针刺联合推拿及中药外敷治疗哺乳期乳腺炎患者的疗效观察

Clinical Effect of Acupuncture Combined with Massage and External A pplication of Traditional Chinese Medicine on Lactating Mastitis and Its Effect on Symptom Score

目的 探讨针刺联合推拿及中药外敷治疗哺乳期乳腺炎患者的临床疗效。方法 选取2021年3月—2022年12月期间唐山市妇幼保健院收治的哺乳期乳腺炎患者120例,按就诊顺序采用单纯随机抽样法分为对照组和治疗组,每组各60例。对照组给予常规西医治疗,治疗组针刺联合推拿及中药外敷,5 d为1个疗程,两组患者治疗2个疗程。观察比较两组患者临床疗效、不良反应情况及治疗前后乳房局部症状积分、临床症状改善情况、炎性因子[C反应蛋白(C-reactive protein, CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白介素-6(Interleukin-6,IL-6)]、血常规[白细胞计数(White Blood Cell, WBC)、红细胞沉降率(Erythrocyte sedimentation rate, ESR)、中性粒细胞百分比(Neutrophil ratio, NE%)]。结果 治疗后治疗组临床总有效率96.67%(58/60)明显高于对照组83.33%(50/60),差异有统计学意义(P<0.05)。治疗后两组患者乳房肿痛、红肿面积及乳汁分泌等症状积分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组乳房肿痛、红肿面积及乳汁分泌等症状积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后治疗组体温恢复时间、乳房肿痛消失时间及通乳时间均优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者炎性因子CRP、TNF-α及IL-6水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组炎性因子CRP、TNF-α及IL-6水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血常规WBC、ESR及NE%值均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血常规WBC、ESR及NE%值均明显低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者均无严重不良反应发生,对照组仅出现轻微头晕、恶心,未进行特殊处理,均自行缓解,后续治疗过程中未出现。结论 针刺联合推拿及中药外敷治疗哺乳期乳腺炎患者效果显著,可降低患者临床症状积分,改善炎性反应,促进血常规指标恢复。

Objective To evaluate the effectiveness of acupuncture combined with massage and external application of Chinese herbal medicine in the treatment of lactating mastitis and its impact on traditional Chinese medicine(TCM)symptom scores.Methods A total of 120 patients with lactation mastitis admitted to Tangshan Maternal and Child Health Hospital from March 2021 to December 2022 were selected and divided into a control group and a treatment group using a simple random sampling method,with 60 in each group.The control group received conventional Western medical treatment,while the treatment group was given acupuncture combined with massage and external application of Chinese herbal medicine.Patients were treated for two courses,5 days as one course.This paper compared the clinical efficacy,adverse reactions,local breast symptom scores,improvement of clinical symptoms,and inflammatory markers[C-reactive protein(CRP),tumor necrosis factor-alpha(TNF-α),and interleukin-6(IL-6)],hematological parameters[white blood cell count(WBC),erythrocyte sedimentation rate(ESR),and neutrophil ratio(NE%)]before and after treatment between the two groups.Results After treatment,the total effective rate in the treatment group was 96.67%(58/60),higher than 83.33%(50/60)of the control group(P<0.05).Symptoms such as breast tenderness,swelling,and milk secretion improved in both groups,with the treatment group presenting lower symptom scores than the control group(P<0.05).The treatment group also had shorter durations for body temperature normalization,resolution of breast swelling and pain,and milk flow restoration compared with the control group(P<0.05).Inflammatory markers CRP,TNF-α,and IL-6 were reduced in both groups after treatment,with the treatment group exhibiting lower levels than the control group(P<0.05).Similarly,WBC,ESR,and NE%decreased in both groups,with the treatment group having lower values than the control group(P<0.05).No serious adverse reactions were reported in either group,with only minor dizziness and nausea observed in the control group,which resolved without intervention and did not recur during subsequent treatment.Conclusion Acupuncture combined with massage and external application of Chinese herbal medicine is significantly effective in treating patients with lactating mastitis.It can reduce clinical symptom scores,improve inflammatory responses,and promote the recovery of hematological parameters.