利水化瘀方在乳头内陷矫正术后乳头组织肿胀中的应用研究(1)
[摘要]目的：评价自拟方剂利水化瘀方在乳头内陷矫正术后乳头组织肿胀中的应用效果。方法：将40例乳头内陷患者随机分为治疗组和对照组，每组20例，所有患者均采用去表皮双菱形皮瓣推进法行乳头内陷矫治术。治疗组于术后口服利水化瘀方，对照组口服抗生素。所有患者分别于术后2d、7d及30d对乳头直径进行测量，并同时行术区疼痛评分测量，从而对药物疗效进行评价。结果：治疗组术后2d、7d乳头直径变化数值明显低于对照组，差异有统计学意义(P<0.05)。术后2d、7d乳头疼痛测量评分明显低于对照组，差异有统计学意义(P<0.05)。结论：乳头内陷矫正术后口服利水化瘀方能明显降低乳头周围组织肿胀程度，缓解患者疼痛，降低乳头坏死风险，缩短术后肿胀消退时间。
[关键词]乳头内陷;去表皮双菱形皮瓣推进法;真皮瓣;中医药疗法;消肿;化瘀
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2020)12-0069-02
Application of Lishui Huayu Decoction in Nipple Swelling after Inverted Nipple Surgery
LIU Xiao-xia，HE Jian
(Department of Plastic Surgery，Wuxi Maternal and Child Health Hospital，Nanjing Medical University，Wuxi 214002，Jiangsu，China)
Abstract： Objective To evaluate the effect of Lishui Huayu Decoction on the nipple swelling after inverted nipple surgery. Methods Totally 40 cases were randomized to the treatment group and the control group， 20 cases in each group. All the patients were treated with bilateral rhomboid skin flap. The treatment group was treated with lishui Huayu Decoction， and the control group was treated with antibiotics. In order to evaluate the drug efficacy， the diameter of the nipple was measured in the 2nd， 7th and 30th day and recorded the pain score measurement. Results The change of nipple diameter was significantly lower than those of the control group on the 2nd and 7th day， and the pain score was significantly lower than the control group， the differences were statistically significant(P<0.05). Conclusion Taking Lishui Huayu Decoction can reduce the swelling degree of the nipple and reduce the risk of nipple necrosis， and shorten the time on the swelling after the nipple inversion-plasty.
Key words： inverted nipple; desquamated rhomboid flap advancement method; dermal flap; traditional Chinese medicine therapy; detumescence; removing blood stasis
乳頭内陷是目前临床较常见的女性乳房畸形，轻者乳头失去凸起，重者乳头外观缺失，完全陷于乳晕平面之下，不能用手挤出。凹陷的乳头内可积存污垢和油脂，造成痒疹或炎症，不能让婴儿吸吮乳汁，同时也会给患者带来心理上的压抑[1]。乳头内陷矫正术是目前解决重度乳头内陷的唯一方式，但由于乳头组织血管神经丰富，术后出血及组织水肿常会给患者带来严重的疼痛感及加重乳头坏死的风险。本次总结笔者科室2015年10月-2019年10月口服利水化瘀方治疗乳头内陷矫正术后组织肿胀的临床病例，现将结果报道如下：
1 资料和方法
1.1 一般资料：本组共40例，年龄25～45岁，平均35岁。选取Ⅱ～Ⅲ型病例。所有患者随机分为两组，每组20例。
1.2 乳头内陷分级标准：Ⅰ型：乳头部分内陷，通常没有明显乳头颈，能轻易用手挤出;Ⅱ型：乳头全部陷于乳晕之中，乳头没有颈部，用手可以挤出;Ⅲ型：乳头完全埋于乳晕下，无法使内陷乳头挤出[1]。
1.3 治疗方法：手术均采用去表皮双菱形皮瓣推进法，术中于乳头根部留有悬吊丝线，术后7d拆线时行乳头悬吊，术后30d拆除悬吊器。治疗组于术后口服利水化瘀方，每日早晚饭后服用，持续7d，对照组于术后口服抗生素3d。利水化瘀方组成：茯苓18g，泽泻10g，牡丹皮10g，赤芍8g，当归10g，白术15g，甘草5g。制剂均由江阴天江药业有限公司提供。, http://www.100md.com(刘晓夏 何俭)
[关键词]乳头内陷;去表皮双菱形皮瓣推进法;真皮瓣;中医药疗法;消肿;化瘀
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2020)12-0069-02
Application of Lishui Huayu Decoction in Nipple Swelling after Inverted Nipple Surgery
LIU Xiao-xia，HE Jian
(Department of Plastic Surgery，Wuxi Maternal and Child Health Hospital，Nanjing Medical University，Wuxi 214002，Jiangsu，China)
Abstract： Objective To evaluate the effect of Lishui Huayu Decoction on the nipple swelling after inverted nipple surgery. Methods Totally 40 cases were randomized to the treatment group and the control group， 20 cases in each group. All the patients were treated with bilateral rhomboid skin flap. The treatment group was treated with lishui Huayu Decoction， and the control group was treated with antibiotics. In order to evaluate the drug efficacy， the diameter of the nipple was measured in the 2nd， 7th and 30th day and recorded the pain score measurement. Results The change of nipple diameter was significantly lower than those of the control group on the 2nd and 7th day， and the pain score was significantly lower than the control group， the differences were statistically significant(P<0.05). Conclusion Taking Lishui Huayu Decoction can reduce the swelling degree of the nipple and reduce the risk of nipple necrosis， and shorten the time on the swelling after the nipple inversion-plasty.
Key words： inverted nipple; desquamated rhomboid flap advancement method; dermal flap; traditional Chinese medicine therapy; detumescence; removing blood stasis
乳頭内陷是目前临床较常见的女性乳房畸形，轻者乳头失去凸起，重者乳头外观缺失，完全陷于乳晕平面之下，不能用手挤出。凹陷的乳头内可积存污垢和油脂，造成痒疹或炎症，不能让婴儿吸吮乳汁，同时也会给患者带来心理上的压抑[1]。乳头内陷矫正术是目前解决重度乳头内陷的唯一方式，但由于乳头组织血管神经丰富，术后出血及组织水肿常会给患者带来严重的疼痛感及加重乳头坏死的风险。本次总结笔者科室2015年10月-2019年10月口服利水化瘀方治疗乳头内陷矫正术后组织肿胀的临床病例，现将结果报道如下：
1 资料和方法
1.1 一般资料：本组共40例，年龄25～45岁，平均35岁。选取Ⅱ～Ⅲ型病例。所有患者随机分为两组，每组20例。
1.2 乳头内陷分级标准：Ⅰ型：乳头部分内陷，通常没有明显乳头颈，能轻易用手挤出;Ⅱ型：乳头全部陷于乳晕之中，乳头没有颈部，用手可以挤出;Ⅲ型：乳头完全埋于乳晕下，无法使内陷乳头挤出[1]。
1.3 治疗方法：手术均采用去表皮双菱形皮瓣推进法，术中于乳头根部留有悬吊丝线，术后7d拆线时行乳头悬吊，术后30d拆除悬吊器。治疗组于术后口服利水化瘀方，每日早晚饭后服用，持续7d，对照组于术后口服抗生素3d。利水化瘀方组成：茯苓18g，泽泻10g，牡丹皮10g，赤芍8g，当归10g，白术15g，甘草5g。制剂均由江阴天江药业有限公司提供。, http://www.100md.com(刘晓夏 何俭)