Prolactinic effects and molecular mechanisms of total sterone from Echinops latifolius Tausch on the milk deficient model rats / 中国临床药理学与治疗学

AIM: To investigate the effect of an effective component total sterone (TSR) of Echinops latifolius Tausch, the main component of a Chinese patent medicine Cuiru Keli (national drug standard WS3-413 (Z-085)-2003 (Z), on lactation and its possible mechanism. METHODS: After mating between male and female SD rats, 60 female rats were randomly divided into normal control group, model group, TSR low-dose and high-dose groups and prolactin granule positive control group, with 12 female rats in each group and 8 newborn rats in each nest. In addition to the normal control group, the rats in each group were intraperitoneally injected with levodopa 2 mg/kg once a day for 7 days from the second day of delivery. The rats in the normal control group were given normal saline by gavage once a day for 14 days. From the beginning of self-sufficiency, the single lactation of the female rats was measured every day until the 14th day, and then the female rats in each group were killed. Pathological HE staining was used to observe the morphological changes of mammary gland tissue in each group. ELISA was used to detect the levels of serum prolactin (PRL) and 5-hydroxytryptamine (5-HT). Immunohistochemistry was used to detect the distribution of PRL in mammary gland tissue of each group. Furthermore, Real-time qPCR was used to detect the expression of milk protein, milk fat related genes β-casein, FAS, ACC and the expression of canonical Wnt signaling pathway related genes β-catenin, c-Myc, CCND1, SFRP4, DNMT1, MeCP2 in mammary gland of each group. RESULTS: Both low and high dose TSR could significantly increase the single lactation volume, improve the pathological morphology of mammary gland, and increase the serum levels of PRL and 5-HT. TSR increased the distribution of PRL and up-regulated the expression of milk protein, milk fat related genes β-casein, FAS, ACC and canonical Wnt signaling pathway related genes β-catenin, c-Myc, CCND1, SFRP4, DNMT1, MeCP2.CONCLUSION: TSR can significantly promote lactation in lactation deficient rats, and its mechanism may be related to promoting the release of PRL and 5-HT in serum, increasing the distribution of PRL in mammary gland, up-regulating the milk protein and milk fat related genes and activating the canonical Wnt signal.

Eficácia da acupuntura auricular na duração do aleitamento materno exclusivo: um estudo piloto randomizado / Efficacy of auricular acupuncture on the duration of exclusive breastfeeding: a randomized pilot study

O aleitamento materno apresenta múltiplos benefícios para a saúde da mãe e do bebê. No entanto, muitos são os fatores que podem interferir na amamentação, destacando-se a percepção de baixa produção láctea. Há evidências de que a acupuntura auricular pode auxiliar nesse contexto. Este estudo tem o objetivo de avaliar por meio de ensaio clínico randomizado se a acupuntura auricular apresenta eficácia na manutenção do aleitamento materno exclusivo e complementado até os seis meses de vida do bebê. Trata-se de um estudo piloto randomizado. O estudo foi aprovado pelo Comitê de Ética em Pesquisa e foi registrada na Plataforma Rebec (Registro Brasileiros de Ensaios Clínicos). A pesquisa foi realizada no Banco de Leite Humano do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo. Foram incluídas 49 participantes com idade igual ou superior a 18 anos, que estavam entre o 5° e o 30° dia pós-parto e que tinham queixa de baixa produção láctea. As participantes foram randomizadas em três grupos: Acupuntura auricular, Acupuntura sham e Placebo. O estudo foi realizado em duas fases: fase de intervenção, no qual foram realizados 5 atendimentos de aleitamento materno para todos os grupos e aplicação da intervenção conforme a alocação da participante no grupo sorteado e a fase de seguimento telefônico em que realizamos ligações até os 6 meses de vida criança. As frequências absolutas e relativas foram calculadas para as variáveis qualitativas. As comparações entre os grupos no tempo basal para as variáveis qualitativas explicativas foram realizadas considerando o teste quadrado, já o teste não paramétrico de Kruskal Wallis foi aplicado para comparar os grupos em relação às variáveis quantitativas. Foram construídos modelos de regressão de efeitos mistos para comparar os tempos e os grupos em relação aos desfechos quantitativos e análise por protocolo. As participantes do grupo três (controle - cuidado usual) eram mais velhas, com média de idade de 36 anos (P-valor 0,0079), identifica-se que a acupuntura auricular teve evidência clínica no efeito protetivo do AME e AMC na fase de seguimento telefônico, pois 2 participantes do grupo de acupuntura auricular ainda amamentavam exclusivamente até os seis meses de vida do bebê de modo exclusivo e nos demais grupos nenhuma participante amamentava. Do ponto de vista estatístico não houveram diferenças significativas

