產後哺乳的中西醫生理機制探討

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

何佳霖1吳炫璋1,2,*

1佛教慈濟醫療財團法人台北慈濟醫院中醫部，台北，台灣

2慈濟大學學士後中醫學系，花蓮，台灣

本文以中西醫文獻中關於產後哺乳生理機制相互對照，闡明中醫古籍關於乳房解剖與生理，同時回顧乳腺的發育、乳腺產生分泌乳汁能力的過程，以及產乳的過程在中西醫之異同。研究結果提出中醫生理認為「乳房屬胃，乳頭屬肝」可對應至現代醫學對泌乳生理之乳汁生成與排乳反射，且古籍中即觀察到乳腺生成的中醫生理機制與現代泌乳乳汁生成的生理機轉不謀而合。本文也增加提供了現代泌乳知識中關於乳汁生成不足與排出不暢與衛教等相關因素。結論建議中醫師於臨床評估產婦乳汁是否充足時，應一併將本文所提之中西醫學知識背景納入分析並考量母嬰相關因素以提供產婦更細緻的照護。

【關鍵詞】產後哺乳 ； 泌乳 ； 生理機制 ； 中醫婦科 ； 婦產科學

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