Effect of traditional Chinese medicine Qihua San local Ta treatment for hematomas and pain degree of local applied after ultrasound-guided minimally invasive rotary mastectomy
-
摘要:
目的 探讨超声引导下乳腺微创旋切术后采用中药七花散局部溻法治疗对患者血肿和疼痛程度的治疗效果。 方法 选取2019年1月~2022年1月本院收治的行超声引导下乳腺微创旋切术后血肿的患者118例，按随机数字表法将患者分为观察组和对照组，59例/组。对照组采用常规西药治疗，观察组在此基础上则使用中药七花散局部溻法治疗，观察治疗后对患者血肿和疼痛程度的影响。 结果 观察组患者血肿、疼痛消退时间均短于对照组（P < 0.05）；治疗后不同时间的视觉模拟评分（VAS）的差异有统计学意义（P < 0.05），观察组与对照组比较，VAS评分较低（P < 0.05），观察组与对照组的VAS评分变化趋势差异有统计学意义（P < 0.05）；观察组患者肿瘤坏死因子-α、白介素-6、前列腺素E2、P物质水平低于对照组（P < 0.05）；观察组患者日常生活能力量表评分高于对照组（P < 0.05），匹兹堡睡眠质量指数评分低于对照组（P < 0.05）。 结论 中药七花散局部溻法治疗对超声引导下乳腺微创旋切术后患者能降低机体炎性因子和疼痛因子水平，促进血肿和疼痛的快速消退，提高术后睡眠质量和日常生活能力。 Abstract:Objective To investigate the effect of local area Ta treatment applied with Qihua San on hematoma and pain degree after ultrasound-guided minimally invasive rotary mastectomy. Methods According to the random number table method, 118 cases of patients with ultrasound-guided minimally invasive mastectomy treated in our hospital from January 2019 to January 2022 were divided into observation group and control group, with 59 cases in each group. The control group was treated with conventional western medicine, and the observation group was local applied with Qihua San Ta treatment on the basis of conventional western medicine. We analyzed the effect of treatment on the degree of hematoma and pain. Results The time of hematoma and pain resolution in observation group was significantly shorter than that in control group (P < 0.05). The visual analog scale (VAS) score was different at different time after treatment (P < 0.05), the VAS score of the observation group was lower than that of the control group (P < 0.05), and the variation trend of VAS score was different between the observation group and the control group (P < 0.05). The levels of TNF-α, IL-6, PGE2 and substance P in observation group were significantly lower than those in control group (P < 0.05). The ADL score in observation group was significantly higher than that in control group (P < 0.05), and the PSQI score was significantly lower than that in control group (P < 0.05). Conclusion Traditional Chinese medicine Qihua San local Ta treatment for ultrasound guided minimally invasive rotary mastectomy patients can reduce the levels of inflammatory factors and pain factors, promote the rapid subside of hematoma and pain, and improve the postoperative sleep quality and the ability of daily living. -
表 1 两组患者症状消退时间比较
Table 1. Comparison of symptom resolution time between the two groups (d, n=59, Mean±SD)
组别 血肿消退时间 疼痛消退时间 观察组 5.12±0.92 4.87±1.03 对照组 6.04±0.87 5.68±1.15 t 5.581 4.030 P ＜0.001 ＜0.001 
下载: 导出CSV
表 2 两组患者疼痛程度（VAS评分）比较
Table 2. Comparison of pain degree (VAS score) between the two groups (scores, n=59, Mean±SD)
组别 治疗前 治疗3 d 治疗7 d 观察组 5.06±1.02 3.27±0.75 0.87±0.21 对照组 4.96±0.96 3.76±0.81 1.15±0.32 F时间，P时间 F=869.300，P＜0.001 F组间，P组间 F=7.960，P=0.005 F交互，P交互 F=4.758，P=0.009
下载: 导出CSV
表 3 两组患者炎性因子水平比较
Table 3. Comparison of inflammatory factors between the two groups (n=59, pg/mL, Mean±SD)
组别 TNF-α IL-6 治疗前 治疗后 治疗前 治疗后 观察组 29.75±5.28 13.33±4.26* 77.64±8.59 36.48±6.28* 对照组 30.14±4.86 15.87±4.31* 77.17±7.82 41.36±6.52* t 0.417 3.219 0.311 4.141 P 0.677 0.002 0.757 ＜0.001 *P＜0.05 vs同组治疗前. TNF-α: 肿瘤坏死因子-α; IL-6: 白介素-6.
