Theoretical Study And Clinical Researchon Treatment Of Postpartum Hypogalactia By Integrated Traditional Chinese Medicine And Western Medicine

Generally acknowledged,breastfeeding is the best way to nurture an infant. There are close correlation between feeding patterns and the growth and development of the infant.Breast milk provides complete and perfect nutrition to meet the changing nutritional needs of the growing infant.Breast milk,which contains various anti-bacterial and anti-viral agents,also aids the development of the infant's own immune system.Meanwhile,breastfeeding creates emotional bonds between the mother and her infant,maximizes a child's intellectual potential.Although breastfeeding is a natural human activity,difficulties are not rare. This thesis mainly focuses on postpartum hypogalactia,which is one of the common causes to result difficulties in breastfeeding.The diagnosis and treatment of postpartum hypogalactia are widely concerned by the practitioners in fields of clinical medicine as it results negative effects on the health of both mothers and children.In view of western medicine,various clinical studies have proven that breastfeeding difficulties can be resolved with such methods as more baby's proper suckling reflex, early breastfeeding and rooming in which allow the baby to obtain enough milk during lactation.On the other hand,there are also a variety of theories and effective therapies treating the postpartum hypogalactia according to Traditional Chinese Medicine.They include the fields of etiology and pathogenesis,syndrome, treatment,prescription,and preventive measurement in TCM theories.While there is lack of evidence-based research to prove the clinical efficacy due to the historical and social limitations,it causes insufficient attention to the application of Traditional Chinese Medicine in treating postpartum hypogalactia by existing public mother and child care systems.On the foundations of classic literatures of Traditional Chinese Medicine and evidence-based research,this thesis proposed a systemized therapeutic and appraisal scheme in the diagnosis and treatment of postpartum hypogalactia under the guidance of Traditional Chinese Medicine.The thesis comprised three sections:literatures review,theorectical study and clinical research.1.Literatures Review:In reviewing the relevant literatures of Traditional Chinese Medicine from Pre-Qin to contemporary era,this section mentions all influential theories and clinical practices about the TCM etiologies and pathogeneses,syndromes, treatments,prescriptions,preventive measurements and internal factors as well as external factors of the postpartum hypogalactia.With complementary review of western medicine,this section also provides a full description in the contemporary progress and problems of integrated western medicine as well as TCM treatments for postpartum hypogalactia.2 Theorectical Study:This section emphasizes on the study of theories of Traditional Chinese Medicine and western medicine for the therapeutic and appraisal scheme,the countermeasures in rehabilitation and prevention of post-natal lack in human breast milk.Objective:Study the crucial theories and clinical practices of the Traditional Chinese Medicine and western medicine about the issues of post-natal lack in human breast milk.Methods:By reorganization,classification,induction and conclusion of all relevant, ancient and contemporary literatures on the issues of post-natal lack in human breast milk,the thesis composes a comprehensive illustration of the postpartum hypogalactia.Results:As a result of the long history and development,the presence of comprehensive theoretical framework inherited from ancestors and its efficacy,the therapeutics of Traditional Chinese Medicine could be strongly recommended and promoted in lactation and treating the postpartum hypogalactia by personal,private and public heath care utilities.Conclusion:On the foundation of rigorous theoretical framework in explaining the internal and external factors,the application of syndrome differentiation treatment and clinical practice,the Traditional Chinese Medicine played an essential role in promoting lactation and treating the postpartum hypogalactia.Although there were enormous experiences and information recorded by our ancestors in their own words,there was not enough systematic and scientific evidence to prove the efficacy in view of modern medicine.Therefore,the final section of the thesis focused on conducting a parallel self-controlled clinical trial to explore the efficacy of treating postpartum hypogalactia with integrated Traditional Chinese Medicine and western medicine therapies. 