基于真实世界数据的肉芽肿性小叶性乳腺炎中医证型与炎症活动性指标的相关性分析

任英楠1; 孙庆颖2; 张梦棣1; 梁爽1; 李昊钰1; 李静蔚

文章摘要

任英楠1，孙庆颖2，张梦棣1，梁爽1，李昊钰1，李静蔚.基于真实世界数据的肉芽肿性小叶性乳腺炎中医证型与炎症活动性指标的相关性分析[J].中医药信息,2025,42(4):60-64

基于真实世界数据的肉芽肿性小叶性乳腺炎中医证型与炎症活动性指标的相关性分析

Correlation Analysis Between TCM Syndromes and Inflammatory Activity Indicators of Granulomatous Lobular Mastitis Based on Real－World Data

投稿时间：2024-08-26 录用日期：2024-10-09

DOI：10.19656/j.cnki.1002-2406.20250411

中文关键词: 真实世界数据肉芽肿性小叶性乳腺炎中医证型炎症活动度

英文关键词: Real－world data Granulomatous lobular mastitis TCM Syndrome Inflammatory activity

基金项目:济南市临床医学科技创新计划（202134004）山东省自然科学基金中医药联合基金（ ZR2022LZY019）济南市科技局项目（202225003）山东省中医药科技项目（Z-2023002T）

作者	单位
任英楠1，孙庆颖2，张梦棣1，梁爽1，李昊钰1，李静蔚

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中文摘要:

目的：基于2017—2023年真实世界数据，探讨肉芽肿性小叶性乳腺炎（GLM）中医证型与炎症活动性指标的相关性。方法：选择744例GLM患者作为研究对象，根据临证表现分为肝经郁热型、热毒炽盛型和正虚邪滞型3种；收集患者的临床中医症状表现，采用肉芽肿性乳腺炎疾病活动指数（GMDAI）进行炎性活动度评估，结合红细胞沉降率（ESR）、C反应蛋白（CRP）、白细胞计数（WBC）、中性粒细胞百分比（NEUT%）等外周血数据，运用Spearman法进行证型与炎症活动性指标的相关性分析。结果：低活动度皆为肝经郁热型，中高活动度以热毒炽盛型为主，其次为正虚邪滞型（P < 0.05）；热毒炽盛型ESR、CRP、WBC水平明显高于其他两种证型（P < 0.05），热毒炽盛型和正虚邪滞型的NEUT%水平略高于肝经郁热型（P < 0.05）；ESR、CRP、WBC、NEUT%水平与GMDAI评分皆呈正相关（r = 0.319，0.414，0.230，0.264，P < 0.05），随着GMDAI评分升高而升高。结论：炎症活动性指标水平可客观反映GLM的中医证型变化，其中CRP水平最具有代表性，且这些指标在辨别热毒炽盛型GLM中意义最大，可为中医证候的鉴别提供客观参考依据。

英文摘要:

Objective： Based on real－world data from 2017 to 2023， this study aimed to investigate the correlation between Traditional Chinese Medicine （TCM） syndromes and inflammatory activity indicators in granulomatous lobular mastitis （GLM）. Methods： A total of 744 GLM patients were enrolled and classified into three syndromes： liver meridian depression and heat type， excessive heat toxin type， and deficiency with stagnation type. Clinical TCM symptoms were collected， and inflammatory activity was assessed using the Granulomatous Mastitis Disease Activity Index （GMDAI）， along with peripheral blood markers such as erythrocyte sedimentation rate （ESR）， C－reactive protein （CRP）， white blood cell count （WBC）， and neutrophil percentage （NEUT%）. The correlation between syndromes and inflammatory activity indicators was analyzed using the Spearman method. Results： Patients with low activity levels predominantly exhibited the liver meridian depression and heat type， while moderate－to－high activity levels were primarily observed in the excessive heat toxin type， followed by the deficiency with stagnation type （P < 0.05）. ESR， CRP， and WBC levels were significantly higher in the excessive heat toxin type compared to the other two syndromes （P < 0.05）. NEUT% levels in the excessive heat toxin and deficiency with stagnation types were slightly higher than those in the liver meridian depression and heat type （P < 0.05）. ESR， CRP， WBC， and NEUT% levels were positively correlated with GMDAI scores （r = 0.319， 0.414， 0.230， 0.264， P < 0.05）， increasing with higher GMDAI scores. Conclusion： Inflammatory activity indicators can objectively reflect the changes in TCM syndromes of GLM， with CRP being the most representative. These indicators are particularly significant in distinguishing the excessive heat toxin type of GLM， providing objective reference data for TCM syndrome differentiation.

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