约10%~30%的新发结直肠癌患者会出现急性肠梗阻,传统急诊手术治疗存在术后并发症高、死亡率高、生存质量低等不足。肠道支架置入联合限期手术作为一种新型治疗策略,展现出显著优势。肠道支架可迅速解除梗阻,改善患者症状,降低手术风险,为肿瘤微创切除创造条件,同时为新辅助化疗提供可能,但其潜在并发症如出血、移位、再梗阻及肠穿孔等也不容忽视,且长期安全性及对肿瘤结局的影响尚不明确。文章综述了肠道支架治疗梗阻性结直肠癌的治疗现状、争议及研究进展,旨在为临床研究和实践提供参考依据。
Approximately 10% to 30% of patients with newly diagnosed colorectal cancer present with acute intestinal obstruction.Traditional emergency surgical intervention is characterized by high rates of postoperative complications,elevated mortality,and diminished quality of life.Combined stent and curative elective surgery(CSCES)has emerged as a novel therapeutic strategy,exhibiting significant clinical benefits.Intestinal stenting can rapidly alleviate obstruction,thereby improving patient symptoms,reducing surgical risks,and facilitating minimally invasive tumor resection.Additionally,it provides an opportunity for neoadjuvant chemotherapy.However,potential complications,including bleeding,stent migration,recurrent obstruction,and intestinal perforation,must be carefully considered.Moreover,the long-term safety and impact on oncologic outcomes remain to be elucidated.This review aims to provide a comprehensive overview of the current status,controversies,and recent advancements in the use of intestinal stents for the treatment of obstructive colorectal cancer,with the goalof informing clinical research and practice.
本文概述了传统日间腹腔镜胆囊切除术患者术后早期康复质量存在的问题,IMB模型通过向患者提供科学的疾病知识,改变其疾病认知与态度,最终促使其采纳并维持健康行为。本文还介绍了IMB模型在日间腹腔镜胆囊切除术后患者早期康复质量中应用涉及的相关概念、研究背景和国内外的研究现状以及未来发展趋势与挑战。研究结果显示,IMB模型可显著降低患者术后疼痛发生率,并提高患者参与治疗决策的程度,为后期关于IMB模型在日间腹腔镜胆囊切除术患者术后早期康复质量的相关研究提供借鉴与参考,以便后期实施相关个性化干预措施,并提供相关理论依据。
This paper summarizes the problems existing in the early postoperative rehabilitation quality of patients undergoing traditional ambulatory laparoscopic cholecystectomy.The IMB model changes patients’ disease cognition and attitude by providing them with scientific disease knowledge,and ultimately promotes their adoption and maintenance of healthy behaviors.It also introduces the relevant concepts involved in the application of the IMB model in the early postoperative rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy,the research background of this study,the current research status at home and abroad,as well as the future development trends and challenges.The research results show that the IMB model can significantly reduce the incidence of postoperative severe pain in patients and the degree of patient participation in treatment decision-making.This provides reference and guidance for subsequent studies on the early rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy using the IMB model,so as to implement relevant personalized intervention measures in the future and provide relevant theoretical basis.
