目的 探讨小金片联合醋酸泼尼松片治疗浆细胞性乳腺炎的临床疗效。方法 选取2020年2月-2023年2月在皖南医学院第二附属医院就诊的80例浆细胞性乳腺炎患者,依据随机数字表法将所有患者分为对照组和治疗组,每组各40例。对照组口服醋酸泼尼松片,30 mg/次,1次/d,连续治疗7 d,然后剂量改为20 mg/次,1次/d,再连续治疗7 d。治疗组在对照组基础上口服小金片,3片/次,2次/d,连续治疗14 d。观察两组的临床疗效,比较两组的乳房红肿、肿块、乳头溢液、疼痛消失时间,比较病灶最大直径、弹性应变率比值,以及血清中细胞间黏附分子-1(ICAM-1)、Toll样受体4(TLR4)、超敏C反应蛋白(hs-CRP)的水平。结果 治疗后,与对照组总有效率67.50%相比,治疗组患者的总有效率87.50%更高,差异有统计学意义(P<0.05)。治疗后,治疗组患者红肿、肿块、乳头溢液、疼痛消失时间均短于对照组,差异有统计学意义(P<0.05)。治疗后,两组的病灶最大直径、弹性应变率比值低于治疗前(P<0.05);治疗后治疗组的病灶最大直径、弹性应变率比值低于对照组,差异有统计学意义(P<0.05)。治疗后,两组的血清ICAM-1、TLR4、hs-CRP水平低于治疗前(P<0.05),且治疗组血清ICAM-1、TLR4、hs-CRP水平较对照组更低(P<0.05)。结论 小金片联合醋酸泼尼松片治疗浆细胞性乳腺炎的疗效确切,能显著改善临床症状,降低炎症反应,药物安全性良好。

Objective To investigate the clinical effect of Xiaojin Tablets combined with Prednisone Acetate Tablets in treatment of plasma cell mastitis. Methods Patients (80 cases) with plasma cell mastitis in the Second Affiliated Hospital of Wannan Medical College from February 2020 to February 2023 were divided into control and treatment groups according to the random number table method, and each group had 40 cases. Patients in the control group were po administered with Prednisone Acetate Tablets, 30 mg/time, once daily. After 7 d of continuous treatment, the dose was changed to 20 mg/time, once daily, and then the treatment was continued for 7 d. Patients in the treatment group were po administered with Xiaojin Tablets on the basis of the control group, 3 tablets/time, twice daily, continuous treatment for 14 d. After treatment, the clinical efficacies were evaluated, and the disappearance times of redness, swelling, nipple discharge, and pain of breast, the maximum lesion diameter and elastic strain rate ratio, the serum levels of ICAM-1, TLR4, and hs-CRP in two groups were compared. Results After treatment, compared with the total effective rate of 67.50% in the control group, the total effective rate of 87.50% in the treatment group was higher, with a statistically significant difference (P < 0.05). After treatment, the disappearance times of redness, swelling, nipple discharge, and pain of breast in treatment group was shorter than that in control group, and the difference was statistically significant (P < 0.05). After treatment, the maximum lesion diameter and elastic strain rate ratio of two groups were significantly increased (P < 0.05). After treatment, the maximum lesion diameter and elastic strain rate ratio in the treatment group were lower than those in the control group, and the difference was statistically significant (P < 0.05). After treatment, the serum levels of ICAM-1, TLR4, and hs-CRP in two groups were lower than before treatment (P < 0.05), and the serum levels of ICAM-1, TLR4, and hs-CRP in the treatment group were lower than those in the control group (P < 0.05). Conclusion Xiaojin Tablets combined with Prednisone Acetate Tablets has definite efficacy in treatment of plasma cell mastitis, which significantly improve clinical symptoms, reduce inflammation, and has good safety.

R984

陕西省重点研发计划项目(2017SF-079)