下载: 导出CSV
表 4 两组患者疼痛因子水平比较
Table 4. Comparison of pain factor levels between the two groups (n=59, Mean±SD)
组别 PGE2（pg/mL） SP（ng/mL） 治疗前 治疗后 治疗前 治疗后 观察组 153.28±32.74 87.26±16.21* 35.41±8.27 15.42±3.22* 对照组 150.68±33.77 95.48±21.32* 36.12±7.36 19.57±4.38* t 0.425 2.357 0.493 5.864 P 0.672 0.020 0.623 ＜0.001 *P＜0.05 vs同组治疗前. PGE2: 前列腺素E2; SP: P物质.
下载: 导出CSV
表 5 两组患者ADL与PSQI评分比较
Table 5. Comparison of ADL and PSQI scores between the two groups (score, n=59, Mean±SD)
组别 ADL PSQI 治疗前 治疗后 治疗前 治疗后 观察组 73.84±8.27 87.48±6.27* 14.36±3.03 6.21±2.31* 对照组 74.22±7.54 82.45±6.82* 14.18±3.12 8.42±2.57* t 0.261 4.170 0.318 4.912 P 0.795 ＜0.001 0.751 ＜0.001 *P＜0.05 vs同组治疗前. ADL: 日常生活能力量表; PSQI: 匹兹堡睡眠质量指数.
下载: 导出CSV
-
[1] Tay TKY, Tan PH. Papillary neoplasms of the breast-reviewing the spectrum[J]. Mod Pathol, 2021, 34(6): 1044-61. doi: 10.1038/s41379-020-00732-3 [2] Gao YH, Liu B, Zhu Y, et al. Detection and recognition of ultrasound breast nodules based on semi-supervised dep learning: a powerful alternative strategy[J]. Quant Imaging Med Surg, 2021, 11(6): 2265-78. doi: 10.21037/qims-20-12B [3] Gao YH, Zhu SC, Xu Y, et al. Clinical value of ultrasound-guided minimally invasive biopsy in the diagnosis or treatment of breast nodules[J]. Cancer Manag Res, 2020, 12: 13215-22. doi: 10.2147/CMAR.S281605 [4] 钱宇峰, 童东明, 昌莉莉. 乳腺微创旋切术与传统开放术治疗乳腺良性肿块术中情况、术后疼痛、瘢痕及并发症的对比分析[J]. 中国妇幼保健, 2018, 33(5): 1170-2. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201805071.htm [5] 王勇, 董江萌, 贾巍. 微创旋切术联合西黄丸治疗急性脓肿型乳腺炎对术后创面恢复、切口感染及乳晕血肿的影响[J]. 现代中西医结合杂志, 2019, 28(35): 3919-23. doi: 10.3969/j.issn.1008-8849.2019.35.011 [6] 沈亚琴. 乳腺良性肿瘤超声引导下微创旋切术围手术期护理[J]. 中国基层医药, 2019, 26(16): 2038-40. doi: 10.3760/cma.j.issn.1008－6706.2019.16.031 [7] 李铁, 贾彩玲, 卓睿. 乳腺微创旋切术中灌注三七总皂苷预防术后乳腺血肿及皮肤瘀斑的临床研究[J]. 广西医学, 2017, 39(3): 345-6, 353. https://www.cnki.com.cn/Article/CJFDTOTAL-GYYX201703017.htm [8] 赵玉沛, 陈孝平. 外科学[M]. 3版. 北京: 人民卫生出版社, 2015. [9] Gassman AA, Yoon AP, Festekjian J, et al. Comparison of immediate postoperative pain in implant-based breast reconstructions[J]. J Plast Reconstr Aesthetic Surg, 2016, 69(5): 604-16. doi: 10.1016/j.bjps.2015.12.009 [10] O'Toole JA, Ferguson CM, Swaroop MN, et al. The impact of breast cancer-related lymphedema on the