目的 探讨血清乳酸脱氢酶(LDH)在中晚期肝癌患者接受靶向联合免疫治疗后的预后预测价值。方法 选取2022年1月—2024年8月在莆田学院附属医院肿瘤内科经病理和影像学检查确诊的中晚期肝癌患者作为研究对象。从医院的电子病历系统中收集患者的基线资料,随访截止2025年8月,并记录随访结果,包括患者的疾病缓解情况和死亡情况,以及无疾病进展生存期(PFS)、总生存期(OS)。采用Kaplan-Meier方法绘制不同基线LDH水平患者的OS生存曲线,并通过Log-rank检验比较生存曲线。同时,运用多因素Cox比例风险回归分析探讨影响中晚期肝癌患者在接受靶向联合免疫治疗后OS的相关因素。结果 结果显示,在50例肝癌患者中,基线LDH低于200 U/L的有15例,而高于200 U/L的有35例。与基线LDH<200 U/L组相比,基线 LDH≥200 U/L患者PFS、OS更短,差异均有统计学意义(χ2分别为5.51、15.6,P值分别为0.019、0.017)。治疗8周后,与LDH降低患者相比,LDH升高患者OS更短,差异有统计学意义(χ2=13.2,P=0.04)。多因素Cox比例风险回归分析结果表明,基线LDH水平超过200 U/L是中晚期肝癌患者接受靶向联合免疫治疗后OS的影响因素[P=0.035,HR(95%CI)=5.03(1.12,22.54)]。结论 基线LDH水平较低的患者表现出更好的OS。基线LDH水平可以作为预测中晚期肝癌患者在接受靶向联合免疫治疗时预后的指标。
Objective To evaluate the prognostic significance of serum lactate dehydrogenase(LDH)levels in patients with advanced hepatocellular carcinoma(HCC)undergoing targeted therapy combined immunotherapy.Methods Patients diagnosed with advanced HCC were selected in Putian College Affiliated Hospital from January 2022 to August 2024,diagnosed with pathological and imaging examinations results.Patient baseline data were collected from the hospital’s electronic medical records,with follow-up extending until August 2025.We documented outcomes such as disease response and mortality,along with progression-free survival(PFS)and overall survival(OS).Kaplan-Meier survival curves were constructed based on baseline LDH levels,and the Log-rank test was employed for comparison.Additionally,multivariate Cox proportional hazards regression analysis was conducted to identify factors influencing OS in patients receiving targeted therapy combined immunotherapy.Results Among the 50 patients,15 had baseline LDH levels below 200 U/L,while 35 had levels above.Patients with baseline LDH≥200 U/L had significantly shorter PFS and OS than those with baseline LDH <200 U/L(χ2=5.51 and 15.6 for PFS and OS,respectively;P=0.019 and 0.017,respectively).After 8 weeks of treatment,patients with increased LDH had significantly shorter OS compared with patients with decreased LDH(χ2=13.2,P=0.04).Multivariate Cox proportional hazards regression analysis indicated that a baseline LDH level exceeding 200 U/L is an independent prognostic factor for OS in patients with intermediate to advanced HCC receiving targeted therapy combined with immunotherapy(P=0.035,HR 5.03[1.12,22.54]).Conclusions Patients with lower baseline LDH levels demonstrated better OS,suggesting that baseline LDH can serve as an important prognostic indicator for advanced HCC patients undergoing targeted combined immunotherapy.
目的 探讨活血通络汤联合恩格列净治疗射血分数降低型心力衰竭(HFrEF)患者的疗效,并分析其对中医证候积分、心功能的影响。方法 选取2024年8月~2025年8月于本院诊治的150例HFrEF患者进行回顾性分析,依据治疗方案不同将其分为对照组、观察组,其中采取恩格列净治疗的75例患者作为对照组,采取活血通络汤联合恩格列净治疗的75例患者作为观察组。统计对比两组临床疗效及治疗前后中医证候积分、Lee氏心衰积分、心功能、6 min步行试验(6MWT)、心衰因子[心肌肌钙蛋白I(cTnI)、可溶性人基质裂解素2(sST2)、N末端B型利钠肽原(NT-proBNP)]、血流动力学、炎症因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、正五聚蛋白-3(PTX-3)]、氧化应激指标[谷胱甘肽过氧化物酶-3(GPX-3)、丙二醛(MDA)、超氧化物歧化酶(SOD)、脂质过氧化物(LPO)、总抗氧化能力]。比较两组不良反应与再住院率。结果 观察组总有效率高于对照组(P<0.05);观察组治疗后中医证候积分、Lee氏心衰积分低于对照组(P<0.05);观察组治疗后LVEDD、LVESD、LVEDV、LVESV及血清cTnI、sST2、NT-proBNP水平低于对照组,LVEF、6MWT高于对照组(P<0.05);观察组治疗后血流动力学改善程度优于对照组(P<0.05);治疗后,与对照组比较,观察组血清IL-6、CRP、IL-1β、PTX-3、MDA、LPO水平降低,GPX-3、SOD、总抗氧化能力水平升高(P<0.05);观察组再住院率低于对照组(P<0.05),且两组不良反应比较无明显差异(P>0.05)。结论 活血通络汤联合恩格列净治疗HFrEF患者,可提高治疗效果,改善临床症状、心功能,调节血流动力学,并可降低炎症反应,抑制氧化应激反应,减少再住院的发生,且具有一定安全性。
