產後急性乳腺炎個案之中藥介入療效報告

A Case Report of Acute Lactation Mastitis Treated with Traditional Chinese Medicine

產後乳脹、產後乳腺炎（lactationmastitis）對於產後婦女為一常見疾病。其主要症狀暨臨床診斷標準為：（1）哺乳的母親（2）發燒＞38.3℃（3）乳房局部出現紅腫熱痛。現代醫學在治療上除強調教導孕母正確手法將乳汁排出外，對於較為嚴重之個案則採用抗生素甚或退乳針等藥物，而患者往往礙於擔心西藥之副作用或擔心藥物經乳汁對嬰孩產生不良影響而拒絕使用藥物。本病例患者為一34歲剖腹產後婦女，因產後出現乳汁排出不暢、乳房局部疼痛拒按、發燒不退、腹部有壓痛脹滿及產後未解大便等症，於住院期間會診本院中醫介入治療。在中藥介入隔天後自覺改善明顯，雖仍有輕微乳脹現象，但已可在個管師協助下將乳汁擠出，自會診當晚服用中藥逍遙散暨調胃承氣湯合方及水煎藥起，乳房脹痛感明顯減緩、體溫量測無發燒情形，隔日晨起服用第二包科學中藥後自解大便，自覺腹脹、矢氣頻等症亦緩解許多，療效達到令病者十分滿意。從本病患的治療追蹤發現，產後乳脹的病者經由中醫辨證、治療，可以提供病者另一種有效的選擇，至於其相關的作用機理仍有待進一步探討。

For postpartum women, lactation mastitis is one of the most common diseases. The main symptoms and the criteria of diagnosis are: (1) Breast-feeding women (2) Fever higher than 38.3°C (3) Localized, painful inflammation of the breast. Apart from methodically instructing the mothers to squeeze out their milk, serious patients usually treat lactation mastitis with antibiotics or with medicines suppressing breast milk production. However, due to worrying at western medicine's side effects on the baby through breast-feeding, patients often refuse to take these drugs. This case report is about a 34-year-old postpartum woman whose baby was delivered by Cesarean section. She suffered from poor breast milk discharge, an acute painful sensation in the breast and constipation after delivery. Since treatment didn't relieve her symptoms, the OBS/GYN doctor consulted our Chinese medicine(TCM) department. One day after the intervention of Chinese medicine, the patient felt that her symptoms were improved. Though she still felt a slight swelling sensation in her breasts, the patient could discharge the breast milk smoothly through the help of the OBS/GYN department's Case Manager. After taking the concentrated herbal extracts of ＂Xiao Yao San＂ with ＂Tiao Wei Cheng Qi Tang＂ and decocting pieces, the patient's breast pain was relieved and she was no longer diagnosed with fever. The next morning, after taking the second dose of the concentrated herbal extracts, the patient's bowel movement was smooth and her symptoms of abdominal fullness and frequent flatulence decreased significantly. The patient was very satisfied with the effect of the TCM treatment. From tracing the treatment of this patient, we discovered that TCM's intervention can provide patients with postpartum mastitis problems the other effective treatment. As for the relevant function and mechanism of lactationl mastitis, it will be further studied in the future.