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Objective:To analyze the medication characteristics and the rules of prescription for the treatment of acute mastitis in Puji Fang; To provide reference for the clinical treatment of acute mastitis in modern TCM. Methods:Prescriptions of the chapters of " Ruyong" and " Duru" contained in Pu Ji Fang? Fu Ren Zhu Ji Men were screened, and the prescription data were analyzed by using the ancient and modern medical record cloud platform V2.3.5 for drug frequency, properties, tastes, meridian tropism, and efficacy. Clustering analysis of high-frequency drugs and analysis of association rules were performed. Results:A total of 141 prescriptions were included, with 201 kinds of Chinese materia medica. The top ten drugs with the high frequency of use were Glycyrrhizae Radix et Rhizoma, Paeoniae Radix alba, Rhei Radix et Rhizoma, Angelicae Sinensis Radix, Astragali Radix, Olibanum, Trichosanthis Fructus, Ginseng Radix et Rhizoma, Scutellariae Radix, Gleditsiae Spina. The main property was cold, the main taste was sweet, the main meridian was spleen meridian, and the main efficacy was heat clearing and detoxification. Three types of high-frequency drugs could be obtained by clustering analysis, namely, Ginseng Radix et Rhizoma-Astragali Radix-Angelicae Sinensis Radix-Rhei Radix et Rhizoma, Scutellariae Radix-Paeoniae Radix alba-Glycyrrhizae Radix et Rhizoma, Trichosanthis Fructus-Olibanum-Gleditsiae Spina. Through correlation analysis of high-frequency drugs, it was found that there was a great correlation between Astragali Radix and Paeoniae Radix alba, Angelicae Sinensis Radix, Glycyrrhizae Radix et Rhizoma, Ginseng Radix et Rhizoma.Conclusions:The pathogenesis of acute mastitis in Pu Ji Fang is mainly damp-heat toxin and blood stasis, and deficiency of qi and blood. The treatment for strengthening healthy qi focuses on tonifying qi and blood of the liver and spleen, while the treatment for eliminating pathogenic factors focuses on removing dampness, clearing heat and toxin, resolving phlegm, dispersing stasis and removing blood stasis. In addition, according to the condition, the treatment will be increased or decreased with the disease.
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[Objective]To explore the clinical efficacy of Qingre Jiedu Decoction in the treatment of acute mastitis during lactation.[Methods]The clinical data of lactating mastitis patients who presented to the Galactophore Department of Beijing Hospital of Traditional Chinese Medicine,Capital Medical University from January 2019 to December 2020 were retrospectively analyzed.In the treatment group,80 patients received internal decoction;in control group,no decoction was taken.The severity index of mastitis,disease improvement rate,breast pain score,milk patency,nipple cracking condition and traditional Chinese medicine(TCM)systemic symptom score were observed.[Results]There were significant statistic differences in the severity index of mastitis,disease improvement rate,breast pain score,milk patency and TCM systemic symptoms scores(P＜0.05).The therapeutic effect of the treatment group was better than that of the control group.[Conclusion]Qingre Jiedu Decoction can effectively release pain,reduce the size of lumps,release swelling and milk stasis of lactation acute mastitis,and the curative effect is good.
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Objective To systematically analyze the current status of outcomes reporting in clinical trials on treating stasis acute mastitis with Traditional Chinese Medicine breast massage.Methods We searched CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, Embase, Cochrane library, JBI, CINAHL, PsycINFO, Clinical Trials Registry Platform portal, Clinical Trials Registry, Australian New Zealand Clinical Trials Registry, Center Watch Registry from inception to May 15, 2022 to find randomized controlled trials, non-randomized controlled trials, case series and cohort studies which reported the outcomes of stasis acute mastitis managed with Traditional Chinese Medicine breast massage, with search terms of mastitis, acute mastitis, lactation mastitis, puerperal mastitis, breast problem, breast engorgement, milk stasis, blocked ducked, breast pain, breast massage, and acupoint massage. Outcomes and the measurement schemes (measurement methods, timing of assessing outcome, frequency of assessing outcome, measurers) were extracted from the included studies. We used the Management of Otitis Media with Effusion in Children with Cleft Palate (MOMENT) to assess the quality of each study, then categorized outcomes derived from the included studies into different domains according to the Outcome Measures in Rheumatology Arthritis Clinic Trials (OMERACT) Filter 2.1 framework.Results We identified 85 clinical trials, in which 54 different outcomes were reported. A total of 81.2% (69/85) of studies were assessed as medium quality with a mean score of 2.6, and 18.8% (16/85) as low quality with a mean score of 0.9. These outcomes were organized in three core areas. Lump size (89.4%, 76/85) was the most frequently reported outcome, followed by breast pain (69.4%, 59/85) and milk excretion (68.2%, 58/85). Five methods were used to assess lump size and four methods to assess breast pain.Conclusions The outcomes reported in clinical trials regarding stasis acute mastitis treated by Traditional Chinese Medicine breast massage are heterogeneous. Developing a core outcome set to achieve consistent standards for reporting outcomes and modalities for validation of the outcomes is clearly warranted.