Objective To explore the therapeutic effect of Huoxue Tongluo Decoction combined with empagliflozin on patients with heart failure with reduced ejection fraction (HFrEF), and analyze its influence on traditional Chinese medicine syndrome scores and cardiac function. Methods A retrospective analysis was performed on 150 HFrEF patients treated in our hospital from August 2024 to August 2025. The patients were divided into control group and observation group according to different treatment regimens, 75 patients receiving empagliflozin alone constituted the control group, while another 75 cases treated with combined Huoxue Tongluo Decoction and empagliflozin were assigned to the observation group. The clinical efficacy, as well as the traditional Chinese medicine syndrome scores, Lee heart failure score, cardiac function 6-minute walk test (6MWT), heart failure factors [cardiac troponin I (cTnI), soluble suppression of tumorigenicity 2 (sST2) and N-terminal pro-B-type natriuretic peptide (NT-proBNP)], hemodynamic parameters, inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP), interleukin-1β (IL-1β) and pentraxin-3 (PTX-3)], oxidative stress indexes [glutathione peroxidase-3 (GPX-3), malondialdehyde (MDA), superoxide dismutase (SOD), lipid peroxide (LPO) and total antioxidant capacity] before and after treatment were compared between the two groups. Adverse reactions and readmission rate were also compared. Results The total effective rate of observation group was higher than that of control group (P<0.05). After treatment, traditional Chinese medicine syndrome scores and Lee heart failure score in observation group were lower (P<0.05). LVEDD, LVESD, LVEDV, LVESD and serum levels of cTnI, sST2, NT-proBNP decreased, while LVEF and 6MWT increased in observation group (P<0.05). The improvement of hemodynamics in observation group was superior to control group after treatment (P<0.05). After treatment, serum levels of IL-6, CRP, IL-1β, PTX-3, MDA and LPO were decreased, while GPX-3, SOD and total antioxidant capacity were increased in observation group compared with control group (P<0.05). The readmission rate was lower in observation group (P<0.05). No significant difference was found in adverse reactions between the two groups (P>0.05). Conclusion Huoxue Tongluo Decoction combined with empagliflozin can elevate therapeutic efficacy, relieve clinical symptoms, improve cardiac function and hemodynamic status, reduce inflammatory and oxidative stress responses, and cut down readmission incidence with favorable safety in HFrEF patients.
