中醫藥防治產後常見病

| 09-05-2017

《中醫藥防治產後常見病》


下葵涌中醫中心  鄧舜元註冊中醫師

           經歷過懷胎十月及分娩痛楚之後,產婦們如同打了一場大仗,身心感到極度疲累,很多都渴望能在產後可以好好休息及復原。然而,不少婦女們卻在產後因調理不當而遇上了不同的產後病,有的更因而患上了產後抑鬱,嚴重影響了健康、生活和家庭。故此,產婦們應該多點認識產後病及防治之法,以幫助大家能輕鬆面對產褥期。若調理得法時可使身體加快復原,甚至可提升體質,有的更勝懷孕之前。

產後病之病因病機

           孕婦分娩後,身體恢復至懷孕前狀態的一段時間,稱為「產褥期」,一般需要六週。而在產褥期發生與分娩或產褥有關的疾病,則稱為「產後病」。

產後病之病因病機一般可分為四類:

  1. 產後惡露不絕

    惡露是指婦女生產後,子宮排出的餘血和濁液。一般而言,鮮紅色的血液惡露會於產後持續3-4天,若產後血性惡露持續10天以上,仍淋漓不盡者,乃是子宮復舊不全,是為產後惡露不絕。另若非血性惡露持續3周或以上未乾淨者,也可歸納為此病。

    氣虛

    症狀:
    惡露量多,色淡質稀,無臭味;面色㿠白,四肢乏力,舌淡苔薄白,脈細弱

    病因病機:
    氣虛致沖任不固,血失統攝

    治法:
    補氣攝血固沖

    血瘀

    症狀:
    惡露量時少或時多,色黯有塊,小腹疼痛拒按,舌紫黯或有瘀點,脈沉澀

    病因病機:
    瘀血內阻,血不歸經

    治法:
    活血化瘀止血


  2. 產後身痛

    產婦在產褥期內,肢體或關節出現酸楚、疼痛、麻木、重着者均稱為「產後身痛」, 俗稱「產後風」。

    血虛

    症狀:
    產後偏身關節酸痛,肢體麻木,面色萎黃,,頭暈心悸,舌淡苔薄白,脈細弱。

    病因病機:
    素體血虛,產後失血過多,使陰血虧虛,經脈關節失於濡養,引致肢體麻木、酸痛,不榮而痛。

    治法:
    養血益氣,溫經通絡

    血瘀

    症狀:
    產後身痛,尤見下肢疼痛,麻木發硬,腫脹明顯,惡露量少,色紫黯夾血塊,小腹疼痛,拒按,舌黯苔白,脈弦澀

    病因病機:
    產後餘血未淨,停滯經脈,不通則痛

    治法:
    養血活血,化瘀止痛

    風寒

    症狀:
    產後偏身疼痛, 屈伸不利或痛無定處;或冷痛劇烈,得熱則舒或關節腫脹,麻木伴惡寒畏風,舌淡苔薄白,脈濡細

    治法:
    養血袪風, 散寒除濕


  3. 產後大便難

    指產後飲食如常,但大便卻乾結或數日不解。

    血虛津虧

    症狀:
    產後大便乾燥,或數日不解,腹無脹痛,面色萎黃,舌淡,苔薄白,脈細弱

    病因病機:
    產後氣血津液耗損,使腸道失去濡潤,令大便乾結

    治法:
    養血潤燥,滑腸通便

    脾肺氣虛

    症狀:
    症見產後大便數日不解,並不乾硬,雖有便意,但努責難出,神倦乏力汗多,舌淡,苔薄白,脈緩弱

    病因病機:
    產後脾肺氣虛,無力傳導大便

    治法:
    補脾益肺,潤腸通便


  4. 產後缺乳

    產後哺乳期內, 產婦乳汁甚少或無乳汁可下者。

    氣血虛弱

    症狀:
    乳汁少或全無,乳汁稀薄,乳房柔軟無脹感,面色少華,倦怠乏力,舌淡苔薄白,脈細弱

    病機:
    多因素體氣血虛弱,復因產時失血耗氣,致使氣血生化不足

    治法:
    補氣養血,通脈增乳

    食療方《鯽魚豬蹄湯》
    材料:
    鮮鯽魚1條,豬蹄1隻,通草6克,鹽姜各適量

    制法:
    將豬蹄洗淨後斬成小塊,鯽魚去鰓及內臟,洗淨後鯽魚放油鍋煎,之後再將豬蹄、通草同放入鍋內, 加適量水及姜, 用中火煮30分鐘左右, 湯呈乳白色後即可飲用

    功效:
    補氣養血增乳

    肝鬱氣滯

    症狀:
    乳汁分泌少,或全無,乳房脹硬疼痛,乳汁濃稠,伴胸脅脹滿,情志抑鬱,食欲不振,舌淡紅,苔薄黃,脈弦或弦滑

    病因病機:
    多因素性抑鬱,肝鬱氣滯,乳絡不通, 阻礙乳汁分泌

    治法:
    疏肝解鬱,活絡通乳

哺乳時注意事項

           哺乳期是指產婦用自己乳汁餵養嬰兒的時期,一般為六至十個月。由於母乳營養豐富,是最適合嬰兒吸收的。另亦因為母乳含多種免疫物質,故能增強嬰兒的抗病能力。

  • 盡早餵哺母乳

    產後三十分鐘內應及時餵哺初乳,記緊要保持正確姿勢。一般每隔三至四小時一次。若嬰兒未吸空,應將多餘的乳汁擠出,以防止乳汁壅積成病,若出現乳頭破裂應及早處理。

  • 衛生護理

    產婦每次哺乳前要用溫開水清洗乳房,乳頭及洗手避免嬰兒吮入不潔之物。

  • 保持心情開朗

    乳母要保持心情開朗,有信心能餵哺孩子,另亦要有充足睡眠,勞逸結合,才能確保乳汁通暢。

  • 飲食調理

    乳母要忌酸澀及寒性食物,以免氣機壅滯。忌辛辣刺激物如咖啡辣椒等,以防耗氣傷血,另亦要忌回乳之品,如麥芽、啤酒等。

  • 適量按摩

    產後可以進行乳房按摩或熱敷,能疏通乳腺及增加血液循環,使乳汁分泌暢順。

           產褥期是女性人生中一個非常重要的階段,分娩後不但需要盡快復元身體,還要能分泌足夠乳汁以喂哺新生兒。故此,必須好好重視產後身體調理,不能掉以輕心。記緊若身體有不明症狀時,必須向合資格醫師求診,不要延誤病情。

文章內容僅供參考,不能作為診斷及治療的醫據。
如需獲得健康方面的幫助,請諮詢中醫師及醫護人員的專業意見。

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