自拟中药离子导入治疗急性哺乳期乳腺炎的临床疗效评估

Clinical Effect of Self-Made Traditional Chinese Medicine Iontophoresis in Treatment of Acute Lactation Mastitis

目的评价自拟中药离子导人治疗急性哺乳期乳腺炎的效果。方法选择2012年4～11月期间廊坊市妇幼保健中心妇保科门诊收治的急性哺乳期乳腺炎患者200例，按患者编号的单双号分为2组，中药组100例，对照组100例。中药组患者采用自拟中药配合光电离子治疗仪进行治疗；对照组患者采用0．9％的生理盐水配合光电离子治疗仪进行治疗。2组患者的1个疗程均为5d，每天2次，每次30min，疗程期间无间断，共3个疗程；治疗的同时普及哺乳期知识。1个疗程后观察治疗效果，未愈者继续治疗；最长治疗3个疗程后观察疗效，仍未愈或化脓者，中止哺乳，行乳腺脓肿切开引流术。治疗结束之Et起3个月后，对2组患者均进行回访，评价复发情况。结果1个疗程后，中药组的临床疗效为痊愈89例，有效6例，无效5例，总有效率为95％（95／100）；对照组为治愈71例，有效16例，无效13例，总有效率为87％（87／100）。3个疗程后，中药组痊愈97例，无效3例，手术率为3％（3／100）；对照组痊愈86例，无效14例，手术率为14％（14／100）。不管是在1个疗程时（χ2=3．96，P〈0．05）还是3个疗程时（χ2=7．78，P〈0．01），中药组的总有效率均较高。治疗结束3个月后，治疗组的乳腺炎复发率为5％（5／100），对照组为35％（35／100），中药组的复发率较低（χ2=28．13，P〈0．01）。结论相对于0．9％生理盐水配合光电离子治疗仪治疗方法，自拟中药离子导入治疗急性哺乳期乳腺炎的疗效较好，手术率降低，且复发率较低，有利于母乳喂养，值得推广。

Objective To assess effect of the self-made traditional Chinese medicine iontophoresis in treatment of acute lactation mastitis. Methods Two hundred cases of acute lactation mastitis who were treated in Langfang Maternal and Child Health-Care Hospital from Apr. to Nov. in 2012 were divided into traditional Chinese medicine group and control group by number of cases, each group enrolled 100 cases. The cases of traditional Chinese medicine group were treated with traditional Chinese medicine iontophoresis by using photoelectric ion therapeutic apparatus, and cases of control group were treated with 0. 9% saline iontophoresis by using the same device. All of the 200 cases were treated with 1-3 courses （5 days per course）, 2 times per day,and every time needed 30 minutes. At the same time, cases were educated the breast- feeding knowledge. Effect evaluation was performed after 1 course and 3 courses of treatment. The cases who were not cured after 3 courses needed to weaning, and needed to receive abscess incision drainage surgery. In 3 months after stopping therapy, telephone interview was performed to investigate the situation of recurrence. Results After 1 course of treatment, the effect was as follows： recovery in 89 cases, effective in 6 cases, invalid in 5 cases, and the total effective rate was 89% （89/100） in traditional Chinese medicine group; recovery in 71 cases, effective in 16 cases, invalid in 13 cases, and thetotal effective rate was 87% （87/100） in control group. After 3 courses of treatment, the effect was as follows： recovery in 97 cases, invalid in 3 cases, and the total effective rate was 97% （97/100） in traditional Chinese medicine group; recovery in 86 cases, invalid in 14 cases, and the total effective rate was 86% （86/100） in control group. There were 3 cases and 14 cases underwent abscess incision drainage surgery in Chinese medicine group and control group respectively. The clinical effect of Chinese medicine group were better than that of control group in 1 course （χ2=3.96, P〈 0. 05） and 3 courses （χ2=7.78, P〈 0.01） of treatment. The recurrence rate of Chinese medicine group and control group were 5% （5/100） and 35% （35/100） respectively, and the rate of control group was higher （χ2=28. 13 ,P 〈 0.01）. Conclusions Com- pared with 0. 9% saline iontophoresis, the effect of traditional Chinese medicine iontophoresis in the treatment of acute lactation mastitis is better, which contribute to the breastfeeding. In addition, it is worth popularizing for that it can reduce the operation rate and recurrence rate effectively.