目的 探讨活血通络汤联合恩格列净治疗射血分数降低型心力衰竭(HFrEF)患者的疗效,并分析其对中医证候积分、心功能的影响。方法 选取2024年8月~2025年8月于本院诊治的150例HFrEF患者进行回顾性分析,依据治疗方案不同将其分为对照组、观察组,其中采取恩格列净治疗的75例患者作为对照组,采取活血通络汤联合恩格列净治疗的75例患者作为观察组。统计对比两组临床疗效及治疗前后中医证候积分、Lee氏心衰积分、心功能、6 min步行试验(6MWT)、心衰因子[心肌肌钙蛋白I(cTnI)、可溶性人基质裂解素2(sST2)、N末端B型利钠肽原(NT-proBNP)]、血流动力学、炎症因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、正五聚蛋白-3(PTX-3)]、氧化应激指标[谷胱甘肽过氧化物酶-3(GPX-3)、丙二醛(MDA)、超氧化物歧化酶(SOD)、脂质过氧化物(LPO)、总抗氧化能力]。比较两组不良反应与再住院率。结果 观察组总有效率高于对照组(P<0.05);观察组治疗后中医证候积分、Lee氏心衰积分低于对照组(P<0.05);观察组治疗后LVEDD、LVESD、LVEDV、LVESV及血清cTnI、sST2、NT-proBNP水平低于对照组,LVEF、6MWT高于对照组(P<0.05);观察组治疗后血流动力学改善程度优于对照组(P<0.05);治疗后,与对照组比较,观察组血清IL-6、CRP、IL-1β、PTX-3、MDA、LPO水平降低,GPX-3、SOD、总抗氧化能力水平升高(P<0.05);观察组再住院率低于对照组(P<0.05),且两组不良反应比较无明显差异(P>0.05)。结论 活血通络汤联合恩格列净治疗HFrEF患者,可提高治疗效果,改善临床症状、心功能,调节血流动力学,并可降低炎症反应,抑制氧化应激反应,减少再住院的发生,且具有一定安全性。
Objective To explore the therapeutic effect of Huoxue Tongluo Decoction combined with empagliflozin on patients with heart failure with reduced ejection fraction (HFrEF), and analyze its influence on traditional Chinese medicine syndrome scores and cardiac function. Methods A retrospective analysis was performed on 150 HFrEF patients treated in our hospital from August 2024 to August 2025. The patients were divided into control group and observation group according to different treatment regimens, 75 patients receiving empagliflozin alone constituted the control group, while another 75 cases treated with combined Huoxue Tongluo Decoction and empagliflozin were assigned to the observation group. The clinical efficacy, as well as the traditional Chinese medicine syndrome scores, Lee heart failure score, cardiac function 6-minute walk test (6MWT), heart failure factors [cardiac troponin I (cTnI), soluble suppression of tumorigenicity 2 (sST2) and N-terminal pro-B-type natriuretic peptide (NT-proBNP)], hemodynamic parameters, inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP), interleukin-1β (IL-1β) and pentraxin-3 (PTX-3)], oxidative stress indexes [glutathione peroxidase-3 (GPX-3), malondialdehyde (MDA), superoxide dismutase (SOD), lipid peroxide (LPO) and total antioxidant capacity] before and after treatment were compared between the two groups. Adverse reactions and readmission rate were also compared. Results The total effective rate of observation group was higher than that of control group (P<0.05). After treatment, traditional Chinese medicine syndrome scores and Lee heart failure score in observation group were lower (P<0.05). LVEDD, LVESD, LVEDV, LVESD and serum levels of cTnI, sST2, NT-proBNP decreased, while LVEF and 6MWT increased in observation group (P<0.05). The improvement of hemodynamics in observation group was superior to control group after treatment (P<0.05). After treatment, serum levels of IL-6, CRP, IL-1β, PTX-3, MDA and LPO were decreased, while GPX-3, SOD and total antioxidant capacity were increased in observation group compared with control group (P<0.05). The readmission rate was lower in observation group (P<0.05). No significant difference was found in adverse reactions between the two groups (P>0.05). Conclusion Huoxue Tongluo Decoction combined with empagliflozin can elevate therapeutic efficacy, relieve clinical symptoms, improve cardiac function and hemodynamic status, reduce inflammatory and oxidative stress responses, and cut down readmission incidence with favorable safety in HFrEF patients.
