Clinical Analysis Of Triple Anti-mycobacterial Drug Treatment Of Granulomatous Lobular Mastitis With Corynebacterium Infection

ObjectiveComparative analysis the clinical efficacy of routine treatment and triple antimycobacterial drugs added on routine treatment in patients with granulomatous lobular mastitis associated with corynebacterium infection,and to explore the clinical effects and safety of triple antimycobacterial drugs on GLM associated with corynebacterium infection.MethodRetrospective surveys and follow-up studies were used to analyze clinical data,collect the patients from January 2014 to September 2017 in our hospital pathologically diagnosed as granulomatous lobular mastitis and bacterial culture of corynebacterium positive.Divide them according to whether or not to add triple antimycobacterial drug on the basis of conventional comprehensive treatment into 2 groups.Patients are divided into triple anti-Mycobacterium treatment group and conventional treatment group;two groups were compared then analyze clinical efficacy.The database of patients in the two groups was established.The clinical features of GLM patients with Corynebacterium infection were analyzed using test and rank sum test to investigate the differences in efficacy and safety between triple antimycobacterial treatment groups and conventional Chinese medicine treatment groups.ResultsA total of 84 cases were included in this study,including 26 in the triple drug group and 58 in the conventional treatment group.The mean age was 31.54±5.00 years.Follow-up time ranged from 7 to 40 months.The mean follow-up time was 21.02 months.Baseline characteristics of the two groups were basically the same,such as mean age of onset,reproductive and lactation history,past history,laboratory tests,clinical manifestations,clinical syndrome classification.There was no significant difference in the clinical cure,breast appearance,and the recurrence of new diseases between the two groups.The treatment time of the triple antimycobacteria treatment group after admission(5.69±1.78 months)was significantly lower than that of the conventional treatment group(7.07±2.68 months),and the difference was statistically significant(P<0.05).The number of outpatient debridements was compared between the two groups of patients.The number of debridement times in the triple-drug group was significantly lower than that in the conventional treatment group,with a significant difference(P<0.05).There was no significant difference in the clinical cure rate,breast shape,recurrence,and total duration of treatment between the two groups.For patients with high blood count,the recurrence of patients with triple antimycobacterial drug group was lower than that of conventional treatment group,and the difference was statistically significant.Patients with clinical type were diffuse type,the breast shape of the triple therapy group was better than that of the conventional treatment group.The difference was statistically significant.There was no serious toxicity or adverse events during the treatment and follow-up of the triple antimycobacterial drug treatment group.Some patients developed mild gastrointestinal or dizziness discomfort.After the drug was reduced,the symptoms were significantly improved.ConclusionIn clinical practice,traditional Chinese medicine treatment has good clinical efficacy for most patients with GLM associated with Corynebacterium infection.For patients with diffuse local lesions of the breast,high white blood cells,and poor long-range hormone therapy,the use of triple antimycobacterial drugs on the basis of conventional Chinese medicine treatment can shorten the treatment duration of patients and can achieve the effect of protecting breast shape.Therefore,conventional Chinese medicine treatment is a good choice for GLM patients with Corynebacterium infections.For patients with GLM who have diffuse lesions,high white blood cells,and poor long-range hormone therapy with Corynebacterium infection,clinicians can try to use Triple antimycobacterial drug treatment.