1.上海中医药大学附属龙华医院,上海市徐汇区宛平南路725号,200032
2.上海交通大学医学院附属瑞金医院
chhfluk@163.com
收稿:2024-12-29,
修回:2025-02-26,
纸质出版:2025-05-02
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孟畑,马菲菲,亢园园等.柴芩消痈饮联合金黄膏治疗肝经蕴热型粉刺性乳痈肿块期的随机、双盲、安慰剂对照临床研究[J].中医杂志,2025,66(09):920-926.
MENG Tian,MA Feifei,KANG Yuanyuan,et al.Clinical Study on Chaiqin Xiaoyong Decoction (柴芩消痈饮) Combined with Jinhuang Ointment (金黄膏) for the Nodular Stage of Acne Mastitis of Liver Meridian Heat Accumulation Type:A Randomized,Double-Blind,Placebo-Controlled Trial[J].Journal of Traditional Chinese Medicine,2025,66(09):920-926.
孟畑,马菲菲,亢园园等.柴芩消痈饮联合金黄膏治疗肝经蕴热型粉刺性乳痈肿块期的随机、双盲、安慰剂对照临床研究[J].中医杂志,2025,66(09):920-926. DOI: 10.13288/j.11-2166/r.2025.09.009.
MENG Tian,MA Feifei,KANG Yuanyuan,et al.Clinical Study on Chaiqin Xiaoyong Decoction (柴芩消痈饮) Combined with Jinhuang Ointment (金黄膏) for the Nodular Stage of Acne Mastitis of Liver Meridian Heat Accumulation Type:A Randomized,Double-Blind,Placebo-Controlled Trial[J].Journal of Traditional Chinese Medicine,2025,66(09):920-926. DOI: 10.13288/j.11-2166/r.2025.09.009.
目的
2
观察中药复方柴芩消痈饮联合金黄膏治疗肝经蕴热型粉刺性乳痈肿块期的临床有效性和安全性。
方法
2
采用随机、双盲、安慰剂对照的临床研究方法,将108例肝经蕴热型粉刺性乳痈肿块期患者随机分为治疗组和对照组,每组54例。两组均予金黄膏外敷,3~5 mm厚敷,每次8 h,每日1次,配合常规护理指导。在此基础上,治疗组予柴芩消痈饮颗粒剂,对照组予安慰颗粒剂口服,均每日2次,每次3袋。两组均连续治疗14天。比较治疗前后两组患者中医症状体征积分、肿块大小、疼痛评分、白细胞(WBC)计数、C反应蛋白(CRP)水平、全身免疫炎症因子(SII),治疗结束比较两组疾病疗效,并进行安全性评估。治疗结束后随访半年,比较期间两组患者接受手术治疗的比例。
结果
2
治疗组疾病疗效总有效率为90.38%(47/52),优于对照组的32.00%(16/50),差异有统计学意义(
P
<0.01)。治疗组中医症状体征积分、疼痛评分、肿块大小以及WBC计数及CRP水平、SII均较对照组低(
P
<0.05或
P
<0.01)。半年随访期间治疗组患者手术治疗的比例为5.77%(3/52),低于对照组的14.00%(7/50),两组差异有统计学意义(
P
<0.01)。两组治疗前后安全性指标未见明显异常。
结论
2
柴芩消痈饮能够减小肝经蕴热型粉刺性乳痈患者的肿块,改善红肿、疼痛等症状,降低中医症状体征积分,提高疾病疗效总有效率,且安全性良好。
Objective
2
To evaluate the clinical efficacy and safety of the traditional Chinese medicine (TCM) compound
Chaiqin Xiaoyong Decoction
(柴芩消痈饮, CXD) combined with
Jinhuang Ointment
(金黄膏, JO) in treating the nodular stage of acne mastitis of liver meridian heat accumulation type.
Methods
2
A randomized, double-blind, placebo-controlled clinical trial was conducted. A total of 108 patients with liver meridian heat accumulation type acne mastitis in the nodular stage were randomly assigned to a treatment group and a control group, with 54 patients in each group. Both groups received topical application of JO once daily at a thickness of 3~5 mm for 8 hours, along with standard nursing care. On this basis, the treatment group received oral CXD granules, while the control group received placebo granules, administered twice daily, 3 sachets per dose, for 14 consecutive days. Clinical efficacy, TCM symptom scores, nodule size, visual analogue scale (VAS) pain scores, white blood cell (WBC) count, C-reactive protein (CRP) level, and systemic immune-inflammation index (SII) were compared. At the end of treatment, efficacy and safety indicators were evaluated. A 6-month follow-up was conducted to compare the proportion of patients undergoing surgical treatment.
Results
2
The total clinical effi
cacy rate in the treatment group was 90.38% (47/52), significantly higher than 32.00% (16/50) in the control group (
P
<0.01). The treatment group also showed significantly lower TCM symptom scores, VAS scores, nodule size, WBC count, CRP level, and SII (
P
<0.05 or
P
<0.01). During follow-up, the surgical intervention rate in the treatment group was 5.77% (3/52), lower than 14.00% (7/50) in the control group, with a statistically significant difference (
P
<0.01). No significant abnormalities were observed in safety indicators before and after treatment in either group.
Conclusion
2
CXD effectively reduces nodule size and alleviates symptoms such as redness and pain in patients with acne mastitis of liver meridian heat accumulation type, improves TCM symptom scores, enhances overall clinical efficacy, and demonstrates good safety.
