Yanghe Decoction for the Treatment of Mastitis
Ms. Jiang, 23 years old. The patient is 62 days postpartum and currently breastfeeding. About 1 month ago, she experienced left breast swelling, hardness, pain, and fever. She received treatment locally and was diagnosed with mastitis. However, the treatment with both Chinese and Western medicine was ineffective. She was later transferred to another hospital where she was diagnosed with "posterior breast abscess". Local surgical drainage was performed, and multiple antibiotics were administered, but her condition did not improve. Currently, the patient is emaciated, pale, mentally fatigued, weak in speech, and has a fever <39℃>. She feels thirsty but does not want to drink. The left breast is enlarged, hard to touch, and painful. The skin color is unchanged, and a small amount of pus is oozing from the wound. The tongue is pale, and the pulse is deep and thin. Blood routine examination shows white blood cells: 1168/mm3, neutrophils: 83%. The diagnosis is breast abscess, which is caused by deficiency of nourishing blood, cold congealing phlegm obstruction, and stagnation of milk ducts. The treatment principle is to tonify qi and nourish blood, and warm and unblock the milk ducts. The prescription includes 30g of cooked Rehmannia, 30g of Astragalus, 5g of cinnamon, 10g of processed ginger, 15g of deer antler gelatin, 15g of Ephedra, 5g of licorice, 10g of balloon flower, 10g of Dahurian Angelica, and 10g of Sophora. After taking the prescription for 3 doses, the fever subsided, body temperature returned to normal, the breast abscess pain improved significantly, and the blood routine examination returned to normal. The original prescription was modified to reduce Ephedra to 5g and add 12g of hawthorn. After taking the prescription for an additional 5 doses, the breast swelling and pain disappeared, but the wound did not heal completely. Eventually, the patient recovered by taking Shiquan Dabu Decoction.
In the early to middle stage of mastitis, the method of clearing heat and detoxification is effective in dispersing masses. However, for those who have been treated for a long time without improvement due to deficiency, the use of Yanghe Decoction often has miraculous effects, with additions of Huangqi, Sophora, and other herbs.
