目的 探究曲安奈德聯(lián)合潑尼松治療肉芽腫性乳腺炎臨床療效。方法 選取2022年10月—2023年12月欽州市婦幼保健院收治的112例肉芽腫性乳腺炎女性患者，通過隨機數(shù)字表法分為對照組（56例）和治療組（56例）。對照組口服醋酸潑尼松片，從30 mg/d潑尼松開始以獲得初始疾病控制，第1個月減量至20 mg/d，第2個月減量至10 mg/d，半個月減量至5 mg/d，直到治療結(jié)束完全停藥以防止癥狀反彈，治療時間為3個月。治療組在對照組基礎上于病變中心注射醋酸曲安奈德注射液，每月注射1次20 mg/cm³，持續(xù)3個月。觀察兩組患者臨床療效，比較治療前后兩組患者乳房腫塊大小及疼痛評分，及泌乳素（PRL）、腫瘤壞死因子-α（TNF-α）、C反應蛋白（CRP）、CD3^＋、CD4^＋、CD4^＋/CD8^＋、免疫球蛋白G（IgG）、IgM和IgA水平。結(jié)果 治療后，治療組患者總有效率為92.86%，顯著高于對照組的75.00%（P＜0.05）。治療后，兩組腫塊大小、疼痛評分均下降（P＜0.05），且治療組顯著低于對照組（P＜0.05）。治療后，兩組患者PRL、TNF-α、CRP、CD3^＋、CD4^＋、CD4^＋/CD8^＋、IgG、IgM、IgA水平均顯著下降（P＜0.05），且治療組這些指標較對照組降低更明顯（P＜0.05）。結(jié)論 潑尼松聯(lián)合曲安奈德治療肉芽腫性乳腺炎患者有較好的臨床療效，能夠縮小腫塊大小，減輕疼痛，顯著減輕患者炎癥反應，抑制過度免疫應答，平衡患者免疫功能。

Objective To investigate the efficacy of triamcinolone combined with prednisone in treatment of granulomatous mastitis. Methods Patients (112 cases) with granulomatous mastitis in Qinzhou Maternal and Child Health Hospital from October 2022 to December 2023 were divided into control (56 cases) and treatment (56 cases) group by random number table method. Patients in control group were po administered with Prednisone Acetate Tablets, starting with 30 mg/d prednisone to achieve initial disease control, the dose was reduced to 20 mg/d in the first month, to 10 mg/d in the second month, and to 5 mg/d in the half month until the end of treatment was completely discontinued to prevent symptoms from rebounding. The treatment period was 3 months. Patients in treatment group were iv administered with Triamcinolone Acetonide Acetate Injection into the center of the lesion on the basis of the control group for 3 months, 20 mg/cm³, once a month. After treatment, the clinical evaluations were evaluated, the breast lump size and pain scores, the levels of PRL, TNF-α, CRP, CD3^＋, CD4^＋, CD4^＋/CD8^＋, IgG, IgM and IgA in two groups before and after treatment were compared. Results After treatment, the total effective rate of patients in the treatment group was 92.86%, which was significantly higher than 75.00% in the control group (P < 0.05). After treatment, the mass size and pain scores were decreased in two groups (P < 0.05), and which in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the levels of PRL, TNF-α, CRP, CD3⁺, CD4⁺, CD4⁺/CD8⁺, IgG, IgM, and IgA in two groups were significantly decreased (P < 0.05), and these indicators in the treatment group were decreased more significantly than in the control group (P < 0.05). Conclusion The combination of prednisone and triamcinolone acetonide has good efficacy in treating granulomatous mastitis, which can reduce the size of the tumor, alleviate pain, obviously reduce the inflammatory response of patients, inhibit excessive immune response, balance the immune function.

R984

欽州市科學研究與技術(shù)開發(fā)項目（20231913）