[Introduction]
Acute mastadenitis refers to infection of the breast due to invasion of bacteria into mammary glands and lac-tiferous ducts. This problem is frequently encountered among women with breastfeeding, especially primipara. It usually occurs 3 - 4 weeks after labor due to rupture of nipple and invasion of bacteria complicated by unsmooth secretion of milk and stagnation of milk. The clinical ma-nifestations are local swelling, pain, tenderness and hard nodules of the breast, accompanied by aversion to cold, fever nnd enlargement of lymph nodes over the armpit on the affected side. This disease pertains to breast abscess in TCM due to invasion of pathogenic factors or accumula-tion of milk; or due to mental upsets and stagnation of liver qi; or due to excessive intake of rich foods and accu-mulation of heat in the stomach meridian that lead to the obstruction of the vessels and stagnation of qi, blood and milk.
The clinical manifestations are sudden lumbago and limited movement of the waist. TCM holds that lumbago is caused by improper exertion or falling and contusion that lead to impairment of the lumbar tendons and meridians as well as stagnation of qi and blood.
[Syndrome differentiation]
Redness, swelling and pain of the breast on the affected side; breast nodules, swelling, pain and difficulty in secreting milk before suppuration; frequently accompa-nied by headache due to cold and heat, nausea and thirst; enlargement of the breast lumps, redness and swelling of skin, local continuous throbbing pain and lingering fever.
Sudden onset of lumbago, aggravation in movement, limited movement of the waist, inability of the waist to straighten, difficulty in pronation and turning of the body or even standing, frequent supporting of the waist with the hands; or spasm of the local muscles on the lower limbs, obvious tenderness and evident sprain history.
[Treatment]
Prescription.. Zusanli (ST 36), Shaoze (SI 1) and Jianjing (GB 21).
Modification. For headache due to cold and heat, Hegu (LI 4), Quchi (LI 11) and Fengchi (GB 20) are added; for distension and pain of the breast, Qimen (LR 14) and Taichong (LR 3) are added; for chest oppression and hiccup, Neiguan (PC 6) and Tanzhong (CV 17) are added.
Performance. Reducing needling technique is used. Fengchi (GB 20) and the acupoints on the chest and back are needled with rotating manipulation. Shaoze (SI 1) is pricked to let blood. Jianjing (GB 21) is needled 0.3 -0.5 cun lest the viscera be impaired. Qimen (LR 14) is nee-dled 0.5 cun obliquely toward the breast. Tanzhong (CV 17) is needled horizontally 1 cun toward the affected part.
1. Body acupuncture
Prescription: Shuigou (GV 26), Houxi (SI 3), Weizhong (BL 40), Yaoyangguan (GV 3 ), Dachangshu (BL 25) and Ashi Acupoints.
Performance: Each time 2 4 acupoints are selected and needled with reducing needling technique. Shuigou (GV 26) or Houxi (SI 3) is needled first. Shuigou (GV 26) is needled obliquely upward with rotating manipula-tion of the needle. The patient is asked to move the waist during the retention of the needle. Weizhong (BL 40) is punctured to let blood with a three-edged needle. The acupoints on the waist can also be moxibusted or treated with cupping. The needles are retained for 20 30 mi-nutes and manipulated at intervals.
2. Ear acupuncture
Prescription: Lumbosacral Vertebrae (AH9), reac-tion points, Ear Shenmen (TF4) and Subcortical (AT4).
Performance: Strong stimulation, 30- 60 minutes of needle retention and manipulation of needles at intervals. Or Wangbuliuxingzi (Semen Vaccariae) is used for ear acupressure.
Mild Reminder:The needles are retained for 30 minutes and manipulated at intervals.
