黎芳 雷叶雁 李志新

〔摘要〕 目的 研究浮針辅助甘露消毒丹加减对湿热蕴结型粉刺性乳痈患者炎症反应的影响。方法 将2019年3月至2020年3月在深圳市中医院就诊的湿热蕴结型粉刺性乳痈患者80例，按随机数字表法分为对照组和联合组，对照组38例给予甘露消毒丹加减进行治疗，联合组42例在对照组的基础上给予浮针进行治疗，两组患者均治疗4周。检测治疗前、治疗后2周、治疗后4周炎症反应指标[白介素-6（IL-6）、白介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）]、免疫球蛋白[IgA、IgG、IgM]水平以及肿块大小、疼痛评分、脓肿评分，比较治疗后4周临床疗效总有效率及并发症发生率，比较治疗后随访6个月（2020年3月至2020年9月）两组患者的复发率。结果 治疗后2周、4周，两组患者IL-6、IL-8、TNF-α、CRP、IgA、IgG、IgM水平及肿块大小、疼痛评分、脓肿评分均低于治疗前（P<0.05）;且联合组IL-6、IL-8、TNF-α、CRP、IgA、IgG、IgM水平及肿块大小、疼痛评分、脓肿评分低于对照组（P<0.05）;治疗后3个月，联合组临床疗效总有效率高于对照组（P<0.05）;随访6个月后，联合组复发率低于对照组（P<0.05）。结论 浮针辅助甘露消毒丹加减可促进患者病情恢复，减轻湿热蕴结型粉刺性乳痈患者炎症反应，改善患者免疫功能，降低复发率，效果显著。

〔关键词〕 粉刺性乳痈;湿热蕴结型;浮针;甘露消毒丹;炎症反应;免疫球蛋白

〔中图分类号〕R246.7      〔文献标志码〕B       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.07.013

〔Abstract〕 Objective To study the effect of modified Ganlu Xiaodu Micropills assisted by floating needle on inflammatory reaction in patients with acne breast carbuncle of damp-heat accumulation type. Methods 80 patients in Shenzhen Hospital from March 2019 to March 2020 with damp-heat accumulation acne breast carbuncle， patients were divided into control group and combined group acording to random number table method， 38 cases in the control group were treated with Ganlu Xiaodu Micropills， the combined group of 42 cases were given floating needle treatment on the basis of control group， patients in both groups were treated for 4 weeks. The levels of inflammatory response markers [interleukin-6 （IL-6）， interleukin-8 （IL-8）， tumor necrosis factor-α （TNF-α）， C-reactive protein （CRP）]， immunoglobulin [IgA， IgG， IgM]， lump size， pain score and abscess score were detected before treatment， 2 weeks and 4 weeks after treatment. The total effective rate and the incidence of complications were compared after 4 weeks of treatment， and the recurrence rate of patients in the two groups was compared after 6 months of follow-up （March 2020 to September 2020）. Results At 2 and 4 weeks after treatment， the levels of IL-6， IL-8， TNF-α， CRP， IgA， IgG， IgM， lump size， pain score and abscess score in 2 groups were lower than those before treatment （P<0.05）; the levels of IL-6， IL-8， TNF-α， CRP， IgA， IgG， IgM， lump size， pain score and abscess score in combined group were lower than those in control group （P<0.05）; 3 months after treatment， the total effective rate of combined group was higher than that of control group （P<0.05）; after 6 months follow-up， the recurrence rate of combined group was lower than that of control group （P<0.05）. Conclusion Floating needle assisted with modified Ganlu Xiaodu Micropills can promote the recovery of patients， relieve the inflammatory reaction of patients with damp-heat accumulation acne breast carbuncle， improve the immune function of patients， and reduce the recurrence rate， with remarkable effect.

〔Keywords〕 acne breast carbuncle; damp-heat accumulation; floating needle; Ganlu Xiaodu Micropills; inflammatory reaction; immunoglobulin

粉刺性乳痈是一种非细菌性乳腺化脓性疾病，主要分为普通乳腺炎、导管扩张、肉芽肿和脓肿[1-2]。该病的临床表现为乳头凹陷、溢液、乳房肿块、乳房疼痛，具有较高的复发率，严重影响女性身心健康[3-4]。粉刺性乳痈的主要发病机制为经络阻塞、气血阻滞、肝气失疏，临床治疗应以活血、解毒、消肿为原则。浮针具有改善血流和放松、修复患肌的作用，在皮下层进行扫散的同时，牵拉患者的疏松结缔组织，调动机体的抗病机制，进而缓解患者的疼痛[5]。甘露消毒丹来源于《温热经纬》一书，主要药物为滑石、茵陈、黄芩、石菖蒲、川贝、木通、藿香、射干、连翘、薄荷、白豆蔻，功效为清热解毒、利湿化浊[6]。……