Breastfeeding has multiple benefits for the health of mother and baby. However, there are many factors that can interfere with breastfeeding, the perception of low milk production, is being an important cause of early weaning among nursing mothers. In this sense Ear acupuncture can help to increase milk production. This study aims to evaluate, through a randomized clinical trial, whether auricular acupuncture is effective in maintaining exclusive and supplemented breastfeeding until the baby is six months old. This is a randomized pilot study. The study was approved by the Research Ethics Committee and was registered on the Rebec Platform (Brazilian Registry of Clinical Trials). The research was realized at the Human Milk Bank of Hospital das Clínicas, Faculty of Medicine of Ribeirão Preto, University of São Paulo. Forty-nine participants aged 18 years or over, who were between the 5th and 30th day postpartum and who complained of low milk production, were included. The Participants were randomized into three groups: intervention group, sham acupuncture and placebo. The study was carried out in two phases: intervention phase, in which 5 breastfeeding sessions were carried out for all groups and application of the intervention according to the participant's allocation in the drawn group and the telephone follow-up phase in which we made calls until 6 months of child life. Absolute and relative frequencies were calculated for qualitative variables. Comparisons between groups at baseline for qualitative explanatory variables were performed using the chi-square test, while the non-parametric Kruskal Wallis test was applied to compare groups in relation to quantitative variables. Mixed-effects regression models were built to compare times and groups against quantitative outcomes and analysis per protocol. Participants in group three (control - usual care) were older, with a mean age of 36 years (P-value 0.0079), it is identified that auricular acupuncture had clinical evidence in the protective effect of exclusivebreastfeeding and complementary breastfeeding in the telephone follow-up 2 participants in the auricular acupuncture group still exclusively breastfed until the baby's six months of life and in the other groups none of the participants breastfed. From a statistical point of view there were no significant differences

Effects of lactagogue of four total alkaloids of barley malt via dopamine D2 receptor in postpartum hypogalactia rat / 中草药

Objective: To explore the regulatory effect of malt alkaloid on prolactin (PRL) secretion in the model rat with postpartum hypogalactia induced by bromocriptine based on dopamine D2 receptor, and determine the active fraction of the malt with galactogogue effect. Methods: The postpartum hypogalactia model was established by intragastric administration of bromocriptine mesylate. After the model was successfully established, all groups were given corresponding drug treatment. The concentration of serum PRL, estradiol (E2) and progesterone (P) in each group was detected by ELISA kits. HE staining was used to observe the pathologic changes of breast tissue. RT-PCR was used to determine the mRNA levels of prolactin receptor (PRLR) and dopamine D2 receptor (DRD2) in pituitary gland of rats. Results: Compared with the control group, the levels of serum PRL, P, and E2 were significantly decreased in the model group as well as the mRNA expression of the pituitary PRL cells. But the mRNA expression of the pituitary DRD2 in the model group was significantly increased compared with the control group. Compared with the model group, the malt total alkaloid significantly increased the volume of mammary lobule and dilated the duct. There was a lot of milk in the duct and acinar in the malt total alkaloid group. Besides, the total alkaloids increased the concentration of serum PRL, P, and E2 and the mRNA expression of the pituitary PRL cells, and decreased the mRNA expression of the pituitary DRD2. Conclusion: The primary the active fraction of malt for galactogogue action is total alkaloids, and its mechanism may be related to promoting PRL secretion, increasing serum PRL receptor level and decreasing the mRNA expression of dopamine D2 receptor.