ability to perform upper extremity activities of daily living[J]. Breast Cancer Res Treat, 2015, 150(2): 381-8. doi: 10.1007/s10549-015-3325-3 [11] Reinsel RA, Starr TD, O'Sullivan B, et al. Polysomnographic study of sleep in survivors of breast cancer[J]. J Clin Sleep Med, 2015, 11 (12): 1361-70. doi: 10.5664/jcsm.5264 [12] Xue XW, Li JL, Wan WB, et al. Molecular mechanisms of breast nodule stiffness[J]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao, 2018, 40(2): 279-83. [13] Layfield L. A Bethesda-like system for breast cytopathology: a retrospective assessment two decades on[J]. Diagn Cytopathol, 2020, 48: 870-6. [14] Li JM, Bu YY, Lu SQ, et al. Development of a deep learning-based model for diagnosing breast nodules with ultrasound[J]. J Ultrasound Med, 2021, 40(3): 513-20. doi: 10.1002/jum.15427 [15] 徐瑶, 刘永花, 王姝, 等. 联合湿敷法在桡动脉介入术后前臂血肿中的应用效果[J]. 中华现代护理杂志, 2018, 24(29): 3574-6. doi: 10.3760/cma.j.issn.1674-2907.2018.29.023 [16] 徐曼, 周琼荣, 谭莲, 等. 水胶体敷料联合湿热敷对动静脉内瘘穿刺后血肿的影响[J]. 中国医药导报, 2020, 17(16): 90-3. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202016024.htm [17] 龙杰, 黄彩云. 加味三黄散外敷联合红外线照射治疗经皮冠状动脉介入治疗术后术肢血肿的临床疗效[J]. 实用心脑肺血管病杂志, 2018, 26(S1): 237-40. [18] 刘凤春, 宋晓萌, 孟茜, 等. 中药外敷方治疗脑血管造影介入术后皮下血肿、瘀斑的疗效观察[J]. 中西医结合心脑血管病杂志, 2022, 20 (11): 2105-8. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYY202211043.htm [19] Chen Y, Li MF, Wen JY, et al. Pharmacological activities of safflower yellow and its clinical applications[J]. Evid Based Complementary Altern Med, 2022, 2022: 2108557. [20] Delshad E, Yousefi M, Sasannezhad P, et al. Medical uses of Carthamus tinctorius L. (Safflower): a comprehensive review from Traditional Medicine to Modern Medicine[J]. Electron Physician, 2018, 10(4): 6672-81. [21] 杨炀, 税丕先, 陈滟, 等. 中药大黄在临床应用中的功效以及对其药理作用[J]. 基因组学与应用生物学, 2017, 36(3): 1226-31. https://www.cnki.com.cn/Article/CJFDTOTAL-GXNB201703058.htm [22] 李芊, 吴效科. 川芎化学成分及药理作用研究新进展[J]. 化学工程师, 2020, 34(1): 62-4, 44. https://www.cnki.com.cn/Article/CJFDTOTAL-HXGC202001017.htm [23] Chen ZJ, Zhang C, Gao F, et al. A systematic review on the rhizome of Ligusticum chuanxiong Hort. (Chuanxiong)[J]. Food Chem Toxicol, 2018, 119: 309-25. -
点击查看大图
图(2) / 表(5)
计量
- 文章访问数: 212
- HTML全文浏览量: 111
- PDF下载量: 2
- 被引次数: 0
