急性早期哺乳期乳腺炎中西医治疗方案的临床对比研究

康文; 马晓梅; 任晓华; 王计辰; 郎林; 张晓军

doi:10.16766/j.cnki.issn.1674-4152.001840

急性早期哺乳期乳腺炎中西医治疗方案的临床对比研究

doi: 10.16766/j.cnki.issn.1674-4152.001840

1.
北京市丰台区南苑医院普外科，北京 100076
2.
北京市丰台区南苑医院中医科，北京 100076
3.
中国中医科学院西苑医院外一科，北京 100091

基金项目:

首都临床特色应用研究与成果推广 Z171100001017105

详细信息

通讯作者:
张晓军, E-mail: zxj6298@sohu.com

中图分类号: R655.8 R242
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- 文章访问数: 272
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- 被引次数: 0
出版历程
- 收稿日期: 2020-04-26
- 网络出版日期: 2022-02-19

Clinical comparative study of Chinese and western medicine treatment for acute early lactation mastitis

1.
Department of General Surgery, Nanyuan Hospital, Fengtai District, Beijing 100076, China

摘要

摘要: 目的观察对比中医综合治疗和西医常规治疗急性早期哺乳期乳腺炎的疗效。方法选取2018年1月—2019年10月于北京市丰台区南苑医院普外科就诊的急性早期哺乳期乳腺炎患者60例，根据随机数表法随机分成中医治疗组和西医治疗组，每组30例。中医治疗组内服、外敷中药方剂，配合手法通乳; 西医治疗组静脉滴注头孢呋辛钠、外敷50%硫酸镁，配合手法通乳及吸奶器吸乳。治疗3 d后评价2组总体疗效、乳腺包块大小、体温、白细胞总数及CRP的变化。结果中、西医治疗组总有效率分别为90%和93%，总体疗效比较差异无统计学意义(Z=-0.301, P=0.764);2组患者治疗前后体温、乳腺包块大小、白细胞总数及CRP比较差异均有统计学意义(均P < 0.05);西医治疗组白细胞总数下降较中医治疗组明显(t=5.425, P＜0.001)。结论对于急性早期哺乳期乳腺炎患者，手法通乳治疗不可或缺。中医综合治疗和西医常规治疗效果相当，但抗生素抗炎效果更明显。临床上可以根据患者的自身情况及对母乳喂养的要求来选择适当的治疗方式。对于初诊炎症较重，乳腺包块较大的患者，早期适当使用抗生素对治疗有利，但需要进一步观察统计证实。
- 急性早期哺乳期乳腺炎 /
- 中医治疗 /
- 西医治疗 /
- 手法通乳 /
- 抗生素
Abstract: Objective To observe and compare the effect of comprehensive treatment of traditional Chinese medicine and routine treatment of western medicine on acute early lactation mastitis. Methods A total of 60 patients with acute early lactation mastitis admitted to the General Surgery Department of Nanyuan Hospital, Fengtai District, Beijing from January 2018 to October 2019 were selected and randomly divided into the traditional Chinese medicine treatment group and the western medicine treatment group according to the random number table method, with 30 patients in each group. Traditional Chinese medicine treatment group were taken orally and applied externally, combined with the manipulation of lactation. Western medicine treatment group were intravenously infused of cefuroxime sodium, external application of 50% magnesium sulfate, combined with manual lactation and breast suction. The changes of overall efficacy, breast mass size, body temperature, white blood cell count, and CRP were evaluated in both groups after 3 days of treatment. Results The total effective rate of the traditional Chinese medicine treatment group and the Western medicine treatment group was 90% and 93%, respectively, with no statistical difference in the overall efficacy (Z=-0.301, P=0.764). Comparison between the two groups before and after treatment: body temperature, breast mass size, total number of white blood cells and CRP were statistically different (P < 0.05). The total number of white blood cells in the Western medicine treatment group was significantly lower than that in the traditional Chinese medicine treatment group, and the difference was statistically significant (t=5.425, P < 0.001). Conclusion For patients with acute early lactation mastitis, manual lactation therapy is indispensable. Traditional Chinese medicine treatment and Western medicine treatment of the same effect, but antibiotics anti-inflammatory effect is more obvious. Clinical treatment can be based on the patient's own situation and the requirements of breastfeeding to choose the appropriate treatment. For patients with heavy inflammation and large breast mass at the first visit, early appropriate use of antibiotics is beneficial for treatment, but further observation and statistical confirmation are needed.
- Acute early lactation mastitis /
- Traditional Chinese medicine treatment /
- Western medicine treatment /
- Manual lactation /
- Antibiotics

HTML全文

表 1 2组急性早期哺乳期乳腺炎患者疗效比较(例)

组别	例数	治愈	有效	无效	总有效率[例(%)]
中医组	30	12	15	3	27(90)
西医组	30	10	18	2	28(93)
注：2组疗效比较，Z=-0.301，P=0.764。

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表 2 2组急性早期哺乳期乳腺炎患者治疗前后观察指标比较(x±s)

组别	例数	时间	体温(℃)	包块直径(cm)	WBC(×10⁹/L)	CRP(mg/L)
中医组	30	治疗前	37.62±0.51	5.0±0.86	9.83±0.99	13.4±3.05
		治疗后	36.75±0.38	1.97±2.09	8.74±1.01	10.93±1.95
西医组	30	治疗前	37.76±0.57	5.09±1.31	9.72±1.53	13.12±3.57
		治疗后	36.68±0.33	2.30±2.31	7.57±0.60^c	10.07±2.07
t值^a			10.906	12.005	8.310	8.375
P值^a			＜0.001	＜0.001	＜0.001	＜0.001
t值^b			12.103	12.694	9.983	6.728
P值^b			＜0.001	＜0.001	＜0.001	＜0.001
注：^a为中医组治疗前后比较; ^b为西医组治疗前后比较; 治疗后组间比较，^cP < 0.05。

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