Effect of electroacupuncture at Shaoze (SI 1) on breast milk volume and composition in postpartum hypogalactia / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture at Shaoze (SI 1) on breast milk volume and nutrient composition in postpartum hypogalactia.@*METHODS@#A total of 62 women with postpartum hypogalactia were randomized into an observation group (31 cases, 3 cases dropped off) and a control group (31 cases, 3 cases dropped off). Electroacupuncture was exerted at Shaoze (SI 1) in the observation group and at Shangyang (LI 1) in the control group, 10 Hz in frequency, 30 min each time, once a day. The treatment for 5 times as one course and 3 courses of treatment were required totally. Separately, before treatment and at the end of 1 course and 3 courses of treatment, the breast milk volume was measured and the composition was analyzed. The breast milk volume, nutrient composition (lactose, fat and protein), breast milk energy and density were observed in the two groups. After treatment, the clinical effect was compared between the two groups.@*RESULTS@#In the observation group, after 1 course of treatment, the breast milk volume and the values of lactose and protein in the breast milk were increased as compared with those before treatment, the breast milk energy and density were increased as compared with those before treatment (all <0.05). After 3 courses of treatment, the breast milk volume and the values of nutrient composition (lactose, fat and protein) were improved as compared with those before treatment, and the breast milk energy and density were increased obviously as compared with those before treatment in the observation group (all <0.05). In the control group, after 1 course and 3 courses of treatment, only breast milk volume was increased obviously as compared with that before treatment (both <0.05). After 1 course of treatment, the nutrient composition (lactose and protein), breast milk energy and density in the observation group were higher than those in the control group (all <0.05). After 3 courses of treatment, the levels of breast milk volume, nutrient composition (lactose, fat and protein), breast milk energy and density in the observation group were all higher than those in the control group (all <0.05). The effective rate was 92.9% (26/28) in the observation group, which was higher than 17.9% (5/28) in the control group (<0.05).@*CONCLUSION@#Electroacupuncture at Shaozhe (SI 1) increases breast milk volume in patients with postpartum hypogalactia and promotes the production of the nutrient composition in breast milk, as well as the breast milk energy and density.

Comportamiento de la lactancia materna. Consultorio Médico de Familia No. 16. Policlínico "Manuel Piti Fajardo" / Behavior of the breastfeeding. Family Doctor´s Office Nr. 16. Policlínic "Manuel Piti Fajardo"

RESUMEN Introducción: que un niño reciba y se alimente con lactancia materna en las sociedades actuales, cada día es una tarea más compleja. Objetivo: caracterizar el comportamiento de la lactancia materna en el Consultorio Médico de Familia No 16. Policlínico "Manuel Piti Fajardo", municipio Cárdenas. Materiales y métodos: se realizó un estudio observacional, descriptivo, transversal. El universo lo constituyeron 68 madres de nacidos vivos pertenecientes a esa área de salud, en el período de enero 2011 -diciembre 2015. Las variables estudiadas fueron: edad, nivel escolar, ocupación, tiempo de lactancia, factores que incidieron en la suspensión de la lactancia materna, planificación familiar, conocimientos sobre lactancia materna. Los datos se obtuvieron de las historias clínicas familiares e individuales, del registro de nacimientos del Departamento de Estadística del Policlínico, del Análisis Integral de la Situación de Salud del Consultorio, la encuesta y la observación. Resultados: predominó en las madres de nacidos vivos el grupo de edad de 25 a 29 años, con el 41,7 %. El 77,9 % tenían nivel preuniversitario y el 47,0 % eran trabajadoras. El 47,5 % lactan entre 1-3 meses. Incidió en el abandono de la lactancia materna el no tener suficiente leche con un 44,1 %, el 50,0 % no planificaron el embarazo, y el 58,8 % no poseían los conocimientos adecuados. Conclusiones: un elevado porcentaje de las madres lactan hasta los 3 primeros meses de vida, la causa de abandono más frecuente de lactancia materna fue el no tener suficiente leche. Prevaleceieron los conocimientos no adecuados sobre la lactancia materna.

