中医手法按摩联合乳腺导管灌注对早期急性哺乳期乳腺炎的效果观察

Observation of the effect of combined breast catheter perfusion with hand massage in traditional Chinese medicine on early acute lactation mastitis

目的观察中医手法按摩联合乳腺导管灌注对早期急性哺乳期乳腺炎患者的临床效果。方法选取2018年12月~2022年10月北京市和平里医院早期急性哺乳期乳腺炎患者183例,按治疗方式分为两组。联合治疗组97例采用堵塞乳腺导管生理盐水灌注加中医手法按摩排乳治疗。对照组86例采用中医手法按摩排乳治疗。两组均采用中药外敷和中药内服治疗。治疗后2周,观察两组临床有效率、世界卫生组织生存质量测定量表简表(World Health Organization quality of life scale-brief,WHOQOL-BREF)评分、目测类比疼痛(VAS)评分、中性粒细胞比值、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)、母乳喂养自我效能评分、纯母乳喂养率和回乳率的差异。结果治疗后2周,与对照组相比,联合治疗组的临床有效率、WHOQOL-BREF评分、母乳喂养自我效能评分和纯母乳喂养率显著升高,差异均有统计学意义(P<0.05)。联合治疗组的VAS、回乳率、TNF-α、IL-6、中性粒细胞比值和hs-CRP水平显著低于对照组,差异均有统计学意义(P<0.05)。结论与单纯中医手法按摩排乳相比,中医手法按摩疗法联合乳腺导管灌注对可有效减轻早期急性哺乳期乳腺炎患者炎症水平,缓解乳房疼痛,改善生活质量,提高纯母乳喂养率。

Objective To investigate the effect of traditional Chinese hand massage therapy combined with breast catheter perfusion in patients with early acute lactation mastitis.Methods 183 patients with early acute lactation mastitis in Beijing Hepingli Hospital from December 2018 to October 2022 were included and divided into 2 groups according to treatment modality.97 patients in the combined treatment group were treated with occlusion of the mammary duct with saline perfusion plus Chinese medicine hand massage for breast evacuation,and 86 patients in the control group were treated with Chinese medicine hand massage.Both groups were treated with external application of Chinese medicine and internal use of Chinese medicine.Two weeks after treatment,the differences in clinical efficiency,World Health Organization quality of life scale-brief(WHOQOL-BREF)scores,visual analog pain scores(VAS),neutrophil ratios,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),ultrasensitive C-reactive protein(hs-CRP),breastfeeding self-efficacy scores,exclusive breastfeeding rates and breastfeeding return rates were observed between the two groups.Results Compared with the control group,the clinical efficiency,WHOQOL-BREF score,breastfeeding self-efficacy score and exclusive breastfeeding rate were significantly higher in the combination treatment group 2 weeks after treatment,and the differences were statistically significant(P<0.05).The VAS,breastfeeding return rate,TNF-α,IL-6,neutrophil ratio and hs-CRP were significantly lower in the combination treatment group than in the conventional control group,and the differences were statistically significant(P<0.05).Conclusion Compared with Chinese medicine hand massage,Chinese massage therapy combined with breast catheter perfusion plus Chinese medicine hand massage pair can effectively reduce the level of inflammation,relieve breast pain,improve the quality of life and increase the rate of exclusive breastfeeding in patients with early acute lactation mastitis.