預防反覆產後乳腺炎再發之中醫病例報告

Prophylactic and Therapeutic traditional Chinese Medicine treatment of Postpartum Recurrent Mastitis : A Case Report

本病例報告是35歲的女性待產婦女，本次懷孕為第三胎，懷孕39週，胎兒足月，產前檢查正常，預計於民國109年2月生產，其前兩胎（民國103年、105年自然生產）在分娩後的第三天均出現皆出現乳腺不通、兩側乳房腫脹石硬，疼痛劇烈，擠乳困難、發燒畏寒等乳腺炎症狀，最終選擇服用抗生素與自費西藥退乳藥「伯汀」（Butin）抑制泌乳，導致無法繼續哺餵母乳。本次生產前擬藉由中醫調治，除預防乳腺炎再發，更希望能順利哺育母乳，故產前求診於本院中醫門診。此待產婦於民國109年2月9日順利生產，生產隔日開始服用中藥湯劑，方義為神效栝蔞散加減。待產婦同年2月27日回診時，表示本次於生產後無出現任何乳房脹痛、泌乳不暢等情形，乳房狀況與乳汁分泌情況良好，哺餵母乳過程順利。本篇文章我們將針對此預防乳腺炎再發之病例，討論其可能的病因、病機與方藥。同時透過此醫案，提供各位同道在臨床上預防乳腺炎再發之中醫思路，以期守護每位產婦的健康。

The 35-year-old female patient with 39 weeks of pregnancy, normal prenatal checkup, had severe mastitis after previous two pregnancies (Normal spontaneous delivery in 2014 and 2016) and chose to take anti-prolactin medicine ''Butin'' to inhibit lactation. With the hope of being a breastfeeding parent and preventing the occurrence of mastitis, she came to our Chinese medicine department to seek treatment before delivery. The patient delivered on February 9, 2020, then started taking traditional Chinese medicine with modified Shen Xiao Gua Lou San the next day. She had no mastitis, breast tenderness, or poor lactation, and had abundant milk supply and comfortable breast condition on follow-up on February 27, 2020. In this article, we will discuss the etiology, pathogenesis, principles, and prescriptions of traditional Chinese medicine for treating mastitis, reducing the occurrence of mastitis, and concerning the health of mother and baby at the same time.