乳腺(xian)炎在中醫中叫什么
急(ji)性乳腺炎(yan)在(zai)中醫(yi)名稱為“乳(ru)癰(yong)”,是以乳(ru)房紅(hong)腫疼痛(tong),乳(ru)汁排出不(bu)暢,以致結膿(nong)(nong)成癰(yong)的急性化膿(nong)(nong)性病證。多(duo)發于產后哺乳(ru)的產婦,尤其是初產婦更(geng)為(wei)多(duo)見,俗稱奶瘡。
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乳腺炎辨(bian)證分型
乳(ru)腺(xian)(xian)(xian)(xian)炎(yan)(yan)(yan)主(zhu)要的(de)發病(bing)原因(yin)是(shi)(shi)乳(ru)汁(zhi)的(de)淤(yu)積致使(shi)細(xi)菌感染。乳(ru)汁(zhi)過多,排乳(ru)不(bu)(bu)暢會(hui)使(shi)得乳(ru)汁(zhi)淤(yu)積成塊,引起細(xi)菌滋生,進而形(xing)成乳(ru)腺(xian)(xian)(xian)(xian)炎(yan)(yan)(yan)。產后體虛,包(bao)裹過于嚴實,出汗(han)過多,清洗(xi)不(bu)(bu)足,使(shi)得細(xi)菌滋生,這(zhe)些都是(shi)(shi)乳(ru)腺(xian)(xian)(xian)(xian)炎(yan)(yan)(yan)發病(bing)的(de)因(yin)素。不(bu)(bu)同(tong)的(de)病(bing)因(yin)將乳(ru)腺(xian)(xian)(xian)(xian)炎(yan)(yan)(yan)主(zhu)要分為(wei)(wei)了(le)不(bu)(bu)同(tong)的(de)類(lei)型,分別是(shi)(shi)急(ji)性化膿(nong)性乳(ru)腺(xian)(xian)(xian)(xian)炎(yan)(yan)(yan)、乳(ru)暈旁瘺管、漿細(xi)胞性乳(ru)腺(xian)(xian)(xian)(xian)炎(yan)(yan)(yan)等(deng),其中急(ji)性乳(ru)腺(xian)(xian)(xian)(xian)炎(yan)(yan)(yan)最為(wei)(wei)常(chang)見。急(ji)性乳(ru)腺(xian)(xian)(xian)(xian)炎(yan)(yan)(yan)主(zhu)要可以(yi)分為(wei)(wei)三個階段的(de)臨床(chuang)表現(xian),分別是(shi)(shi)一期(qi)(qi)紅腫期(qi)(qi)、二期(qi)(qi)膿(nong)腫形(xing)成期(qi)(qi)以(yi)及三期(qi)(qi)膿(nong)腫潰后期(qi)(qi)。一旦到了(le)膿(nong)腫形(xing)成期(qi)(qi),炎(yan)(yan)(yan)癥的(de)繼續加重會(hui)是(shi)(shi)的(de)組織壞死,形(xing)成的(de)腫塊會(hui)不(bu)(bu)斷加大(da)且變硬(ying);到了(le)三期(qi)(qi),膿(nong)腫會(hui)自行破潰,或需要進行手(shou)術切開排出膿(nong)液。因(yin)此,乳(ru)腺(xian)(xian)(xian)(xian)炎(yan)(yan)(yan)需要盡(jin)早(zao)的(de)發現(xian)和治療。
此外,乳腺炎有(you)三種常見的分型:急性(xing)(xing)膿腫(zhong)型、炎性(xing)(xing)腫(zhong)塊(kuai)型以及慢性(xing)(xing)瘺管(guan)型。
1、急性膿腫(zhong)型,膿腫(zhong)塊主(zhu)要位于乳暈的周圍,呈扁(bian)平或者(zhe)結(jie)節(jie)狀(zhuang),或伴有乳頭內陷。