目的 探讨达格列净在行经皮冠状动脉介入治疗(Percutaneous Coronary Intervention,PCI)后2型糖尿病(Type 2 Diabetes Mellitus,T2DM)伴不稳定型心绞痛(Unstable Angina,UA)患者中的应用价值及短期心功能改善效果。方法 本研究为单中心、随机对照试验,纳入90例PCI术后2型糖尿病合并不稳定型心绞痛患者,随机分为达格列净组(n=43)和二甲双胍组(n=47),规范调整降糖药物保证降糖强度一致。治疗期间及治疗后6-12个月通过心脏彩超测量左心室射血分数(Left Ventricular Ejection Fraction,LVEF)、左室舒张末期内径(Left Ventricular End-Diastolic Diameter,LVEDD),并采集静脉血样检测N端B型利钠肽前体(N-terminalpro-Brain Natriuretic Peptide,NT-proBNP)水平,以评估心功能变化。 结果 PCI治疗后的6-12个月随访中,观察组NT-proBNP(P<0.01)显著降低,左心室射血分数LVEF(P<0.01)显著提升。与对照组相比:观察组NT-ProBNP水平明显下降(P<0.01),且低于对照组。结论 在PCI术后合并不稳定型心绞痛的T2DM患者中,加用达格列净治疗可显著改善NT-proBNP和LVEF等心功能替代指标,且安全性良好。
Objective:To explore the application value of dapagliflozin and its short-term cardiac function improvement effect in patients with type 2 diabetes mellitus (T2DM) combined with unstable angina (UA) after percutaneous coronary intervention (PCI). Methods: This was a single-center, randomized controlled trial. A total of 90 patients with type 2 diabetes mellitus (T2DM) complicated with unstable angina (UA) after percutaneous coronary intervention (PCI) were enrolled and randomly assigned to a dapagliflozin group (n=43) and a metformin group (n=47). Hypoglycemic agents were adjusted routinely to ensure consistent glycemic control intensity between the two groups. During treatment and at 6–12 months after treatment, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) were measured by echocardiography, and venous blood samples were collected to determine the level of N-terminal pro-Brain Natriuretic Peptide (NT-proBNP) for the evaluation of cardiac function changes. Results: During the 6-month follow-up after PCI treatment, the N-terminal pro-brain natriuretic peptide (NT-proBNP) level in the observation group decreased significantly (P<0.01), and the left ventricular ejection fraction (LVEF) increased significantly (P<0.01).Compared with the control group, the NT-proBNP level in the observation group was notably lower (P<0.01) and also remained below that of the control group. Conclusion: For type 2 diabetes mellitus (T2DM) patients complicated with unstable angina pectoris after PCI, adjuvant treatment with dapagliflozin for 6 months can significantly improve cardiac function surrogate markers such as NT-proBNP and LVEF, with favorable safety profile.
目的 观察超声引导下针刺蝶腭神经节治疗过敏性鼻炎的临床疗效。方法 将80例过敏性鼻炎患者随机分成干预组(40例)和对照组(40例),干预组采用超声引导针刺蝶腭神经节,对照组采用常规方法针刺蝶腭穴,每周2次,持续4周。结果 治疗4周后,干预组和对照组均显示出良好疗效。干预组的总有效率为92.50%,对照组的总有效率为82.50%,差异有统计学意义(P<0.05);干预组在鼻症状总分(TNSS)、非鼻症状总分(TNNSS)、视觉模拟量表(VAS)和鼻结膜炎生活质量问卷(RQLQ)等指标上的改善均优于对照组(P<0.05)。结论 超声引导下针刺蝶腭神经节治疗过敏性鼻炎能有效改善患者的临床症状。
Objective To investigate the main clinical effect of acupuncture of pterygopalatine ganglion on patients with allergic rhinitis under the guidance of ultrasound.Methods A total of 80 patients with allergic rhinitis were randomly divided into intervention group and control group.The intervention group was treated with ultrasound guided acupuncture of the sphenopalatineganglion,the control group was treated with conventional acupuncture at sphenopalatine point.The clinical efficacy was determined after the course of treatment.Results The total effective rate was 92.50% in the intervention group and 82.50% in the control group.The improvement of total nasal symptom score,total non-nasal symptom score,VAS and Arhinoconjunctivitis Quality of Life Questionnaire scores in the treatment group was significantly better the control group Conclusions Ultrasound-guided acupuncture of the sphenopalatine ganglion can improves clinical symptoms of patients with allergic rhinitis.
