| BackgroundGranulomatous mastitis,Granulomatous mastitis,GM),also known as Granulomatous lobular mastitis,its pathological characteristics are caseous necrotic Granulomatous draw confined to the mammary gland flocculus.GM is a kind of high incidence in the women give birth of chronic inflammatory diseases.The disease early to local lump in her breast,the pain as the main clinical manifestations,late then burst into a fistula,abscess is lingering painless.It's not clear at present,the cause of the disease,pathogenesis,modern research thought that the disease caused by autoimmune.Clinical treatment of the disease at home and abroad method is more,but have not yet reached a consensus.Tutor professor ZhuDongSheng sum up clinical experience for many years,of traditional Chinese medicine internal and combine traditional Chinese medicine external treatment of Chinese medicine conservative treatment for the disease,although the treatment cycle is long,but the treatment effect is remarkable,and can better protect the breast shape,low cost of treatment,patient acceptance.The conservative treatment of traditional Chinese medicine can be used throughout the course of treatment,whether it is in the lump stage,the abscess stage,or in the late period.ObjectiveThis topic mainly through the eastern hospital outpatient service of mammary gland of GM patients clinical investigation,and to explore the current social environment east hospital patients with granulomatous mastitis treatment,the indications of conservative treatment,the law of TCM syndrome distribution,medication and treatment effect,thus for clinical syndrome differentiation,legislation,medication,and further research ideas and methods of provide advantage.MethodsMammary gland of hospital of Beijing university of Chinese medicine were reviewed and analyzed the east between December 2015 and November 2015 in clinic diagnosis of GM during the patient's medical record information,by incorporating and exclusion standard screening of patients,the patients in the general information,treatment,clinical situations such as data collection,analyzing results and through statistical software.Analysis summary GM indications of conservative treatment and syndrome type distribution,observe its drug laws(single herbs frequency),the treatment effect(tumor size,tumor number,breast pain,breast lesions under ultrasound range),with the statistics once every two weeks.The statistics period is 3 months.Results1.Married postpartum middle-aged women are the high prevalence of GM.2.This disease can be found in women of all ages.In this study,the age of 52 of the 40 GM patients was the maximum age,18 was the minimum age,and the average age of onset was 34.02 years.3.The four seasons of this disease can occur.In this study,among 40 GM patients,18 cases occurred in spring and 5 in winter,but the incidence of spring was higher and the incidence of winter was lower.Among the 40 GM patients,34 were married,6 were unmarried,34 were pregnant,15 were pregnant,12 were pregnant twice,1 was pregnant 4 times,and the number of pregnancies was 1 to 2 times.Among the 40 patients,30 were lactating.Of the 40 patients,16 were natural breast milk.There were 26 cases of side nipple collapse.It was found that the occurrence of this disease was closely related to the patient's production condition,lactation condition,breast recovery condition,and the condition of the nipple,and the induced factors of GM were naturally returned to the breast and the nipple.In previous history,there were history of lactation disorders,history of breast trauma,history of hyperprolactinemia,history of mastitis,and smoking history.4.40 patients with this study,of which 8 cases of breasts,the disease occurs in one breast,18 cases of right breast disease,14 cases of left breast,no difference between the two side breast infection situation.It can occur in all quadrants,with more cases in the central and outer quadrant,and less in the lower quadrant.5.In this study,31 of the 40 GM patients had initial symptoms of pain,and had moderate pain.In 9 patients,the first symptom was breast mass,and the mass was more than 5cm,and the majority of patients were 1 lump.6.This study found that patients with liver fire syndrome,liver qi stagnation syndrome,yang deficiency stabbed syndrome,Yu,phlegm,and fire as the main pathological factors.According to its syndrome differentiation treatment,it summarizes the characteristics of its medication during the outpatient period.The frequency of traditional Chinese medicine used in the liver-qi stagnation and fire syndrome is:36 times of Chaihu,35 times of Xiangfu,35 times of Yujin,35 times of Citrus,32 times of dandelion,31 times of honeysuckle,30 times of Huangqi,30 times of Mudanpi,30 times of Scrophulariae,Chuanxiongzi 29 times,Corydalis 29 times,Prunella 27 