陈红风 , 裴晓华 , 陈前军 . 实用中医乳房病学 [M]. 北京 : 中国中医药出版社 , 2023 : 139 .
YUAN Q , XIAO S , FAROUK O , et al . Management of granulomatous lobular mastitis: an international multidisciplinary consensus (2021 edition) [J]. Mil Med Res , 2022 , 9 ( 1 ): 20 .
ZHOU F , LI H , WANG F , et al . Efficacy and safety of rifampicin-based triple therapy for non-puerperal mastitis: A single-arm, open-label, prospective clinical trial [J]. Int J Infect Dis , 2024 , 140 : 25 - 30 . doi: 10.1016/j.ijid. 2023.12.008 http://dx.doi.org/10.1016/j.ijid.2023.12.008 .
中华中医药学会 . 中医外科临床诊疗指南 [M]. 北京 : 中国中医药出版社 , 2020 : 44 .
郑宜南 . 疮疡外科名家顾筱岩学术经验 [J]. 中医文献杂志 , 2008 , 26 ( 5 ): 31 - 34 .
孟畑 , 褚美玲 , 代秋颖 , 等 . 陈红风基于“疮形于外,实根于内”理论内外并举治疗粉刺性乳痈经验 [J]. 北京中医药 , 2023 , 42 ( 7 ): 721 - 723 .
陈豪 , 杨铭 , 陈红风 . 疏肝清热法治疗粉刺性乳痈的用药规律研究 [J]. 上海中医药杂志 , 2022 , 56 ( 8 ): 22 - 26 .
SCHNITT SJ , COLLINS LC . 乳腺病理活检解读 [M]. 3版 .李国霞,译. 北京 : 北京科学技术出版社 , 2019 : 39 - 40 .
陈玲 , 张晓云 , 王延文 , 等 . 肉芽肿性小叶性乳腺炎300例临床病理学分析 [J]. 中华病理学杂志 , 2019 , 48 ( 3 ): 231 - 236 .
陈志奎 , 薛恩生 , 林礼务 , 等 . 乳腺疾病超声诊断学 [M]. 北京 : 科学出版社 , 2022 : 89 .
陈红风 . 中医外科学 [M]. 5版 . 北京 : 中国中医药出版社 , 2021 : 109 - 111 .
章烨欣 , 杨银 , 陈鹏 , 等 . 金黄散外敷联合柴胡清肝汤口服治疗浆细胞乳腺炎20例 [J]. 河南中医 , 2020 , 40 ( 6 ): 890 - 893 .
国家中医药管理局 . 中医病证诊断疗效标准 [M]. 南京 : 南京大学出版社 , 1994 : 46 - 47 .
林毅 , 唐汉钧 . 现代中医乳房病学 [M]. 北京 : 人民卫生出版社 , 2003 : 182 - 194 .
中华中医药学会乳腺病专业委员会 . 肉芽肿性小叶性乳腺炎中医诊疗专家共识(2021版) [J]. 中国中西医结合外科杂志 , 2022 , 28 ( 5 ): 597 - 602 .
MCCORMACK HM , HORNE DJ , SHEATHER S . Clinical applications of visual analogue scales:a critical review [J]. Psychol Med , 1988 , 18 ( 4 ): 1007 - 1019 .
ISLAM MM , SATICI MO , EROGLU SE . Unraveling the clinical significance and prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and delta neutrophil index: an extensive literature review [J]. Turk J Emerg Med , 2024 , 24 ( 1 ): 8 - 19 .
中华预防医学会妇女保健分会乳腺保健与乳腺疾病防治学组 . 非哺乳期乳腺炎诊治专家共识 [J]. 中国实用外科杂志 , 2016 , 36 ( 7 ): 755 - 758 .
MONTAZER M , DADASHZADEH M , MOOSAVI TOOMATARI SE . Comparison of the outcome of low dose and high-dose corticosteroid in the treatment of idiopathic granulomatous mastitis [J]. Asian Pac J Cancer Prev , 2020 , 21 ( 4 ): 993 - 996 .
MA X , MIN X , YAO C . Different treatments for granulomatous lobular mastitis: a systematic review and Meta-Analysis [J]. Breast Care (Basel) , 2020 , 15 ( 1 ): 60 - 66 .
孟畑 , 程亦勤 , 仇闻群 , 等 . 顾氏外科综合外治法治疗120例粉刺性乳痈的临床研究 [J]. 中华中医药杂志 , 2021 , 36 ( 6 ): 3728 - 3731 .
ZHOU Y , GONG J , DENG X , et al . Novel insights: crosstalk with non-puerperal mastitis and immunity [J]. Front Immunol , 2024 , 15 : 1431681 . doi: 10.3389/fimmu. 2024.1431681 http://dx.doi.org/10.3389/fimmu.2024.1431681 .
LOU Y , XU H , LU Z , et al . Immune regulation: a new strategy for traditional Chinese medicine-based treatment of granulomatous lobular mastitis [J]. Front Immunol , 2024 , 15 : 1494155 . doi: 10.3389/fimmu.2024. 1494155 http://dx.doi.org/10.3389/fimmu.2024.1494155 .
TANG Y , PENG B , LIU J , et al . Systemic immune-inflammation index and bone mineral density in postmenopausal women: a cross-sectional study of the national health and nutrition examination survey (NHANES) 2007-2018 [J]. Front Immunol , 2022 , 13 : 975400 . dio:10.3389/fimmu.2022.975400.
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