揉抓排乳联合中药外敷治疗非脓肿期急性哺乳期乳腺炎临床研究

Clinical Study of Human Milk Ejection by Rubbing and Scratching Combined with Chinese Herbs External Application for Acute Mastitis in Lactation Period During the Non-Abscess Stage

目的:观察揉抓排乳联合中药外敷治疗非脓肿期急性哺乳期乳腺炎的临床疗效。方法:将120例患者随机分为2组各60例,中医治疗组采用揉抓排乳联合中药外敷治疗;联合治疗组在揉抓排乳、中药外敷的基础上联合抗生素治疗。观察2组患者的乳房疼痛、红肿范围、肿块大小等疗效指标和不良反应,并对2组患者的中段乳汁进行病原学检测。结果:中医治疗组细菌感染阳性率11.7%,联合治疗组16.7%,2组比较,差异无统计学意义(P>0.05)。细菌感染阳性组的病程长于阴性组(P<0.01)。病程越长,细菌感染的风险就越高[OR=11.621,95%CI:(3.729~36.214)]。2组症状缓解时间比较,差异无统计学意义(P>0.05)。中医治疗组总有效率为96.7%,联合治疗组总有效率为98.3%,2组比较,差异无统计学意义(χ~2=0.342,P=0.559)。结论:非脓肿期急性哺乳期乳腺炎细菌感染率低,尽早解决乳汁瘀滞是有效控制病情和预防乳腺脓肿的关键,揉抓排乳联合三黄膏外敷治疗疗效确切,安全可行,且不干扰正常哺乳。

Objective：To observe the clinical effect of human milk ejection by rubbing and scratching combined with Chinese herbs external application in treating acute mastitis in lactation period during the non-abscess stage.Methods：Divided120 cases of patients with acute mastitis in lactation period during the non-abscess stage into two groups randomly,60 cases in each group.Both groups received milk ejection by rubbing and scratching combined with Chinese herbs external application,while the combination treatment group additionally received antibiotics.Observed indexes for therapeutic effect such as breast pain,range of red swelling and size of breast mass as well as adverse reaction in both groups.The pathogenic detection of middle-stage milk was carried out in both groups.Results：The positive rate of bacterial infection was 11.7%in the Chinese medicine treatment group and 16.7%in the combination treatment group,no significance being found in the comparison between two groups（P〉 0.05）.The course of the positive bacterial infection group was longer than that of the negative bacterial infection group（P〈0.01）.The longer the course was,the higher the risk of bacterial infection was[OR=11.621,95%CI：（3.729-36.214）].No significance being found in the comparison of the reliving time of symptom between two groups（P〉 0.05）.The total effective rate was 96.7%in the Chinese medicine treatment group and 98.3%in the combination treatment group,the difference being not significant（χ2=0.342,P=0.559）.Conclusion：The bacterial infection rate of acute mastitis in lactation period during the non-abscess stage is low.The key to controling disease and prevention of breast abscess is to deal with milk stasis as soon as possible.The therapy of milk ejection by rubbing and scratching combined with external application of Sanhuang plaster has exact curative effect.It is safe and feasible,without interfering with the normal lactation.