| 引用本文: |
丁继果, 高金辉, 杨春睿, 李辉斌, 熊伟.清肝解郁化痰方结合刺络拔罐对肉芽肿性小叶性乳腺炎局部肿痛及免疫炎症的影响[J].湖南中医药大学学报,2026,46(8):1583-1589[点击复制] |
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| 清肝解郁化痰方结合刺络拔罐对肉芽肿性小叶性乳腺炎局部肿痛及免疫炎症的影响 |
| 丁继果,高金辉,杨春睿,李辉斌,熊伟 |
| (南京市中西医结合医院, 江苏 南京 210000) |
| 摘要: |
| 目的 探讨清肝解郁化痰方联合刺络拔罐对肉芽肿性小叶性乳腺炎（GLM）患者局部症状的改善作用，分析该联合疗法对患者体液免疫及炎症反应的调节效应，观察其复发率及不良反应情况。方法 选取南京市中西医结合医院2021年1月至2024年3月收治的GLM患者100例为研究对象，按SPSS 26.0软件生成的随机序列分为对照组、治疗组，每组50例。对照组给予醋酸泼尼松片口服（第1~2周初始剂量20 mg/d，第3~6周减至10 mg/d，第7~8周减至5 mg/d，8周后停药），治疗组在对照组基础上给予清肝解郁化痰方口服（200 mL/次，2次/d），并结合局部刺络拔罐治疗（1次/3 d），两组总疗程均为8周。对比两组患者临床疗效、肿块体表面积、临床症状评分、视觉模拟评分法（VAS）；检测两组患者体液免疫指标[免疫球蛋白A（IgA）、IgG、IgM及补体C3、C4水平]及炎症指标[C-反应蛋白（CRP）、白细胞介素-6（IL-6）、红细胞沉降率（ESR）水平]变化；追踪随访1年期间疾病复发率；观察治疗期间及随访阶段患者全身性不良反应情况，统计不良反应发生率；记录刺络拔罐相关局部不良反应。结果 治疗后，治疗组临床总有效率（90.0%）高于对照组（72.0%）（P＜0.05）。与治疗前比较，治疗后两组患者肿块体表面积缩小（P＜0.05），VAS评分、临床症状评分（包括疼痛、肿块、皮肤维度）、体液免疫指标IgA、IgG、IgM水平及炎症指标CRP、IL-6、ESR水平均降低（P＜0.05），体液免疫指标补体C3、C4水平升高（P＜0.05）；且治疗组肿块体表面积小于对照组（P＜0.05），VAS评分、临床症状评分（包括疼痛、肿块、皮肤维度）、体液免疫指标IgA、IgG、IgM水平及炎症指标CRP、IL-6、ESR水平均低于对照组（P＜0.05），体液免疫指标补体C3、C4水平高于对照组（P＜0.05）。随访1年期间，治疗组复发率（8.0%）低于对照组（24.0%）（P＜0.05）；两组患者在治疗期间及随访阶段均未出现严重全身性不良反应，组间全身性不良反应发生率差异无统计学意义（P＞0.05）。结论 清肝解郁化痰方联合刺络拔罐可提升GLM临床疗效，促进病灶消退，有效缓解机体炎症反应并增强免疫应答，同时降低疾病复发风险，且安全性较高。 |
| 关键词: 肉芽肿性小叶性乳腺炎|清肝解郁化痰方|刺络拔罐|免疫功能|炎症反应 |
| DOI：10.3969/j.issn.1674-070X.2026.08.006 |
| 投稿时间：2026-04-29 |
| 基金项目:江苏省中医药科技发展计划项目（ZD202428）。 |
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| Effects of Qinggan Jieyu Huatan Formula combined with pricking-cupping therapy on local swelling and pain and immune-inflammatory responses in granulomatous lobular mastitis |
| DING Jiguo, GAO Jinhui, YANG Chunrui, LI Huibin, XIONG Wei |
| (Nanjing Integrated Traditional Chinese and Western Medicine Hospital, Nanjing, Jiangsu 210000, China) |
| Abstract: |
| Objective To investigate the effects of Qinggan Jieyu Huatan Formula (QGJYHTF) combined with pricking-cupping therapy on improving local symptoms in patients with granulomatous lobular mastitis (GLM), analyze the regulatory effects of this combined therapy on humoral immunity and inflammatory responses, and observe the recurrence rate and adverse reaction. Methods A total of 100 GLM patients admitted to Nanjing Hospital of Integrated Traditional Chinese and Western Medicine from January 2021 to March 2024 were selected as study subjects and randomly divided into a control group and a treatment group using a random sequence generated by SPSS 26.0 software, with 50 cases in each group. The control group received oral prednisone acetate tablets (initial dose of 20 mg/d in the first 2 weeks, reduced to 10 mg/d from weeks 3 to 6, then reduced to 5 mg/d in weeks 7~8, and discontinued after week 8). In addition to the control regimen, the treatment group received QGJYHTF orally (200 mL/time, twice daily) combined with local pricking-cupping therapy (once every 3 days). The total course of treatment was 8 weeks for both groups. Clinical efficacy, lesion surface areas, clinical symptom scores, and Visual Analog Scale (VAS) scores were compared between the two groups. Serum humoral immunity markers [immunoglobulin A (IgA), IgG, IgM, complement C3 and C4] and inflammatory markers [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and interleukin-6 (IL-6)] were measured. Disease recurrence rates were followed up for 1 year. Systemic adverse reactions were observed during the treatment and follow-up, and the incidence of adverse reactions was calculated. Local adverse reactions related to pricking-cupping were recorded. Results After treatment, the total clinical effective rate in the treatment group (90.0%) was higher than that in the control group (72.0%) (P<0.05). The lesion surface areas decreased in both groups after treatment (P<0.05); VAS scores, clinical symptom scores (including pain, mass, and skin dimensions), humoral immunity markers (IgA, IgG, IgM) and inflammatory markers (CRP, ESR, IL-6) decreased in both groups (P<0.05), while complement C3 and C4 increased (P<0.05). The lesion surface area in the treatment group was smaller than that in the control group (P<0.05); VAS scores, clinical symptom scores (including pain, mass, and skin dimensions), humoral immunity markers (IgA, IgG, IgM), and inflammatory markers (CRP, ESR, IL-6) in the treatment group were lower than those in the control group (P<0.05), while complement C3 and C4 were higher than those in the control group (P<0.05). During the 1-year follow-up, the recurrence rate in the treatment group (8.0%) was lower than that in the control group (24.0%) (P<0.05). No severe systemic adverse reactions occurred in either group during the treatment and follow-up, and there was no statistically significant difference in the incidence of systemic adverse reactions between the two groups (P>0.05). Conclusion QGJYHTF combined with pricking-cupping therapy can improve the clinical efficacy of GLM, promote lesion regression, effectively alleviate inflammatory responses, and enhance immune responses, reducing the risk of disease recurrence with favorable safety profile. |
| Key words: granulomatous lobular mastitis|Qinggan Jieyu Huatan Formula|pricking-cupping therapy|immune function|inflammatory response |
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