| Research Background:Granulomatous mastitis(GM)is a non-specific inflammatory lesion that occurs in the breast,and it occurs in women of childbearing age who have a history of lactation.The initial stage of the disease is non-specific inflammation that invades the lobules of the mammary gland and causes a lump in the breast.Progression of the disease will gradually appear local dark red,pain,ulceration,or even form a fistula,sinus,difficult to heal.Because of its long course of disease,high recurrence rate,and severe damage to the appearance of women's breasts,patients will have certain economic and mental pressure during treatment,and even patients will have their breasts removed.Scholars at home and abroad are still controversial about the etiology and pathogenic factors of this disease,and there is currently no unified treatment plan.In recent years,the state has attached importance to and developed the cause of traditional Chinese medicine,which has led to an increase in people's understanding of traditional Chinese medicine and medical care,and more and more people have increased Concerned,they improve their physical fitness by adjusting the diet structure or increasing physical exercise to improve immunity and reduce susceptibility to disease,which has gradually deepened people's understanding of the relationship between physical fitness and disease.With the continuous accumulation and development of the constitution theory of traditional Chinese medicine,the research of the constitution theory has gradually shifted from the constitution and disease prevention to the identification of the constitution to treat diseases.Through the judgment and analysis of the physique type of traditional Chinese medicine in GM patients,the undergraduate department adopts syndrome differentiation treatment while correcting the physical bias and cooperates with surgical treatment to treat the disease,which has achieved good clinical results.Therefore,this study is a study on the physique type of GM patients and the treatment effect of correcting physique bias on the disease.Research purposes:Through the investigation and research on the generalcondition and physique type of GM patients,it analyzes and summarizes the general condition and high-occurrence physique types of GM patients,and factors that affect physique.Provide a theoretical basis for the prevention and care of GM.At the same time,by comparing the clinical effects of adjuvant therapy with traditional physical therapy on GM patients with yang-deficiency physique and mass,we explored new ideas for clinical treatment of GM.Research method: According to the content to be investigated,"Patient Information Registration Form" and "Patient's Constitution Classification Judgment Form" are prepared respectively.The "Patient Information Registration Form" contains the patient's name,age of onset,time of onset,place of residence,nature of work,etc.,as well as height,weight,smoking history,drinking history,family history related to breast disease,allergy history,number of births,diet Basic situation such as preference and emotional state."Patient TCM Constitution Classification Judgment Table" is based on the "Chinese Medicine Constitution Classification and Judgment" standard issued and implemented in 2009.Through the "Patient Information Registration Form" to investigate the basic information of the patient's general situation and morbidity,etc.,and the "TCM Constitution Classification Decision Form" to determine the patient's physical type.Organize the data and analyze its correlation.At the same time,according to the "TCM Constitution Classification Judgment of Patients",the patients who meet the diagnosis of mass GM are analyzed for physique,and the patients with yang deficiency are selected,and the patients are randomly divided into an observation group and a control group,and the control group is the traditional treatment group.The observation group was the adjuvant treatment group for physical differentiation.30 people in each group.The control group received pre-operative conventional treatment before surgery,that is,daily oral administration of Xiaojin Pill 3g Bid(Governance: Sanjie swelling,stasis and pain relief;main ingredients: musk,wood turtle,grass making,maple balm,frankincense,myrrh,Wulingzhi,Danggui,Dilong,Xiangmo),while using golden ointment(in-hospital preparation)for external application to the affected area once a day for6-8 hours each time.The observation group was given the addition and subtraction of Chinese medicine decoction Yanghe decoction and Wenyang decoction.How to take:Shuijianbi,two doses a day,warm morning and evening.Yanghe Decoction is used to treat yin and gangrene,and has the effect of warming Yang and nourishing blood,and dispersing cold and stagnation;,Zhigancao)is a commonly used prescription for the treatment of Yang deficiency constitution by Wang Qi,a master of traditional Chinese medicine.According to the patient's condition,it changes according to the patient's condition.Yu Zhifa was the same as the control group.Both groups of patients underwent surgical treatment.The operations were performed by the same physician.The surgical methods were basically the same.Both were complete debridement and suture surgery centering on the inflammatory mass.The specific surgical method was centered on the nipple along the long axis of the mass Radial incision,if the lump is near the nipple and areola,turn into an arc incision next to the areola,cut the skin and subcutaneous tissue,and free the normal glands to both sides of the incision,open the pus cavity completely after cutting the gland,and remove necrosis Lesion and removal of diseased glands,exploration of suspicious glands,removal of diseased and necrotic glands,retention of reversible glands,flushing of wounds with saline,trimming of skin margin,moderate tension of incision,drainage tube drainage,intermittent suture of glands,subcutaneous tissue,skin.Penicillin antibiotics are preferred in both groups after the operation,generally used for 3-7 days,and the drainage tube is removed 1-2 days after the operation.The wound is changed daily every day after the operation until healed.After the operation,the two groups continued to take the oral drug as before,with 3 months as a course of treatment.Observe the changes in the size of the mass before operation,the degree of liquefaction,the healing time of the incision after surgery,the recurrence(new episode)within 1 year,and evaluate the postoperative breast shape.Research results: Through the study of the general situation of the patients,it wasfound that the patients who participated in this study had more onset of women after the first postpartum,aged 29-34 years old accounted for a relatively large proportion,and had lived in the city for a long time,mostly engaged in mental work,diet Most people prefer to eat spicy and spicy stimuli and have a fat and thick taste,most of them are overweight,usually have irritability and irritability,and there are few people with history of smoking and drinking;the cause of the disease is not related to genetic factors.Through relevant research on the patient's physique type,it is found that the physique is biased and the disease is prone to suffer from this disease.Among the various physique types,the highest incidence is yang deficiency,followed by phlegm and dampness,qi depression,calmness,dampness and heat,and qi deficiency Quality,yin deficiency and blood stasis are the most rare.According to the correlation analysis of the top 3 physical types of the physique,it is found that there is no difference in the onset season and BMI of patients with different physique types;there are significant differences in emotional characteristics of patients with different physique types.There are differences in the eating habits of patients with different physique types.The clinical observation of 60 cases of GM patients with yang-deficiency mass stage that met the inclusion criteria by correcting physical bias treatment and traditional treatment results showed that the observation group and the control group had preoperative mass size,liquefaction degree and postoperative incision in both groups.There were differences in healing time,recurrence(new incidence),and postoperative breast shape evaluation(P<0.05),and the observation group had a higher degree of tumor reduction and liquefaction than the control group before surgery,and the wound healing time was short.The recurrence(new-onset)rate is low,and breast shape evaluation is high after surgery.From this,it can be guessed that correcting the patient's physical bias can promote the liquefaction of GM masses,promote wound healing,reduce the rate of recurrence(new incidence),and improve the postoperative breast shape integrity.Analysis conclusion:(1)The physique type of GM patients is complex,and most of them are biased.The top three physiques of incidence are yang deficiency,phlegm and dampness,andqi stagnation.(2)Emotional factors and dietary factors have a certain influence on the constitution of patients with granulomatous mastitis;(3)Through the analysis of the clinical manifestations and physical types of patients with granulomatous mastitis,they can be classified as "sores" and "necrosis";(4)The clinical effect of correcting physique bias in the treatment of GM is superior to traditional treatments in improving the preoperative symptoms of GM,shortening the healing time of the incision,reducing the rate of recurrence(new incidence),and postoperative breast shape. |
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