目的 分析“侧俯卧位”MRI引导腰脊神经后根神经节脉冲射频治疗腰椎间盘突出症的手术体位护理效果。方法 对2018年9月—2020年12月在广州市荔湾中心医院住院接受经MRI引导腰脊神经后根神经节脉冲射频的腰椎间盘突出症患者62例随机分为两组:侧俯卧位组和俯卧位组,每组各31例。侧俯卧位组采用患侧抬高约30 °的侧俯卧位手术,俯卧位组采用标准俯卧位手术。记录两组手术时间、手术并发症、手术体位相关并发症及术者对术野显露的满意度评价。结果 所有患者均顺利完成手术,未见出血、感染、下肢麻痹加重神经损伤、脏器损伤等手术并发症,无患者发生眼压增高、臂丛损伤、压疮等体位相关并发症。侧俯卧位组手术时间(60.65±12.45)min,俯卧位组手术时间(70.58±10.25) min,组间比较差异有统计学意义(t=3.429,P=0.001)。术者对侧俯卧位组和俯卧位组术野侧显露总满意度分别为93.55%和77.42%,组间比较差异有统计学意义(χ2=4.292,P=0.038)。结论 侧俯卧位MRI引导腰脊神经后根神经节脉冲射频治疗腰椎间盘突出症安全、有效,做好手术体位护理可有效防止并发症。
Objective To analyze the effect of surgical position nursing for radiofrequency ablation in posterior root ganglion in lumbar spinal nerve guided by MRI in lateral prone position.Methods Sixty-two patients with lumbar disc herniation hospitalized in Liwan Central Hospital of Guangzhou from September 2018 to December 2020 were randomly divided into two groups(the lateral prone position group and the prone position group,31 patients in each group).The lateral prone position group used the lateral prone position with about 30 degrees elevation of the affected side,and the prone position group used the standard prone position for operation.Operating time,surgical complications,surgical position related complications,and operator satisfaction evaluation of surgical field exposure were recorded in both groups.Results All patients completed the operation successfully.No surgical complications such as bleeding,infection,lower limb paralysis,aggravated nerve injury or organ injury were found in the two groups.No surgical position related complications such as intraocular pressure raising,brachial plexus injury or pressure ulcers in both the groups either.The operation time was(60.65±12.45)min in the lateral prone position group and(70.58±10.25)min in the standard prone position group,respectively,and the difference was statistically significant(t=3.429,P=0.001).The surgeon’s satisfaction evaluation of the surgical field exposure was much higher in the lateral prone position group(93.55%)compared with the standard prone position group(77.42%),and the difference was statistically significant(χ2=4.29,P=0.038).Conclusions Radiofrequency ablation in posterior root ganglion of lumbar spinal nerve guided by MRI in lateral prone position is safe and effective.Good surgical position nursing can effectively prevent complications.
