针刺联合循经按摩及中药外敷治疗哺乳期急性乳腺炎患者的疗效观察

Efficacy of Acupuncture Combined with Meridians Massage and External Application of Traditional Chinese Medicine in Treating Acute Mastitis During Lactation

目的探讨针刺联合循经按摩、中药外敷治疗哺乳期急性乳腺炎患者的临床疗效。方法回顾性分析2021年1月—2022年12月期间唐山市妇幼保健院中医科门诊收治的360例早期哺乳期急性乳腺炎患者,按随机数字表法分为对照A组(循经按摩+中药外敷)77例、对照B组(针刺+循经按摩)82例、对照C组(针刺+中药外敷)98例、治疗组(针刺+循经按摩+中药外敷)113例。对照A组患者循经按摩+中药外敷治疗,对照B组患者针刺+循经按摩治疗,对照C组患者针刺+中药外敷治疗,治疗组患者针刺+循经按摩+中药外敷治疗。治疗2个疗程后,观察比较4组患者临床疗效、临床症状、体征消退时间、疼痛及体温变化及复发率,治疗前后血清炎性指标[白细胞计数(White blood cell,WBC)、中性粒细胞百分比(Neutrophilicgranulocyte,NE%)、C-反应蛋白(Creactiveprotein,CRP)]水平。结果治疗后治疗组患者临床总有效率68.14%(77/113)明显高于对照A组患者53.25%(41/77)、对照B组患者51.22%(42/82)、对照C组患者53.06(52/98),差异有统计学意义(P<0.05)。治疗后治疗组患者疼痛消退时间、肿块消失时间、皮肤发红消退时间、体温恢复时间均明显优于对照A组、对照B组、对照C组患者,差异有统计学意义(P<0.05)。治疗后4组患者外周血WBC、NE%、CRP水平均较治疗前明显降低,差异有统计学意义(P<0.05);且治疗组患者外周血WBC、NE%、CRP水平均明显低于对照A组、对照B组、对照C组患者,差异有统计学意义(P<0.05)。治疗后治疗组患者哺乳意愿、哺乳行为率明显高于对照A组、对照B组、对照C组患者,差异有统计学意义(P<0.05);复发率明显低于对照A组、对照B组、对照C组患者,差异有统计学意义(P<0.05)。结论针刺联合循经按摩、中药外敷治疗哺乳期急性乳腺炎患者能有效提高临床疗效,降低患者炎症因子水平及疼痛感,增加哺乳意愿及哺乳行为,降低复发率。

Objective To explore the clinical efficacy of acupuncture combined with meridian massage and external application of traditional Chinese medicine(TCM)in treating patients with acute mastitis during lactation.Methods A retrospective analysis was conducted on 360 patients with early lactation acute mastitis who were admitted to the Department of Traditional Chinese Medicine outpatient department at Tangshan Maternal and Child Health Hospital from January 2021 to December 2022.The patients were randomly divided into four groups using a random number table method:control group A(meridian massage combined with external application of TCM,77 cases),control group B(acupuncture combined with meridian massage,82 cases),control group C(acupuncture combined with external application of TCM,98 cases),and the treatment group(acupuncture combined with meridian massage and external application of TCM,113 cases).Each group received the respective treatment.After two treatment courses,the clinical efficacy,clinical symptoms,resolution time of signs,changes in pain and body temperature,and recurrence rates were observed and compared among the four groups.Serum inflammatory indicators,including white blood cell count(WBC),neutrophil percentage(NE%),and C-reactive protein(CRP)levels were measured before and after treatment.Results After treatment,the overall clinical effective rate in the treatment group was 68.14%(77/113),which was significantly higher than that in control group A(53.25%,41/77),control group B(51.22%,42/82),and control group C(53.06%,52/98),with a statistically significant difference(P<0.05).The treatment group showed significantly shorter times for pain relief,tumor disappearance,skin redness resolution,and temperature normalization compared to all the control groups,with a statistically significant difference(P<0.05).Post-treatment levels of peripheral blood WBC,NE%,and CRP were significantly lower in all groups compared to pre-treatment levels,with a statistically significant difference(P<0.05);these levels were significantly lower in the treatment group compared to all the control groups,with a statistically significant difference(P<0.05).The willingness and behavior rates for breastfeeding were significantly higher in the treatment group,while the recurrence rate was significantly lower compared to the control groups,with a statistically significant difference(P<0.05).Conclusion Acupuncture combined with meridian massage and external application of TCM effectively improves clinical efficacy in patients with acute mastitis during lactation.This combined treatment reduces the levels of inflammatory factors and pain,increases the willingness and behavior for breastfeeding,and reduces the recurrence rate,demonstrating significant clinical value.