中药内服+外敷+推拿联合西药治疗急性乳腺炎随机平行对照研究  

External Application of Chinese Medicine + Massage combined with Western Medicine in the Treatment of Acute Mastitis Randomized Controlled Study

作　　者：吴春霞[1] 苏杰[2] 

机构地区：[1]济南市第五人民医院中医内科,济南250001 [2]山东中医药大学第二附属医院中医内科,济南250001

出　　处：《实用中医内科杂志》2016年第11期30-33,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察中药内服＋外敷＋推拿联合西药治疗急性乳腺炎疗效。[方法]使用随机平行对照方法,将70例门诊患者按就诊顺序号抽签方法简单随机分为两组。对照组35例青霉素钠400~800万U＋0.9%生理盐水250m L,静滴;青霉素钠过敏选其它抗生素。治疗组35例,内服瓜蒌牛蒡汤加味：瓜蒌、牛蒡子各20g,王不留行15g,漏芦、路路通各10g,柴胡、蒲公英各12g,连翘、丝瓜络、赤芍各7g,浙贝母、皂刺各6g;肝郁加香附、合欢花;胃热加大黄、黄连,1剂/d,水煎200m L,早晚分服;外敷,蒲公英研磨成粉,用食醋调为糊状,外敷在患处,2次/d;外敷同时烤灯热疗;手法推拿,揉抓排乳法：1按摩通经：手法触诊了解肿块位置与大小,并对患侧乳房进行热敷、消毒,然后涂抹润滑剂,五指从乳房四周根部轻轻向乳头方向按摩,以刺激乳汁排出,同时用手轻提乳头数次,使乳头乳管发生扩张;2通导乳络：患者坐位,暴露乳房,一手掌面轻托乳房,一手由乳房四周往乳头方向进行均匀按压,顺摸到乳晕,在四个象限内反复按摩推拿数次,遇到肿块可适当增加按摩次数,直到乳络通畅,此时可观察到乳头数个乳络口内有乳汁流出,肿胀一侧乳头内流出淤乳或稠脓,每次按摩一侧乳房30min,1~2次/d;西药治疗同对照组。连续治疗7d为1疗程。观测临床症状、肿块大小、不良反应。连续治疗2疗程（14d）,判定疗效。[结果]治疗组痊愈15例,显效12例,有效6例,无效2例,总有效率94.28%;对照组痊愈7例,显效6例,有效14例,无效8例,总有效率77.14%;治疗组疗效优于对照组（P〈0.05）。[结论]中药内服＋外敷、推拿联合西药治疗急性乳腺炎，无严重不良反应，值得推广。[Objective] To observe the external application of Chinese medicine＋massage combined with western medicine in the treatment of acute mastitis. [Methods] 70 outpatients were randomly divided into two groups according to the random parallel control method. Control group of 35 cases of penicillin sodium 400-800 million U＋0.9% normal saline 250 mL, intravenous drip; penicillin sodium allergy and other antibiotics. The treatment group 35 cases, oral Trichosanthes burdock decoction： Gualou, Niubangzi, 20g, Wangbu Linxing 15g, Loulu,Lulutong lOg, Chaihu,Pugongying 12g, Liaoqiao, Sigualuo, Chishao 7g, Zhebeimu, Zaojiaci 6g; liver and stomach of perfuming flowers; plus rhubarb, coptis chinensis, 1 agent/d, decoction 200 mL, sooner or later the service; Dandelion grinding into powder, vinegar into a paste, apply on affected area, 2 times/d; at the same time with light roast massage, massage therapy; catch milk： massage method： manual palpation through the understanding of the size and location of tumor, and hot compress, disinfection on the breast, and then apply lubricant, fingers from the breast to nipple direction around the roots gently massage to stimulate the milk discharge, and gently put ~he nipple several times, so that the nipple duct dilatation; the conduction network： milk patient seat, A palm surface light exposed breast, breast care, hand from the breast to the nipple around uniform press, Shun touch areola massage, repeated several times in the four quadrant, encountered mass can increase the appropriate number of times until the milk massage, collateral patency, the observed number of nipples a milk contact in mouth milk flow one side of the nipple, swelling and outflow of milk or thick pus, each massage breast 30 rain, 1-2/d; westernmedicinewiththecontrolgroup. Continuous treatment for 1 courses of 7d. Clinical symptoms, tumor size, and adverse reactions were observed. Continuous treatment for 2 course of treatment （14d）, to determine the efficacy. [Results] The treatment group 15 cases wer

关 键 词：急性乳腺炎 乳痈 中药内服 中药外敷 推拿 揉抓排乳 通导乳络 中西医结合治疗 

分 类 号：R271.44[医药卫生—中医妇科学]