3 Clinical Research:Conducting a parallel self-controlled clinical trial to explore the efficacy of treating postpartum hypogalactia with integrated Traditional Chinese Medicine and western medicine therapy.Objective:Suggest a systematic approach for relevant practitioners to recognize and handle the issues of lactation.Accordingly,the clinical practitioners analyzed the factors of the postpartum hypogalactia,its differences in individual sufferers and their analytical statistics of breast milk nutrients.The sufferers were treated by integrated western medicine and Traditional Chinese Medicine under the principle of syndrome differentiation treatment.The outcome proved that the treatment successfully resolved the postpartum hypogalactia.The sufferers were rehabilitated to supply enough breast milk with sufficient nutrients to feed the infants.Methods:By Parallel Comparison Clinical Research.On the one hand,the clinical practitioners collected information via a close-ended questionnaire from the volunteer outpatients of breastfeeding consultation utilities.The outpatients were suffering postpartum hypogalactia.The questionnaire contained 11 fields about the outpatients' situation of breastfeeding.On the other hand,another group of subjects were recruited during the period of 1^st April 2009 to 30^th April 2009.The subjects were the clients of the Breast-Feeding Consultation OPD of GanSu Provincial Mother and Child-care Hospital,the Jiangsu Provincial YangZhou Mother and Child-care Hospital,the Jiangsu Provincial HuAian Mother and Child-care Hospital,The Guangxi Provincial LiuZhou Mother and Child-care Hospital.During the research,the clinical practitioners interviewed the subjects,who were in period of lactation and suffering postpartum hypogalactia,to collect relevant information for diagnosis and therapy with the assistance of the software of Breast Feeding Quality Promotion System,Version 1.20.Meanwhile,the subjects' breast milk was collected to analyze its relationship between the ingredients and relevant ultrasonic parameters before and after the treatment.The data was processed by the Ultrasonic Analyser for breast milk (LACTOSCAN LA30).Subsequently,all subjects were under clinical observation in terms of therapy efficacy and rehabilitation according to the therapeutic and apprasial scheme.Finally,the information of the research was processed by software of SPSS 13.0 for statistical analysis and conclusion in views of factors affecting the lactation and performance appraisal of the therapeutic scheme.Results:In the research period,there were 52 effective questionnaires collected.In summary,67%of the subjects selected mixing feeding for lacking or insufficient breast milk.57.69%of the subjects' infants did not satisify with the breast milk quantity.75%of the subjects worried about insufficient quantity of breast milk for the infants.59.62%of the subjects made their own dicision to mixly feed the infants when they thought the breast milk being insufficient.28.85%of subjects suffered postpartum hypogalactia would like to seek help of the advisers or doctors.It sought that 75%of the subjects with postpartum hypogalactia had knowledge about the foodstuffs to stimulate lactogensis.However,38.46%of the subjects with postpartum hypogalactia could not improve the breast milk quantity and quality satisfactorily as well as the fullness of the breast.There were 46 sufferers in postpartum hypogalactia with syndromes strictly complied with the official therapeutic guideline.23 subjects were excluded according to the standards of rejection.23 subjects were qualified to be effective cases for further clinical observation.According to the therapeutic principle of Traditional Chinese Medicine,most of the subjects were suffering syndromes of deficiency.28.26%were identified as pattern ofasthenia of qi and blood,19.56%in liver-qi stagnation,2.1%in phlegm and qi stagnation.The most common symptom was insufficiency of breast milk,which occupied 76%of the subjects.It was indicated that among the 23 subjects,the effective rate was 13.04%,critical effective rate was 52.17%and the rate for clinical-controlled was 21.04%.There were 84 subjects with lack of breast milk in the breastfeeding consultation utilities and their milk components had "density" in 1028.11±2.70 kg/m³,"fat" in 3.30±1.46 g/ 100g,"protein" in 0.94±0.05 g/100g,and "lactose" in 6.76±0.37 g/ 100g.Conclusion:It is feasible to treat the sufferers of the postpartum hypogalactia with integrated Traditional Chinese Medicine and western medicine in the suitable mother and child care hospitals or clinics.