乳宁颗粒联合按摩疏通法治疗肝郁气滞型急性哺乳期乳腺炎临床研究

Clinical Study on Treatment of Liver-Qi Stagnation Type of Acute Mastitis During Lactation by Runing Granule(乳宁颗粒)and Tuina Therapy

目的观察乳宁颗粒联合按摩疏通法治疗肝郁气滞型急性哺乳期乳腺炎临床疗效以及血清白细胞计数(WBC)、降钙素原(PCT)、C-反应蛋白(CRP)、雌二醇(E_(2))、孕酮(P)、催乳素(PRL)指标的变化情况,探讨其治疗急性哺乳期乳腺炎的机制。方法采用随机对照方法,对门诊就诊的180例肝郁气滞型急性哺乳期乳腺炎患者分为两组,各90例。治疗组在对照组的基础上加用2周乳宁颗粒冲剂口服,观察两组治疗前后的临床治疗效果、治愈时间、转归情况及复发性的相关指标和各项实验室指标。结果两组比较治疗组治疗周期短、使用抗生素率低、复发率低、发生脓肿率低、被动停乳率低:治疗组临床总有效率94.44%(85/90),明显高于对照组80.00%(72/90)的有效率(P<0.01);治疗组血清WBC、PCT、CRP恢复正常时间明显短于对照组;治疗组血清E、P、PRL水平比对照组明显提高,差异均有统计学意义(P<0.01)。结论乳宁颗粒联合按摩疏通法治疗肝郁气滞型急性哺乳期乳腺炎比单纯按摩法有较好的疗效,改善临床症状缩短治疗时间,缓解患者抑郁情绪,有效降低患者血清WBC相关炎性指标,提高有效的激素水平,有利于早期治愈,减少复发率和停乳率。

Objective To observe the efficacy of Runing Granule(乳宁颗粒)treating acute mastitis during lactation with syndrome of liver-Qi depression and investigate its effects on the serum levels of white blood cell(WBC),precalcitonin(PCT),C-reactive protein(CRP),progesterone(P),estradiol(E_(2))and prolactin(PRL)to explore the mechanism of traditional Chinese medicine in the treatment of acute mastitis during lactation,so as to obtain more effective treatment for the treatment of lactation acute mastitis.Methods According to randomized control method,one hundred and eighty out-patient visits with liver-Qi stagnation type of lactation acute mastitis were selected and randomly divided into treatment group and control group with 90 cases in each.Both groups were treated with Tuina therapy.Based on the treatment in the control group,the patients in the treatment group were additionally treated with Runing Granule(1 bag/time,tid)for 2 weeks.Two groups were compared about therapeutic effect,healing time,turnover situation and recurrence factor before and after treatment.The observation laboratory indicators between two groups were compared.Results According to the comparison between the treatment group and control group before and after treatment,the rates of treatment time,antibiotic usage,abscess development and stopping lactation of the treatment group were evidently lower than those of the control group.The total clinical effective rate of the treatment group was 94.44%,obviously higher than 80%in the control group(P<0.01).After treatment,the healing time in serum levels of WBC,PCT and CRP in the treatment group were obviously lower than those in control group(P<0.01).After treatment,the serum levels of estradiol(E2),progesterone(P)and prolactin(PRL)in the treatment group were remarkably higher than those in the control group.The differences were statistical significance(P<0.01).Conclusion Runing Granule combined with Tuina therapy has better therapeutic effects on lactation acute mastitis with syndrome of liver-Qi depression than single Tuina therapy and can effectively improve the clinical symptoms,shorten the treatment time,relieve live-Qi depression,improve inflammatory symptoms,reduce the serum levels of WBC and inflammatory factors,and improve the serum levels of hormones and the clinical curative effects.It is helpful to cure early and reduce the recurrence rate and stopping lactation rate.