| Background:Hypogalacitia refers to postpartum women who secrete less milk or no milk at all. Women in Taiwan concern most about not producing sufficient breast milk so that the baby stays in hunger. The amount of milk secretio n has a close relationship with nursing mother’s emotion, their physical c ondition and time for rest and labor. Any psychological disturbances suc h as anxiety, fear, stress, sadness could Parasecretion of milk. Less mil k secretion could come from a congenital poor development of the mammary gland, excessive postpartum bleeding or postpartum bad mood. Infection, d iarrhea and semiliquid stools may also cause a shortage in milk or make m ilk secretion unsmooth. Western medicine still has no effective treatment s for no milk secretion, even though they have a way to force a smoother flow of milk through intramuscular injection of oxytocin or using breast pump to induce milk. Chinese medicine believes that the syndrome of insuf ficient milk secretion is caused either by a lack in vital energy or by a physical impediment. Those who have no vital energy usually are the ones with weak circulation and lack sources for milk production. This syndrom e can generally be identified through a soft breast or a breast without s welling pain. Those who have physical impediments usually suffer a circul ation problems in liver or blood. These women have a hard, swelling and a ching breast and some may also have scattered heat spots in their bodies. The clinical diagnosis should be based on a comprehensive analysis of sy mptoms from the whole body, not to be based only on whether the breast ha s a swelling pain. Along this line of reasoning, supplementary treatment should be given to those who lack vital energy and dredging is the way to treat patients with blocked circulation. To promote milk secretion women usually choose to take traditional Chinese medicine and only very few ch oose to use acupuncture. Acupuncture can be localized in the treatment to improve energy circulation and consequently the milk secretion. It can b e applied to those who lack the vital energy or those who suffer blocked circulation. Modern research shows that the acupuncture treatment for pos tpartum hypogalactia mainly works through adjusting the function of hypot halamic-pituitary axis to promote oxytocin. Higher prolactin secretion le ads to more milk secretion. The purpose of this research is to design an experiment to compare the acupuncture treatment with the traditional Chin ese medicine treatment. By detecting the difference in lactation and bloo d prolactin before and after the treatment, the clinical evidence from th e research may support acupuncture as an effective treatment for postpart um hypogalactia. The evidence may also help promote acupuncture as an eff ective and comprehensive treatment for postpartum hypogalactia in Taiwan, convince education providers to add acupuncture treatment into the curri culum for pregnant women, establish acupuncture as a clinical path in tre ating postpartum hypogalactia, and eventually gain a support from Taiwan National Health Insurance Agency of the Ministry of Health and Welfare to make acupuncture a standard medical payment for hypogalactia women.Purpose:This research is to understand the effect of the acupuncture treatmen t on hypogalactia women in Taiwan through an experimental design that det ects changes in blood prolactin and milk secretion. The ultimate goal is to apply the findings to the general practice in Chinese medicine, use it as a basis for diagnosis and treatment, and promote the acupuncture trea tment for postpartum hypogalactia. The research, after investigating the curative effect of acupuncture treatment for postpartum women in Taiwan, will also provide a clinical guideline for those who use acupuncture in t reating postpartum hypogalactia.Methods:This research selected 72 postpartum hypogalactia patients who met th e diagnostic criteria. Based on the principles of random sampling, the re search assigned 35 patients to the treatment group and 37 to the control group. Patients in the treatment group received acupuncture treatment tar get ing. at three acupoints (shan zhong, zu san li and shao zer) once a day for a week. Patients in the control group took Chinese herb soup mixed w ith six other elements (ophiopogon tuber, bellflower, Chinese cucumber ro ot, sweet gum fruits, luffa, angelica root). A daily dose was to be taken three times a day after the meals. This treatment lasted for a week. The amount of blood prolactin and milk secretion from the patients in the tw o experiment groups were recorded for two weeks before and after the trea tment. The effectiveness of two different treatments was systematically a ssessed to explore the difference in treatment between the two groups.Outcome:This thesis studied how different treatments, acupuncture or traditio nal Chinese medicine, may cure postpartum hypogalactia. Statistical metho ds were used to compare the difference in milk secretion and blood lactat ion prolactin collected from the two groups of patients before and after the treatments. A rigorous statistical analysis was employed to investiga te and compare the effectiveness of the two treatments.The statistical analysis indicated that there is no difference betwee n the two groups of patients with postpartum hypogalactia in terms of the ir age, number of giving the birth, ways of delivering the baby, and educ ation. Because the p-value was greater than 0.05, the difference was stat istically not significant.The research also found that, after the treatments, the volume of mil k secretion increased for patients in both the treatment group and the co ntrol group. The change was statistically significant (P<0.05) for patie nts in each group, indicating that both treatments were able to increase milk secretion.This research discovered some encouraging evidence based on the chang e in milk secretion and blood prolactin that were collected from the two groups before and after treatment. A week of treatment resulted in 72 cli nical cases. Among the 35 cases collected from the acupuncture group,31 patients were cured and 4 patients improved, showing a 100% effective rat e. The Chinese traditional medicine group yielded 37 cases. Among them al 1,24 patients were cured,10 patients improved and 3 patients showed no effects. The total efficiency improvement rate was 92%. However, the resu Its suggested that there was no statistically significant difference betw een the two groups (P> 0.05). The findings concluded that, even though bo th treatments were effective, there was no difference between using eithe r one as indicated either by milk secretion or by blood prolactin.Conclusion:The clinical cases and statistical results indicated that acupuncture treatment is an effective cure for postpartum hypogalactia. When compari ng acupuncture with traditional Chinese medicine, they showed equal or si milar curative effects. Both treatments increased milk secretion and prom ote blood prolactin. Nevertheless, acupuncture deserves to be promoted be cause it is easy to pinpoint the acupoints, simple in operation, and inex pensive in clinical applications. |
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