الموضوعات
Child , Female , Humans , Australia , Massage , Mastitis/therapy , Mastodynia , Medicine, Chinese Traditionalالملخص
We applied literature review and the Delphi method to develop technical operation of manual lactation technique. The databases and websites were systematically searched, such as UpToDate, the Cochrane Library, CNKI, VIP, Wanfang, and SinoMed. The evidence related to the technique was evaluated by Appraisal of Guidelines for Research and Evaluation (AGREE Ⅱ), and A Measure Tool to Assess Systematic Reviews 2 (AMSTAR 2). the included evidence was classified and summarized to form the preliminary draft of the technical operation specification. A total of 26 experts were selected to evaluate the draft, and some recommendations were deleted and modified according to the screening criteria and expert opinions, resulting in the final technical specifications for manual lactation technique applicable to health care professionals. The study included 4 guidelines, 5 expert consensus articles, 2 clinical decisions, and 3 systematic reviews, and the overall quality of the evidence was fair. A total of 26 questionnaires were collected in each of 2 rounds of expert consultation, with a 100% return rate and an overall authority coefficient of 0.91. The technical practice specification was formed in 11 aspects, including assessment content, indications, contraindications, operation methods, adverse events, and treatment methods, with a total of 50 recommendations. The technical operation specification is comprehensive, and the recommendations are clearly expressed, which is in line with the real clinical situation and can provide effective reference for the clinical practice of this technique.
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Objective]Through judging the constitutional types of traditional Chinese medicine(TCM) of acute mastitis patients, do statistics and analysis of the distribution of the acute mastitis patients’constitutional types of TCM, and study their laws, in order to provide guiding basis of constitutional theory of TCM for preventing and early treating mastitis. [Method] By means of questionnaire method, judge the constitutional types of TCM of 77 acute mastitis patients according to the classification and judgment of constitution of TCM ,and analyze the results by statistical methods. [Results] The number of the constitutional types of TCM of 77 acute mastitis patients from high to low is as follows: dampness-heat constitution is 65 cases, energy-stagnant constitution is 52 cases, yang-deficiency constitution is 51 cases, qi-deficiency constitution is 37 cases, yin-deficiency constitution is 34 cases, phlegm-dampness constitution is 32 cases, blood-stasis constitution is 29 cases, normal constitution is 12 cases, and special-natural constitution is 7 cases. Individuality constitution has 9 cases, two and three mixed constitution each has 12 cases, four and five mixed constitution each has 9 cases, six mixed constitution has 14 cases, seven mixed constitution has 11 cases, eight mixed constitution has 1 case. In the main constitutional types of TCM of 77 acute mastitis patients, dampness-heat constitution(54 cases, 70.13%) is most, followed by normal constitution(12 cases, 15.58%) and yang-deficiency constitution(5 cases, 6.49%). In the individuality constitution and two mixed constitution, the proportion of dampness-heat constitution(60 cases, 39.47%) is highest, and that of yang-deficiency constitution(34 cases, 22.37%) is also higher. This shows that: 1. Dampness-heat constitution is the most common constitutional type related with the occurrence of acute mastitis, and yang-deficiency constitution is the second. 2. The acute mastitis patients have a variety of constitutional types such as dampness-heat constitution, energy-stagnant constitution etc. Mixed constitution is common and complex. May be it is associated with the particular period of postpartum lactation period. [Conclusion] Constitution as internal factors of disease has an important influence on occurrence and development of acute mastitis. It has great meaning to adjust prejudiced constitutional types of TCM as dampness-heat constitution and yang-deficiency constitution for preventing and early treating acute mastitis. This reflects the TCM thought of“treat unoccurred disease”.
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Objective To investigate the distribution and antibiotic resistance characteristics of pathogen in mastitis patients and to provide important foundation for clinical rational antibiotic use .Methods The bacterial isolates from 114 mastitis specimens were collected .Identification and antimicrobial susceptibility testing were carried out .Results A total of 67 strains were isolated from clinical specimen ,in which Staphylococcus aureus[50 .7% (34/67)] and Staphylococcus epidermidis[44 .8% (30/67)] were themostcommonisolate,also Escherichiacoli[1.49% (1/67)],Klebsiellapneumoniae[1.49% (1/67)]andAcinetobactercalcoace-ticus[1 .49% (1/67)] were isolated .The rates of methicillin-resistant Staphylococcus aureus(MRSA) and methicillin-resistance to coagulase-negative Staphylococci(MRCNS) were 8 .8% and 46 .7% ,respectively .The sensitive rates of minocycline ,vancomycin , teicoplanin ,furadantin to MRSA strains were 100 .0% .The sensitive rates of vancomycin ,teicoplanin ,levofloxacin ,furadantin and oxacillin to methicillin-sensitive Staphylococcus aureus(MSSA) were 100 .0% .The sensitive rates of minocycline ,rifampin ,furadan-tin ,vancomycin ,teicoplanin and oxacillin to methicillin-sensitive to coagulase-negative Staphylococci(MSCNS) were 100 .0% .The sensitive rates of vancomycin ,teicoplanin ,minocycline and furadantin to MRCNS were 100 .0% .The resistance rates of penicillin to MRSA ,MSSA ,MSCNS ,MRCNS were 100 .0% .Conclusion Staphylococcus is the main pathogen of mastitis patients .Penicillin is not a first selective drug for acute mastitis .
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Objective: To observe the clinical effect of treating acute mastitis with tuina manipulation.Method: Tuina manipulation was applied to treat 32 cases in the observation group, while external Jinhuang san was applied to treat 16 cases in the control group. Result: The total effective rate in the observation group was 96.8% and the total effective rate in the control group was 87.4%. The therapeutic effect of the two groups had significant difference (P＜0.01) and the treatment period and times between the two groups had significant difference as well (P＜0.01). Conclusion: Tuina manipulation had better effect for acute mastitis.