目的 研究并分析星状神经节阻滞联合银杏叶提取物治疗颈源性头晕的临床效果。方法 选取周口骨科医院100例颈源性头晕的住院患者作为研究对象,于2022年6月—2023年6月期间内收治,根据入院顺序奇偶号将其分为对照组与观察组,各50例,对照组实行星状神经节阻滞治疗,观察组在对照组基础上联合使用银杏叶提取物治疗,对比两组患者的临床症状(头痛、眩晕、耳鸣、视物模糊)改善程度、颈部疼痛量表、临床效果和不良反应发生率。结果 治疗30 d后,观察组临床症状评分低于对照组(P<0.05)。两组治疗前的数字分级法评分差异无统计学意义(P>0.05),治疗15 d与30 d时,观察组数字分级法评分评分均低于对照组(P<0.05)。观察组患者的治疗总有效率高于对照组(P<0.05);治疗期间,观察组的并发症发生率低于对照组,比较差异有统计学意义(P<0.05)。结论 颈源性头晕患者使用星状神经节阻滞联合银杏叶提取物治疗,能够明显改善疾病症状,缓解颈部疼痛感,有效提高临床效果,同时降低不良反应发生率。
Objective To analyze the clinical study of stellate ganglion block combined with Ginkgo biloba extract to treat cervical dizziness.Methods A total of 100 hospitalized patients with cervical dizziness at Zhoukou Orthopedic Hospital were selected as the study subjects,who were admitted between June 2022 and June 2023.They were divided into a control group and an observation group based on the odd and even numbers of admission,with 50 cases in each group.The control group received stellate ganglion block treatment,while the observation group received a combination of Ginkgo biloba extract treatment on the basis of the control group,The degree of improvement in clinical symptoms(headache,dizziness,tinnitus,blurred vision),neck pain scale,clinical efficacy,and incidence of adverse reactions were compared between two groups of patients.Results After 30 days of treatment,the clinical symptom score of the observation group was lower than that of the control group(P<0.05).There was no statistically significant difference in the numerical grading scores between the two groups before treatment(P>0.05).On the 15th and 30th day of treatment,the observation group had lower numerical grading scores than the control group(P<0.05).The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).During the treatment period,the incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions The use of stellate ganglion block combined with Ginkgo biloba extract in the treatment of patients with cervicogenic dizziness can significantly improve their disease symptoms,significantly alleviate their neck pain,effectively improve the clinical effect,while reducing the incidence of adverse reactions.
目的 研究内托生肌法治疗肉芽肿性乳腺炎溃后期的临床疗效。方法 63例符合肉芽肿性乳腺炎溃后期的患者,分为西药组31例和中药组32例。西医药组予常规激素、抗生素等治疗,中药组予内托生肌法,加减组方,两组治疗时间为6个月。比较两组患者的疾病转归、乳房外形评价、临床症状观察评分等指标。结果 中药组6个月治愈率高于西药组,中药组临床治愈18例(56.2%)、痊愈11例(34.4%),相较于西药组临床治愈11例(35.5%)和痊愈9例(29%);治疗后中药组乳房外形评价优于西药组,中药组临床症状评分较低,组间比较差异具有统计学意义。两组患者治疗前后免疫球蛋白IgA、IgG、IgM水平比较差异均未见统计学意义。中药组相较于西药组不良反应更少,患者依从性更高。结论 内托生肌法治疗肉芽肿性乳腺炎溃后期能促进肉芽肿创面愈合,加快肉芽组织新生,改善破溃流脓症状以及在恢复乳房外观方面具有明显的优势。
Objective To study the clinical efficacy of endotropic muscle-generating therapy in treating late-stage ulcerative granulomatous mastitis.Methods Sixty-three eligible patients were included in the western medicine group(31 cases)and the traditional Chinese medicine group(32 cases).The western medicine group received conventional hormones and antibiotics,while the traditional Chinese medicine group received the endotropic muscle-generating method with adjustments.The treatment duration for both groups was six months.Disease regression,breast shape evaluation,clinical symptom observation scores,and other relevant indices of both groups were compared.Results The study found that the six-month cure rate in the traditional Chinese medicine group(56.2% clinically cured,34.4% cured)exceeded that of the western medicine group(35.5% clinically cured,29% cured).Breast appearance evaluation in the traditional Chinese medicine group significantly better that of the western medicine group post-treatment,and clinical symptom scores were lower,demonstrating a statistically significant difference.Before and after treatment,there was no significant difference in the levels of immunoglobulins A,G,and M observed between the two groups.The traditional Chinese medicine group exhibited fewer side effects and higher patient compliance compared to the western medicine group.Conclusions The endotropic muscle-generating method,when employed to treat granulomatous mastitis in the late ulcerative stage,proves effective in promoting granulomatous wound healing,accelerating the generation of new granulation tissue,and improving ulceration and pus flow symptoms.Additionally,it contributes to the restoration of breast appearance.