摘要
目的:观察针刺联合中药热奄包辅助治疗急性肿块期浆细胞性乳腺炎的疗效及对Ras同源基因家族成员A(Ras homologous gene A,RhoA)/Rho激酶(Rho associated Kinase,ROCK)通路的影响。方法:90例患者随机分为两组,每组45例。对照组第1 w给予注射用头孢呋辛钠联合甲硝唑氯化钠注射液,第2 w口服头孢呋辛酯片;观察组在对照组基础上给予针刺联合中药热奄包。疗程2 w。治疗前,治疗2 w、4 w分别观察两组乳房症状(乳房疼痛、肿块面积、皮肤红肿);治疗前后采用酶联免疫法检测血清肿瘤坏死因子-α(Tumor necrosis factor,TNF-α)、白介素(interleukin,IL)-6、C反应蛋白(C-reactive protein,CRP),采用酶联免疫法检测血清及乳房组织液中RhoA、ROCK I和ROCK II的含量。观察两组疗效,不良反应及随访3 m复发率。结果:观察组总有效率97.7%,较对照组的76.2%高(P<0.05)。观察组复发率2.3%,较对照组的34.4%低(P<0.05)。治疗后与对照组比较,观察组乳房疼痛、皮肤红肿积分降低(P<0.05),肿块面积缩小(P<0.05),TNF-α、IL-6、CRP、RhoA、ROCK I和ROCK Ⅱ含量下降(P<0.05)。结论:针刺联合中药热奄包辅助可明显缓解急性肿块期浆细胞性乳腺炎患者的乳房疼痛、肿块面积、皮肤红肿等症状,其作用机制可能与调节RhoA/ROCK通路有关。
Objective:To observe the effect of acupuncture combined with Chinese medicine hot election bag on acute mass stage plasma cell mastitis and its effect on Ras homologous gene A(RhoA)/Rho associated kinase(ROCK)pathway.Methods:90 patients were randomly divided into 2 groups,45 cases in each group.The control group was given cefuroxime sodium for injection combined with metronidazole sodium chloride injection at the first week,and cefuroxime axetil tablet at the second week.Observation group was given acupuncture combined with Chinese medicine hot election bag based on control group for 2 weeks.Before treatment,treatment for 2 weeks,4 weeks,breast symptoms(breast pain,lump area,skin redness and swelling)were observed in the two groups.The serum tumor necrosis factor-α(TNF-α),interleukin(IL-6),C-reactive protein(CRP)was detected by enzyme-linked immunoassay before and after treatment.The RhoA,ROCK I and ROCK II in serum and breast tissue fluid were determined by enzyme-linked immunosorbent assay.The serum and breast tissue(RhoA,ROCK I and ROCK II)were detected by Protein quantitative assay before and after treatment.The clinical efficacy,adverse reactions,and recurrence rate of 3 months follow-up was observed.Results:The total effective rate was 97.7% in the observation group higher than that 76.2% in the control group(P<0.05).The recurrence rate was 2.3% in observation group higher than that 34.4% in control group(P<0.05).Compared with the control group after treatment,breast pain,lump area,skin swelling,TNF-α,IL-6,CRP,RhoA,ROCK I and ROCK Ⅱ were decreased in the observation group(P<0.05).Conclusion:Acupuncture combined with Chinese medicine hot election bag can significantly relieve the symptoms of breast pain,mass area,skin redness and swelling in patients with acute mass stage plasma cell mastitis,and the mechanism may be related to the regulation of RhoA/ROCK pathway.
作者
赵莉
栗粟
Zhao Li;Li Su(Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou 450002,China)
基金
河南省中医药科学研究专项课题(2022ZY1081)。
