中医全科医疗服务模式下社区产妇乳汁淤积症的预防及治疗

Observation on the Curative Effect of Special Diseases of Galactosis after the New Model of General Medical Service of Traditional Chinese Medicine

目的:探讨中医全科医疗服务模式下社区产妇乳汁淤积症的预防及治疗效果。方法:2020年上海市浦东新区上钢社区卫生服务中心(简称中心)对社区产妇开展了中医全科医疗服务模式下乳汁淤积症的预防及治疗专病试点工作,对乳汁淤积症产妇采用“六步奶结疏通法”进行治疗。对试点前(2018—2019年)、试点后(2020—2021年)产妇访视率、乳汁淤积症发病率及疗效进行评价。结果:2018—2021年各年度在该中心建档的孕妇分别为686人、637人、505人和504人,产后访视率分别为94.7%、93.7%、98.0%和97.0%,乳汁淤积症发病率分别为18.3%、17.4%、10.6%和10.5%。2018—2021年各年度乳汁淤积症产妇1次治疗有效率分别为97.3%、98.0%、100.0%和100.0%,1次治愈率分别为83.9%、88.8%、90.2%和91.7%;2次治疗有效率均为100.0%,2次治愈率分别为96.4%、95.9%、98.0%和97.9%。均未见并发症发生。结论:该中心对社区产妇开展中医全科医疗服务模式下乳汁淤积症的预防及治疗专病试点工作后,产妇产后访视率较试点前有所提升,乳汁淤积症发病率较试点前明显下降,同时疗效进一步提高。此模式值得在社区推广应用。

OBJECTIVE To explore the prevention and treatment effect of community maternal milk stasis under the TCM general practice service mode.METHODS In 2020,Community Health Service Center of Shanghai Pudong New Area(the Center)carried out the pilot work of prevention and treatment of milk stasis under the mode of TCM general medical service for community pregnant women.The“six-step milk knot dredging method”was used to treat women with milk stasis.The maternal visit rate before the pilot(2018—2019)and after the pilot(2020—2021)were evaluated.RESULTS From 2018 to 2021,there were 686,637,505,504pregnant women,respectively,and the postpartum visit rate was 94.7%,93.7%,98.0%,and 97.0%,and the incidence of milk cholestasis was 18.3%,17.4%,10.6%,and 10.5%,respectively.From 2018 to 2021,the treatment response rate of milk stasis was97.3%,98.0%,100.0%and 100.0%,respectively.The cure rate was 83.9%,88.8%,90.2%and 91.7%,and the second treatment response rate was 100.0%,96.4%,95.9%,98.0%and 97.9%,respectively.CONCLUSION After the center carried out the pilot work of prevention and treatment of milk stasis under the TCM general medical service mode in the community,the postpartum visit rate of puerpera increased compared with that before the pilot,and the incidence of milk stasis decreased significantly compared with that before the pilot,and the curative effect was further improved.The model is worth promoting and applying in the community.