ABSTRACT Introduction: breastfeeding in current societies is a very complex task. Objective: to characterize breastfeeding in the Family Doctor´s Office Nr. 16 of the Policlinic ¨Manuel Pity Fajardo¨, municipality of Cardenas. Materials and methods: a cross-sectional, descriptive, observational study was carried out. The universe was composed by 68 mothers of born-alive children belonging to that health area in the period January 2011-December 2015. The studied variables were age, scholarship, job, breastfeeding time, factors causing breastfeeding delay, family planning, and knowledge on breastfeeding. Data were gathered from the individual and family records, from the births´ register of the Policlinic Statistics Department, from the Comprehensive Analysis of Health Situation, enquire and observation. Results: the 25-29-years-old age group predominated among mothers of born-alive children (41.7 %). 77.9 % had senior high school scholarship, and 47.0 % were workers. 47.5 % of them breastfeed 1-3 months. Not having enough breast milk (44.1 %), a non-planed pregnancy (50.0 %), and not having the adequate knowledge (58.8 %) influenced in breastfeeding delay. Conclusions: a high percent of mothers breastfeed just during the first three months of life; the most common cause of breastfeeding delay was not having enough breast milk. There it was a prevalence of non-adequate knowledge on maternal breastfeeding.

Literature analysis of tuina therapy for postpartum hypogalactia based on CNKI database / 国际中医中药杂志

Objective To explore the characteristics and efficacy of manual treatment for postpartum hypogalactia.Methods To retrieve the CNKI from 2007 to 2017 on the massage and manual treatment for postpartum hypogalactia,and analyze its syndrome differentiation,acupoint selection,manipulation rules,treatment frequency,treatment courses and clinical efficacy.Results Among the 83 articles included,the massage therapy for postpartum hypogalactia were based on the diseases and syndromes,and the selection of acupoints was diverse and combined with local and distance such as Danzhong (CV 17),Rugen (ST 18),Shaoze (SI 1),Zusanli (ST 36),Pishu (BL 20).The therapy were rich in techniques which often use acupoint stimulation and manipulation.Conclusions Tuina therapy for postpartum hypogalactia is widely used with safety and reliablility.But the operational procedures and efficacy standards need to be further standardized.

Application of acupoint massage in postpartum hypogalactia in puerpera / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the effects of acupoint massage for postpartum hypogalactia in puerpera.</p><p><b>METHODS</b>A total of 60 puerpera of cesarean section were randomized into an observation group and a control group, 30 cases in each one. In the observation group, 2 cases were dropped out. Finally, there were 28 cases in the observation group and 30 cases in the control group. In the control group, the routine nursing after operation in obstetrics department was given, guiding maternal breastfeeding and postpartum health education. In the observation group, on the basis of the treatment as the control group, the corresponding acupoints were selected from the breast related meridians for massage. Acupoint massage was given since the 3rd day after operation, 8:00 am to 9:00 am, once a day, 1 min at one acupoint, continuously for 5 days. The lactation volume, breast filling, galactostasis and milk viscosity were compared in the parturient of the two groups. The clinical therapeutic effects were compared between the two groups.</p><p><b>RESULTS</b>From the 1st to the 2nd days, the differences were not significant in lactation volume, breast filling and galactostasis score between the two groups (all>0.05). From the 3rd to 5th days, the lactation volume, breast filling and galactostasis score in the observation group were all lower than those in the control group (all<0.01). The difference in milk viscosity was not significant in the first 4 days between the two groups (all>0.05). On the 5th day, the score of milk viscosity in the observation group was lower than that in the control group (<0.01). The cured rate was 64.3% (18/28) in the observation group, which was better than 13.3% (4/30) in the control group (<0.05).</p><p><b>CONCLUSION</b>Massage at the acupoints from the breast related meridians effectively promotes the lactation secretion in puerpera of postpartum hypogalactia and alleviates breast distention.</p>

The effect of acupuncture combined with auricular application for puerperal hypogalactia / 中国基层医药

