产後哺乳的中西医生理机制探讨

Discussion on the Physiological Mechanism of Postpartum Breast-feeding in Traditional Chinese and Western Medicine

何佳霖1吴炫璋1,2,*

1佛教慈济医疗财团法人台北慈济医院中医部，台北，台湾

2慈济大学学士後中医学系，花莲，台湾

本文以中西医文献中关於产後哺乳生理机制相互对照，阐明中医古籍关於乳房解剖与生理，同时回顾乳腺的发育、乳腺产生分泌乳汁能力的过程，以及产乳的过程在中西医之异同。研究结果提出中医生理认为「乳房属胃，乳头属肝」可对应至现代医学对泌乳生理之乳汁生成与排乳反射，且古籍中即观察到乳腺生成的中医生理机制与现代泌乳乳汁生成的生理机转不谋而合。本文也增加提供了现代泌乳知识中关於乳汁生成不足与排出不畅与卫教等相关因素。结论建议中医师於临床评估产妇乳汁是否充足时，应一并将本文所提之中西医学知识背景纳入分析并考量母婴相关因素以提供产妇更细致的照护。

【关键词】产後哺乳 ； 泌乳 ； 生理机制 ； 中医妇科 ； 妇产科学

This article compares the physiological mechanisms of postpartum breastfeeding in traditional Chinese medicine (TCM) and Western medicine (WM) literature to clarify the anatomy and physiology of breasts in ancient TCM Classics. It also reviews the development of the mammary gland (Mammogenesis), the process of the mammary gland’s ability to secrete milk (lactogenesis), and the similarities and differences in the milk production process in TCM and WM. The results suggest that the TCM’s theory that "breasts belong to the stomach and nipples belong to the liver" can correspond to WM’s understanding of the lactation physiology of milk production and milk ejection reflex. Moreover, the TCM physiological mechanism of mammary gland production and the physiology of modern lactation milk production have been observed in TCM Classics. This article also provides related factors such as insufficient milk production, poor discharge and health education in modern lactation knowledge. The conclusion suggests that Chinese medicine practitioners should include the TCM and WM knowledge background mentioned in this article into the analysis and consider maternal and child-related factors when clinically evaluating whether maternal milk is sufficient to provide more detailed care for pregnant women.

【Keywords】Postpartum lactation ； Physiological mechanism ； Lactation ； Gynecology of TCM ； Obstetrics and Gynecology