摘要
目的探讨加味玉屏风散(主要由黄芪、白术、防风、桑白皮和甘草组成)煎汤乳头涂抹对乳头皲裂/疼痛的预防效果。方法本实验采用随机对照设计,选取2014年12月—2015年6月的初产妇,简单随机化分组分为全程干预组(95例)、产后干预组(94例)、对照组(90例)。全程干预组于孕37周始开始使用加味玉屏风散煎汤涂抹乳头、乳晕,每日早晚各一次,于每次哺乳后继续使用延续至产后7 d;产后干预组于分娩后2 h回病房时给予加味玉屏风散煎汤涂抹,并于每次哺乳后使用至产后7 d,涂抹方法同全程干预组;对照组仅用清水清洁乳头,时间每天一次,如有初乳分泌,则挤出初乳涂抹于乳头表面。各组均给予正确母乳喂养姿势及相关喂养知识指导,在分娩后12 h至出院前每天观察和评估婴儿吸吮、乳头疼痛及皲裂情况,产后6个月电话随访婴儿喂养情况。结果全程干预组、产后干预组和对照组的乳头皲裂发生率分别为10.53%、21.28%和25.56%,3组间比较差异有统计学意义(P<0.05)。3组间乳头皲裂的严重程度差异无统计学意义(P>0.05)。3组产妇乳头明显疼痛分别为17例(17.89%)、30例(31.91%)和35例(38.89%),3组间乳头疼痛程度差异有统计学意义(P<0.05)。结论加味玉屏风散煎汤涂抹乳头,于孕37周始至产后7 d的连续使用,能有效降低乳头皲裂的发生率,也能有效减轻婴儿吸吮造成的乳头疼痛,间接提高了6个月内的纯母乳喂养率。
Objective To evaluate the preventive effectiveness of modified Yupingfeng powder decoction（ astragalus root,atractylis ovata,radix sileris,the root bark of white mulberry,liquoric root,etc. were included） smearing on cracked nipple and pain during breastfeeding in in Chinese breastfeeding women. Methods Using the randomized control design,279 primipara in our hospital between December,2014 and June,2015 were enrolled and randomized into control group,pre and postnatal intervention group and postnatal intervention group. Women in pre and postnatal intervention group were treated with modified Yupingfeng powder decoction twice a day on the morning and night started from 37 gestation weeks till 7 days postpartum,while the postnatal intervention group were started from 2 hours after delivery till 7 days postpartum,and the control group were treated with plain water or colostrums if it was available. Breastfeeding skills were implemented under the supervision of midwives. Nipple trauma and pain intensity were evaluated by nipple trauma score and visual analog scale（ VAS） every day after 12 hours postpartum. Baby feeding condition was followed up by phone calls 6months after delivery. Results The incidence of cracked nipple were 10. 53%,21. 28% and 25. 56% in the pre and postnatal intervention group and control group,respectively,with significant difference（ P〈0. 05）. There was no significant difference among the three groups in severity. There were 17 cases（ 17. 89%） in pre and postnatal intervention group,30 cases（ 31. 91%） in postpartum intervention group and 35 cases（ 38. 89%） in control group suffered from severe nipple pain,and the difference among the three groups was significant（ P〈0. 05）. Conclusion The use of modified Yupingfeng powder decoction from 37 gestation weeks to 7 days postpartum is effective on preventing nipple cracks and relieving nipple pain in Chinese Breastfeeding Women. The treatment may indirectly increase the rate of pure breastfeeding in 6 months.
出处
《中华全科医学》
2017年第6期1040-1043,1090,共5页
Chinese Journal of General Practice
基金
浙江省中医药科技计划项目(2014ZA084)
关键词
玉屏风散
乳头皲裂
中药涂抹
母乳喂养
预防
Yupingfeng powder
Cracked nipple
External Chinese medicine
Breastfeeding
Prevention