Objective To observe the effect of acupuncture and auricular application in the treatment of puerperal hypogalactia.Methods 300 patients with puerperal hypogalactia,according to the principle of random, balanced,together,were divided into 3 groups:Chinese herbal medicine group and acupuncture combined with auricular group and massage group,each group in 1 00cases.Collected patients'informed consent,and obtained the hospital ethics committee approval.The clinical curative effect was observed.Results After 3 days,in the Chinese herbal medicine group 34 cases recovered,24 cases were markedly effective,efficient in 1 5 cases,27 cases were invalid.In the massage group 7 cases recovered,1 3 cases had marked effect,1 5 cases were effective,ineffective in 65 cases.In the acupuncture combined with auricular group 73 cases cured,1 3 cases were markedly effective,effective in 9 cases, 5 cases were ineffective.The total effective rate between the acupuncture combined with auricular group and Chinese herbal medicine group had significant difference(χ2 =9.600,P <0.01 ).The total effective rate between the acupuncture combined with auricular group and the massage group had significant difference (χ2 =1 3.400,P <0.01 ).The total effective rate between Chinese herbal medicine group and massage group had significant difference (χ2 =6.400,P <0.01 ).Conclusion Acupuncture and auricular application has obvious curative effect for patients with postpartum hypogalactia.

Analysis of the Deficiency of Postnatal Lack of Lactation of / 浙江中医药大学学报

[Objective] The artical summarizes in diagnosis and treatment of postnatal lack of lactation academic thoughts and characteristics of drug use,and own thoughts. [Method] Summary by reading text and access to my perception ,combined with the actual clinical,summarized his main syndrome differentiation and treatment of postnatal lack of lactation thought,medication,and explain orally .[Results] FU Qingzhu according to the cause of postnatal lack of lactation divided into two types, deficiency of Qi and blood,blockage of liver. Pointed out that the error appeared in the dialectical and put forward the correct opinions;and that the disease is mainly related to the lack of blood and liver qi stagnation; the main therapy is tonifying qi and blood, smoothing liver qi, dredging collateral for promoting lactation;the corresponding therapeutic prescriptions were given and analyzed;clinical application of good results.[Conclusion] FU Qingzhu 's idea put forward the original opinion and treatment of medicine, in order to inherit traditional Chinese medicine academic, improve the curative effect of postpartum hypogalactia,and give my opinion, may be the hope of the authority.

Study on the Lactagogue Effect of Rutong Granule on Rat with Postpartum Hypogalactia / 中国药房

OBJECTIVE: To study the lactagogue effect of Rutong granule on rat with postpartum hypogalactia. METHODS: Female rats which had kittening behavior within 24 h were selected to induce rat model by perfusing bromocriptinum. Meanwhile, model rats were given Rutong granule via i.g. gtt. Milk yield of female rats and body weight of young rats were determined everyday from the second day. Rats were sacrificed on the 8th day. The level of PRL and histological change of breast were observed. RESULTS: Rutong granule can increase the serum PRL level gradually to promote the increase of acinar number and dilatation of gland ducts. Rutong granules can also increase the milk yield of female rats and weight of young rats. CONCLUSION: Rutong granule can promote secretion of milk by means of increase of PRL level and expediting of secretion channels.

Therapeutic effect of bee venom in sows with hypogalactia syndrome postpartum

The objective of this study was to determine the clincotherapeutic effect of whole bee venom in hypogalactic sows postpartum. Sows after parturition were assigned to treated and nontreated control groups. In the treated group, 22 sows were bee acupunctured once a day for 3 consecutive days. Honeybees (Apis mellifera L.) for bee acupuncture were about 15 days after metamorphosis. One live bee was used to sting the acupoints known as Yang-ming (ST-18, 1.5 cm lateral to the base of the last 2 pairs of teats) and Jiao-chao (GV-1, at the indentation between the base of tail and the anus). In the control group, 20 sows were intramuscularly injected with a standard dosage of penicillin G (400,000 IU/head) once a day for 3 consecutive days. At post-treatment, 85.0% of the drug-treated control and 90.9% of the bee venomtreated group recovered from hypogalactia syndrome. The advantages of apitherapy were that the patients did not have stress because they were not restrained for a long period. The result suggested that apitherapy using bee venom is an effective treatment for sows with hypogalactia syndrome postpartum.