Abstract:

Objective　To investigate the ultrasonographic characteristics of granulomatous mastitis and to evaluate the efficacy of Neituo Shengji San for patients with late-stage ulcerative granulomatous mastitis. Methods　A retrospective analysis was conducted on the clinical data of 20 patients with late-stage ulcerative granulomatous mastitis treated at Guangdong Provincial Maternal and Child Health Hospital from January 2021 to January 2024. They were 27-40 years old. All the patients were treated with Neituo Shengji San. They were examined by ultrasound before and after the treatment, and the lesion conditions were recorded in detail. The ultrasound characteristics of granulomatous mastitis were analyzed. The clinical efficacy was evaluated by ultrasound. The patients were followed up for 0.5-6.0 months to observe the recurrence or aggravation. Paired t test was used for the statistical comparison. Results　The main ultrasound findings of granulomatous were nodule type, sheet hypoecho type, and diffuse type. After the treatment, 2 were cured; 7 were obviously effective; 8 were improved; 3 were ineffective. The diameter before the treatment was 31.50 (21.50, 42.75) mm; the diameter after the treatment was 10.50 (7.25, 17.50) mm; there was a statistical difference (Z=-2.960; P=0.003). The patients were followed up 2.6 months averagely, and no recurrence or aggravation occurred. Conclusions　In the ulcerative phase, it is crucial to regulate and supplement qi and blood to support detoxification and muscle regeneration. Neituo Shengji San is the main formula for granulomatous mastitis in the ulcerative phase, focusing on the substantial replenishment of qi and blood, and promoting the transformation of decay into muscle, thereby shortening the treatment course for patients with granulomatous mastitis, improving therapeutic efficacy, reducing recurrence. It is a clinically minimally invasive treatment plan that can preserve the appearance and is effective.

Key words:

Ultrasound, Granulomatous mastitis, Neituo Shengji San, Efficacy

摘要：

目的　探讨溃后期肉芽肿性乳腺炎（GM）的影像学特点及内托生肌法治疗溃后期GM的疗效。方法　回顾性分析，选取2021年1月至2024年1月在广东省妇幼保健院门诊就诊符合溃后期GM患者20例，年龄27～40岁，均接受内托生肌散治疗。受试者于治疗前及治疗后进行超声检查，详细记录病灶情况，分析GM的超声影像学特点，并通过超声评价内托生肌散治疗溃后期GM的临床疗效，随访0.5～6个月观察复发或加重情况。统计学方法采用非参数检验。结果　GM的超声影像学主要表现为结节型、片状低回声型、弥漫型3种声像图特征。20例溃后期GM患者经过治疗后，痊愈2例、显效7例、好转8例、无效3例。治疗前，溃后期GM患者病灶长径为31.5（21.50，42.75）mm，高于治疗后的10.50（7.25，17.50）mm，差异有统计学意义（Z=-2.960，P=0.003）。平均随访2.6个月，未出现复发或加重。结论　溃后期乳腺炎的治疗重在调补气血、托毒生肌。内托生肌散为主方治疗溃后期GM，可以大补气血，化腐生肌，缩短GM患者疗程，提高疗效，降低复发，是一种上创伤小、能保留乳房外形且有效的治疗方案。

关键词:

超声, 肉芽肿性乳腺炎, 内托生肌, 疗效