2、炎性腫(zhong)(zhong)塊(kuai)型,這是在慢性病變的(de)基(ji)礎上(shang)出現急性感染,進而形成了腫(zhong)(zhong)塊(kuai)。嚴重時還會有局(ju)部的(de)紅腫(zhong)(zhong)、觸痛感等癥狀。
3、慢性(xing)瘺管(guan)(guan)型(xing),這種類(lei)型(xing)比較稍尖,屬(shu)于膿腫自行破潰(kui)或引流(liu)術后(hou)形成(cheng)瘺管(guan)(guan)或竇(dou)道(dao)。
乳腺炎中醫治療
1、中醫外治方法
(1)推(tui)拿(na):乳(ru)(ru)(ru)腺以(yi)(yi)(yi)(yi)通為(wei)用,以(yi)(yi)(yi)(yi)堵為(wei)逆,以(yi)(yi)(yi)(yi)塞為(wei)因,治療(liao)以(yi)(yi)(yi)(yi)消(xiao)為(wei)貴,外治以(yi)(yi)(yi)(yi)“通”為(wei)主,“通”能蕩滌淤乳(ru)(ru)(ru),使敗乳(ru)(ru)(ru)、毒(du)熱排(pai)出(chu),疏(shu)表(biao)邪以(yi)(yi)(yi)(yi)通衛氣,通乳(ru)(ru)(ru)絡以(yi)(yi)(yi)(yi)去(qu)積乳(ru)(ru)(ru),積乳(ru)(ru)(ru)去(qu)則(ze)諸癥自消(xiao)。中(zhong)醫推(tui)拿(na)直接(jie)作用于病變部位,起到擴張乳(ru)(ru)(ru)管、疏(shu)通經絡、排(pai)除(chu)乳(ru)(ru)(ru)栓、消(xiao)除(chu)積乳(ru)(ru)(ru)等作用,而快速緩解(jie)癥狀(zhuang)。
(2)中藥(yao)(yao)外敷:傳統藥(yao)(yao)物有金黃膏、芙蓉膏等,單味中藥(yao)(yao)如(ru)馬齒莧、蒲公英等,具有清熱解毒(du)、消(xiao)腫(zhong)散結等功(gong)效,配合中醫(yi)推拿(na),能取得滿意(yi)療效。
2、中藥內服方(fang)法
(1)早期:中藥以(yi)(yi)通(tong)(tong)(tong)乳(ru)絡以(yi)(yi)去積乳(ru),和(he)營血以(yi)(yi)散淤(yu)滯(zhi),行氣滯(zhi)以(yi)(yi)消結塊(kuai),通(tong)(tong)(tong)腑實(shi)以(yi)(yi)瀉胃熱(re),清肺熱(re)以(yi)(yi)通(tong)(tong)(tong)大腸(chang)為治療原則,具體(ti)用藥可選理氣、通(tong)(tong)(tong)乳(ru)、活血、散結、通(tong)(tong)(tong)便之品(pin),常用藥物有炮山甲、王不留行、桔梗、郁金、陳(chen)皮、絲瓜(gua)絡、路路通(tong)(tong)(tong)、漏蘆、青皮、牛蒡子、柴(chai)胡、通(tong)(tong)(tong)草等。
(2)化膿(nong)期:早起如治(zhi)療(liao)不當則病情(qing)進一步(bu)發展,形成膿(nong)腫,治(zhi)宜(yi)清熱解毒、托(tuo)里排膿(nong),常用(yong)藥物(wu)有炮山(shan)甲(jia)、皂(zao)角刺、郁金(jin)、青皮、桔梗(geng)、王不留行(xing)、全瓜蔞、蒲(pu)公英、連翹(qiao)、牛蒡子、黃(huang)芪、黨參(can)、白芷等。
(3)恢復期:成膿期膿腫潰破或術手切開排膿后至愈合的一段時期,以氣血兩虛、余毒未清最為常見,治療目標為祛腐生肌,促進愈合,治宜益氣養血、和營托毒,常用藥物有黃芪、黨參、山藥、白術、茯苓、陳皮、皂角刺、桔梗、金銀花、當歸、川芎等。