王婷　王永悦　王鸿林　高原　吕钢

【摘 要】 目的：系统评价中医药治疗肉芽肿性乳腺炎（GLM）的临床疗效及安全性。方法：检索建库至今发表于CNKI、VIP、CBM及PubMed数据库中关于中医药治疗GLM的期刊文献，文献类型限于临床随机对照试验（RCT）。应用Meta分析方法的纳入、排除标准进行严格筛选，对纳入文献进行定量综合分析。结果：共纳入文献12篇，包括864例GLM患者，其中治疗组443例，对照组421例。Meta分析显示，中医药治疗GLM的总有效率高于西医治疗[OR=3.11，95%CI（1.92，5.03），Z=4.63，P<0.00001]，同样在乳房优良率上比西医治疗有优势（P<0.05），而毒副反应、复发率两组间无统计学差异（P>0.05）。结论：中医药治疗GLM有较大的优势;现阶段研究文献可能欠严谨，需要更多高质量的临床随机对照文献。

【关键词】 肉芽肿性乳腺炎;中医药治疗;Meta分析

【中图分类号】R655.8 【文献标志码】 A【文章编号】1007-8517（2022）14-0114-05

Meta-analysis of Traditional Chinese Medicine in the Treatment of Granulomatous Mastitis

WANG Ting WANG Yongyue WANG Honglin GAO Yuan LYU Gang^*

Chongqing Hospital of Traditional Chinese Medicine，Chongqing 400021， China

Abstract：To evaluate the clinical effect and safety of Traditional Chinese medicine（TCM）therapy for granulomatous mastitis（GLM）.Methods The CNKI， WanFang，VIP and PubMed databases were searched by computer to find randomized controlled trials （RCTs） on the treatment of GLM with traditional Chinese and western medicine.They were strictly screened according to the inclusion and exclusion criteria of Meta analysis.A comprehensive and quantitative analysis of the literature was made.Results  There are 864 cases of granulomatous mastitis in a11 12 documents，of which 443 cases in treatment group and 421 cases in control group.The Meta-analysis showed that the total effective rate of TCM treatment group Was significantly higher than that of the Western medicine control group[OR=3.11，95%CI（1.92，5.03），Z=4.63，P<0.00001].At the same time，TCM treatment is more effective than Western medicine treatment in the rate of breast excellence（P<0.05）.And yet there was no significant difference in toxicity and recurrence rate between the two groups（P>0.05）.Conclusion TCM for GLM has a few higher advantages.And the current research literature may be not strict.We need more high quality RCTs research papers.

Key words：Granulomatous Mastitis;Traditional Chinese Medicine Treatment;Meta-analysis

肉芽腫性乳腺炎（granulomatous mastitis，GLM）是一种病因病机尚未明确的以终末导管小叶单位为中心的慢性化脓性肉芽肿性病变^[1]。本病临床反应无征兆，乳腺彩超、钼靶及核磁检查缺乏特异性，确诊依赖组织病理学。在世界范围内GLM 的发病呈散发状，国外报道的病例较多出自中东地中海国家（土耳其）及美国、英国和法国等欧美国家^[2]。国内既往报道发病率低，近几年临床发现及报道的病例逐年增多。因本病的病因病机不明，故治疗方法多样。西医通常认为手术、抗生素和类固醇激素的应用是治疗本病的关键。目前国内有部分专家应用单纯保守治疗的方法，如中医药内服外治等，或许会在外形、治疗毒副作用以及保留乳房哺乳功能等方面有一定的优势^[3]，但缺乏对于中医药治疗GLM疗效的系统评价，笔者对中医药治疗GLM的相关临床研究进行系统评价，总结分析如下。……