疏肝消肿通乳法联合手法排乳治疗外吹乳痈郁滞期的效果观察

Clinical research of Shugan Xiaozhong Tongru therapy combined with manual milking technique on early lactation acute mastitis

目的观察疏肝消肿通乳法联合手法排乳治疗外吹乳痈郁滞期的效果。方法选择2018年3月至2020年3月于南京中医药大学附属医院就诊的外吹乳痈郁滞期患者80例。应用随机数字表法将患者分为观察组与对照组,各40例。观察组予通乳方口服,对照组予阿莫西林钠克拉维酸钾或头孢唑林钠静脉滴注,连续治疗7 d,治疗期间2组均联合手法排乳治疗。分别于治疗前、治疗7 d后检测血清白细胞介素6(IL-6)、白细胞计数(WBC)、C反应蛋白(CRP)水平,评估患者的症状评分,比较2组临床疗效。结果治疗后,2组血清IL-6、WBC及CRP水平均低于治疗前,且观察组均低于对照组[(20±6)ng/L比(39±9)ng/L、(6.9±1.2)×10^(9)/L比(9.3±0.9)×10^(9)/L、(6.2±0.8)mg/L比(22.7±1.6)mg/L],差异均有统计学意义(均P<0.05)。治疗后,2组乳房胀痛、局部皮肤、恶寒发热、头痛身痛、烦躁、口渴、便秘评分及总分均低于治疗前,且观察组均低于对照组,差异均有统计学意义(均P<0.05)。观察组临床疗效优于对照组,差异有统计学意义(P<0.001)。结论疏肝消肿通乳法联合手法排乳可以显著降低外吹乳痈郁滞期患者血清中炎症因子水平,改善临床症状。

Objective To observe the clinical efficacy of Shugan Xiaozhong Tongru therapy combined with manual milking technique on early lactation acute mastitis.Methods Totally 80 patients with early lactation acute mastitis were enrolled in Affiliated Hospital of Nanjing University of Chinese Medicine from March 2018 to March 2020.Patients were randomly divided into observation group and control group,with 40 cases in each group.The observation group was given Tongru decoction orally,and the control group was given amoxicillin sodium and clavulanate potassium or cefazolin sodium intravenous drip.All of patients were treated for 7 d,and were given manual milking technique therapy.The serum levels of interleukin-6(IL-6),white blood cell count(WBC)and C-reaction protein(CRP)of patients were detected before and 7 d after treatment.Symptom score of patients was evaluated and the clinical effect was compared between the two groups.Results After treatment,serum levels of IL-6,WBC and CRP in both groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group[(20±6)ng/L vs(39±9)ng/L,(6.9±1.2)×10^(9)/L vs(9.3±0.9)×10^(9)/L,(6.2±0.8)mg/L vs(22.7±1.6)mg/L](all P<0.05).After treatment,Symptom scores of breast tenderness,local skin,aversion to cold and fever,headache and body pain,irritation,thirst,constipationthe and the total score in both groups were lower than those before treatment,and the scores in the observation group were lower than those in the control group(all P<0.05).The clinical effect in the observation group was better than that in the control group(P<0.001).Conclusion Shugan Xiaozhong Tongru therapy combined with manual milking technique can reduce serum levels of inflammation factors and improve the clinical symptoms in patients of early lactation acute mastitis.