天宗穴刮痧在肝郁痰凝型乳癖的临床观察

朱晓平　　许月萍　　朱云

[關键词] 护理干预;天宗穴;刮痧;肝郁痰凝;乳癖

[中图分类号] R271.44          [文献标识码] B          [文章编号] 1673-9701（2021）14-0168-06

Clinical observation of scraping therapy at Tianzong point in the treatment of breast nodules of liver qi depression and phlegm stasis

ZHU Xiaoping   XU Yueping   ZHU Yun

Jiaxing Hospital of T.C.M. of Zhejiang Province， Jiaxing   314001， China

[Abstract] Objective To explore the therapeutic effect and clinical application value of scraping at Tianzong point in patients with breast nodules of liver qi depression and phlegm stasis. Methods A total of 130 patients with breast nodules of liver qi depression and phlegm stasis treated in our hospital from January 2019 to December 2019 were selected and randomly divided into the control group and the observation group according to the number table method. The control group was given the conventional treatment， and the observation group received scraping therapy at Tianzong point. Both groups were treated for one month. The total effective rate of treatment， breast pain and tumor grade， inflammatory factors and hormone changes in the body， quality of life and ultrasound indicators were compared between the two groups. Results The total effective rate of chemotherapy in the observation group was 93.85%， which was higher than 76.92% in the control group， with statistically significant differences（P<0.05）. The breast pain score （8.01±1.25） of the observation group after treatment and the breast mass grading score（10.02±1.03） were lower than those of the control group after treatment， with statistically significant difference （P<0.05）. After treatment， the estradiol was （121.65±1.98） pg/mL in the observation group， lower than that in the control group， and the progesterone was （16.44±2.02） ng/mL and luteinizing hormone was（16.16±2.36） mIU/mL in the observation group， which was higher than that in the control group， with statistically significant differences （P<0.05）. SOD of the observation group was （89.54±8.97） U/L， higher than that of the control group after treatment. MDA was （4.11±1.03） μmol/L and TNF-α was （1.02±0.76） ng/mL of the observation group， which were lower than that of the control group after treatment， with statistically significant differences（P<0.05）. After treatment， the scores of physiology， psychology， social relations and environment in the observation group were （85.12±8.21）， （74.65±5.79）， （75.23±5.67） and （70.96±6.03）， respectively， which were significantly higher than those in the control group， with statistically significant differences（P<0.05）. After treatment， the diameter of hypoecho， lump， inner diameter of lactiferous duct and thickness of gland layer in observation group were （14.02±1.25）mm， （1.44±0.21）mm， （1.32±0.23） mm and（6.02±1.03）mm， which were lower than those in control group， with statistically significant differences（P<0.05）. Conclusion The application of scraping therapy at Tianzong point can improve the therapeutic effect， reduce breast pain， reduce breast mass， adjust hormone changes in the body， reduce oxidative stress， and improve the quality of life of patients with liver qi depression and phlegm stasis. It is worthy of clinical applications.

[Key words] Nursing intervention; Tianzong point; Scraping therapy; Liver qi depression and phlegm stasis; Breast nodules

乳腺增生是临床常见的疾病，主要包括乳腺组织增生、乳腺腺病、乳腺囊性增生等，属于非炎症、非肿瘤、增生性病变，患者的乳腺间质发生增生和复旧不全导致乳腺结构数量和形态变化，临床主要以乳房肿块和疼痛为主，对女性的身心健康产生严重的影响[1]。目前临床治疗乳腺增生具有重要的临床和社会意义，以往主要采取纠正激素分泌紊乱的药物治疗为主，目的是调整患者体内激素水平至平衡，虽然可以快速缓解临床症状，但是无法从根本上调节内分泌功能，因此不建议长期应用和早期应用[2]。中医学是临床重要的补充替代医学，中医认为乳腺增生属于“乳癖”范畴，一般是情志不畅、肝气瘀滞等因素造成病发，因此中医提倡以疏肝解郁、调理气机为主要治疗原则，刮痧治疗是中医常用的外治疗法，遵循了“经脉所过，主治所及”原则，让邪气以“出痧”方式从体内排出，有助于将体内有害物质和代谢产物通过毛细血管壁外渗，随着“痧”的形成与消散达到“透痧脱毒”的作用[3]。本研究观察了护理干预配合天宗穴刮痧应用在肝郁痰凝型乳癖患者中的疗效，以期为临床提供指导和依据，现报道如下。

1 资料与方法

1.1 一般资料

选取在本院开展治疗的肝郁痰凝型乳癖患者130例，按照数字表法将患者分为对照组和观察组，患者入院时间为2019年1～12月，每组各65例。……