中医健康管理指导在社区产褥期妇女母乳喂养中的作用

Traditional Chinese medicine health management guidance to the community of puerperal women’s breast-feeding

目的：将中医药保健服务与目前社区产褥期妇女健康管理相结合，探索在基层社区对产褥期妇女母乳喂养进行中医健康管理的可行性。方法将符合入选标准的产褥期妇女按居住地居委会分为2组，非中医干预组225人、中医干预组215人。采取入户访视的形式，非中医干预组对产褥期妇女进行保健指导，中医干预组在非中医干预组基础上配合中医适宜技术指导。分析干预前后产褥期妇女母乳喂养情况。结果干预后，中医干预组乳汁不足的产褥期妇女母乳喂养率为76.9%（60/78）、混合喂养率为21.8%（17/78），非中医干预组分别为56.9%（41/72）、40.3%（29/72），2组母乳喂养率与混合喂养率比较，差异有统计学意义（χ2＝5.916、5.178，P＜0.05）。中医干预组，母乳喂养率与混合喂养率分别为78.1%（168/215）、17.2%（37/215），非中医干预组分别为62.7%（141/225）、33.3%（75/225），2组母乳喂养率与混合喂养率比较，差异均有统计学意义（χ2＝11.860、14.226，P＜0.01）。结论在社区对产褥期妇女进行中医健康管理指导，可有效提高产褥期妇女的母乳喂养率。

Objective By combining the traditional Chinese medicine（TCM） health care service and the current community puerperal women＇s health management, to explore the feasibility of TCM health management in the grass-roots community on puerperal women’s breast-feeding. Methods 440 patients meeting the inclusion criteria of puerperal women according to the neighborhood of residence were recruited into a non TCM intervention group of 225 people, and a TCM intervention group of 215 people. The non TCM intervention group was given health guidance on puerperal women. On such basis, the TCM intervention group was further cooperated with appropriate technical guidance of TCM. Puerperal women breastfeeding before and after the intervention was studied. Results After the intervention, the milk shortage of puerperal women breastfeeding rate of TCM intervention group was higher than the non TCM intervention group, 76.9% （60/78） vs. 56.9% （41/72）, and mixed feeding rate was lower 21.8% （17/78） vs. 40.3%（29/72）, the difference was statistically significant （χ2=5.916, 5.178; P 〈 0.05）. The rate of breast feeding and mixed feeding rate were also statistically different between the TCM intervention group and the non TCM intervention group 78.1%（168/215） and 17.2% （37/215） vs. 62.7% （141/225） and 33.3% （75/225）, （χ2=11.860, 14.226; P〈0.01）. Conclusion TCM health management guidance on puerperal women in the community can effectively improve the hypogalactia puerperal women＇s breastfeeding rate.