in this disease.In clinical practice,it is easy to be confused with breast cancer,plasma cell mastitis,etc.,causing delays in treatment,or improper operation,which will cause distortion of the shape of the breasts,lack of attractiveness of the breasts,and cause certain physical and mental health and quality of life for women.Negative effects,because GLM often appears in young women of childbearing age and has high requirements on the appearance of breasts,it is very necessary to choose the correct timing of surgery and a clear diagnosis before surgery."Granulomatous mammary carbuncle" was officially named at the national consensus meeting on the diagnosis and treatment of granulomatous mastitis by TCM experts held in 2017.The disease has been in a blowout situation this year.The cause and pathogenesis of the disease are unknown,and the course of the disease is difficult to predict.The best treatment is still controversial.Physical fitness has a major impact on the occurrence of disease,tendency to occur,pathogenesis,syndromes and prognosis.In recent years,the physique has been continuously improved and developed,and there have been more and more researches on the correlation between physique and syndromes.The undergraduate department has carried out research and discussion on the relationship between the nine constitutions and syndromes of GLM patients in traditional Chinese medicine.Research purpose: to collect general information and physique types of GLM patients in the outpatient clinics and wards of our department to summarize the general conditions of GLM patients,high-risk physique types,factors affecting physique,and whether there is a correlation between physique and syndrome types,To provide guidance for the clinical work of GLM.Research method: 163 patients with GLM from the outpatient clinic or ward of the undergraduate department were used to make "Patient Information Registration Form","Patient TCM Physique Classification Judgment Table" and "Granulomatous Mastitis TCM Syndrome Types" according to the content of the investigation.table"The "Patient Information Registration Form" contains the general information of the patient’s name,age,occupation,and season of onset,as well as height,weight,marriage and childbirth history,dietary taste,usual mood,history of tobacco and alcohol,time of first onset,time of last childbirth,pregnancy and childbirth History,whether the nipple is indented,drug history,PLR and other laboratory tests.The "Patient TCM Physique Classification and Judgment Table" is made according to the "Traditional Chinese Medicine Physique Classification and Judgment Table" in the "Classification and Judgment of Traditional Chinese Medicine Physique" published and implemented in 2009.According to the "Patient Information Registration Form" to investigate the basic information of the patient’s general condition and morbidity,determine the patient’s physique type according to the "Chinese Medicine Physique Classification Judgment Table",and organize the data and analyze the data according to the "Granulomatous Mastitis TCM Syndrome Classification Scale" Its related relationship.Research result(1)General information: There are 163 people in this case,with an average age of 32.58±5.148 years old,the youngest age is 19 years old,the youngest age is 55 years old,the age distribution is 29-34 years old is the age of high incidence of GLM mass;the number of people engaged in mental work A total of 102 people were at most,accounting for 62.5%;summer and autumn had the largest number of cases,of which 51 were onset in summer,accounting for 31.2% of the total,52 were onset in autumn,accounting for 31.9% of the total;88 were usually emotionally unstable,Accounting for 53%;88 of the majority of GLM patients have no special preference for diet,accounting for 53.9% of the total;the number of smokers and drinkers is small;the number of births is as many as 104,accounting for 63.8 of the total %,among them,1 case of women who gave birth at one time was onset during pregnancy;the number of people with the disease course in 3≤the course of disease was less than6 months.There were 48 people,accounting for 29.4%;according to the height and weight of the patient,the body mass index(BMI)was calculated.),110 people are overweight,accounting for 58.5% of the total;73 people with inverted nipples,accounting for 44.7%;13 people with breast trauma history,accounting for 7.9%;22people with irregular menstruation,13.4%;There were 5 contraceptives,accounting for 3%;28 people with hyperprolactinemia,accounting for 17.1%;2 people with a history of mental illness,accounting for 1.2%.Among them,10 cases had suffered from granulomatous mastitis;(2)Distribution of specific syndrome types: 57 people with stagnation of qi stagnation syndrome,accounting for 34.9%;106 patients with syndrome of yang deficiency and phlegm condensation,accounting for 65%.It can be seen that among the 163 patients in the mass stage of GLM,there are yang deficiency and phlegm condensation.The number of people is the largest,followed by stagnation of qi and heat.(3)Specific physique distribution: Among the 163 GM patients surveyed in this survey,23 were moderate,accounting for 14.1%;140 were biased,accounting for85.8%.Among them,10 people had Qi deficiency,accounting for 6.1%;34 had Qi depression,accounting for 20.8%;17 had damp heat,accounting for 10.4%;33 had phlegm,accounting for 20.2%,and 2 had special qualities.It accounts for 1.2%;2people have blood stasis,accounting for 1.2%;39 people have yang deficiency,accounting for 23.9%;3 people have yin deficiency,accounting for 1.8%.From more to less,Yang-deficiency quality 23.9%> Qi-stagnation quality 20.8%> Phlegm-damp quality 20.2%> Peaceful quality 14.1%> Damp-heat quality 10.4%> Qi-deficiency quality 6.1%> Yin-deficiency quality 1.8%> Special quality 1.2% = Yin deficiency quality.(4)Correlation analysis of physique and syndrome types:(1)The damp-heat constitution is more likely to manifest as stagnation of qi and heat.(2)Yang deficiency is more likely to manifest as yang deficiency and phlegm coagulation syndrome.Analysis conclusionBy studying the general conditions of patients,the analysis results are as follows:1.There are more morbidities in primipara;2.The age of 29-34 is relatively large;3.The majority are engaged in mental work;4.In the survey on dietary preferences,most people are addicted to spicy stimuli;5.The majority are overweight;the majority are usually impatient and irritable;6.The history of tobacco and alcohol has little relationship with the onset of this disease.The correlation analysis results of TCM physique and syndrome types at the stage of GLM mass are as follows:1.The main physical types of this disease are: Yang deficiency,Qi stagnation,and phlegm dampness;2.There is a correlation between TCM constitution and TCM syndrome types.The stagnation of qi and heat is more common in damp and heat;the syndrome of yang deficiency and phlegm coagulation in yang deficiency is more common,and the stagnation of qi and heat is rare. |
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