times,Fritillaria 27 times,Fructus Citrifolia 27 times,Peach kernel 26 times,Safflower 25 times,Ophiopogon japonicus 22 times,Angelica 22 times,TCS 22 times,Glycyrrhiza 19 times;the frequency of traditional Chinese medicine used in the liver qi stagnation card is:36 times of Chaihu,35 times of Xiangfu,35 times of turmeric,35 times of dried tangerine peel,32 times of angelica,31 times of medlar,30 times of corydalis,30 times of seaweed,purple 30 times in grass,29 times in earth flesh,29 times in melons,27 times in gallbladder,27 in orange,27 in turtles,26 in licorice,25 in Prunella,22 in hawthorn,22 in dandelion,21 in honeysuckle 18 times;the frequency of Chinese medicine used in the yang deficiency syndrome is:32 times of rehmannia,31 times of antler gum,31 times of artillery ginger,31 times of cinnamon,28 times of epimedium,27 doses of curculigo,26 times of prunella,white Mustard seeds 26 times,earth beetles 26 times,melon crickets 25 times,Cyperus rotundus 24 times,dried tangerine peel 23 times,licorice 23 times,medlar 23 times,bile Southern Star 21 times,hawthorn 20 times,Lithospermum 20 times,Angelica 19 times,Atractylodes 18 times The frequency of traditional Chinese medicine used in liver stagnation and blood stasis syndrome is:29 times of Radix bupleuri,27 times of angelica,25 times of medlar,23 times of red peony,23 times of peony,22 times of turmeric,21 times of Prunella,20 times of comfrey,and seaweed 18 times,peach kernel 17 times,safflower 17 times,trigonous 15 times,curcuma 15 times,dried tangerine peel 14 times,ground dragon 14 times,frankincense 10 times,myrrh 10 times,hawthorn 9 times,and trichosanthin 9 times.The nature of the drugs used in each syndrome was as follows:sexual taste 17 times,cold 10 times,sweet 9 times,symptomatic 6 times,level 4 times,light 3 times;13 times in the stomach,11 times in the liver,and 10 times in the lung Spleen 9 times,heart 6 times,bile 4 times,kidney 2 times.The main drugs for external use are raw sandalwood,Perilla frutescens,Perilla frutescens,Evodia rutaecarpa,Radix paeoniae Alba,etc.Governance to qi in the wide,Shugan Jieyu,swelling and pus,analgesic and so on.Mainly to the liver,lungs,stomach.Bitter,sweet and cold are the main tastes.7.After conservative treatment of traditional Chinese medicine,22 of the 40 patients were cured,and 10 were recovered,and the effect of good clinical treatment was achieved.Three of them relapsed,with a recurrence rate of 7.5%.There were statistically significant differences in the length of the tumor,the incidence of breast pain,the range of the lesions,and the number of tumors.Conclusions1.The incidence of this disease is mostly married postpartum women.2.Related factors:it can be found in the four seasons of the year.Among the 40 GM patients,18 cases of spring onset and 5 cases in winter can be found with high spring incidence and low winter incidence.In this study,65%of the total number of nipples were found in the study,and 60%of the total number of miscarriages were recorded,which may be closely related to the occurrence of the disease.3.Diagnosis:the clinical manifestations of the patients in this study were mainly breast pain accompanied by mass,and the diagnosis was mainly based on the patient's clinical manifestations,imaging examination and years of experience of the clinician.4.Treatment plan:in this study,the patients were in the stage of mass or partial abscess,and the conservative treatment of traditional Chinese medicine was effective in treating the disease.Compared with the general literature,the recurrence rate was low.5.The disease is closely related to the liver,spleen,stomach and lung.The pathological factors mainly include gas depression,phlegm,and fire,and the traditional Chinese medicine for the treatment of the disease has the function of dreariness,phlegm,and detoxification.The sexual flavor is bitter,cold and sweet;The liver,spleen,stomach and lung were the main subjects.6.The external application of traditional Chinese medicine has the function of dredging the liver,relieving the swelling,discharging the swelling and discharging the pain.The liver,spleen,stomach classics,the sexual flavor of bitter,cold,gan.7.All cases included in the application of traditional Chinese medicine conservative treatment,the study found that the advantages of Chinese medicine conservative treatment is the curative effect is distinct,although the treatment cycle is long,but curative effect,and better protection for breast shape,low cost of treatment,patients accept degree is high.8.The patients studied in this study were all outpatient patients,and the clinical performance was consistent with the diagnostic criteria of granulomatous mastitis in our hospital's mass stage or partial abscess stage,mainly in the lump period. |
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