剖宫产术式对妇女产后痹发生的影响调查及中医调理效果分析  

Investigation of Effect of Cesarean Section Surgical Methods on Occurrence of Postpartum Arthralgia and Analysis of Effect of TCM Nursing

作　　者：岳洁[1] 刘晓华[1] 申英[1] 

机构地区：[1]承德市中心医院妇产科,河北承德067000

出　　处：《辽宁中医杂志》2017年第3期519-522,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：河北省科学技术厅河北省科技成果(20140613)

摘　　要：目的:调查剖宫产术式对妇女产后痹证发生的影响,探究中医综合调理干预在产后痹临床应用中的价值。方法:回顾性分析986例产妇临床资料,根据其产后痹证发生情况分为产后痹证组(n=84)和正常组(n=902),比较两组产妇分娩方法差异;以产后接受中医调理情况为依据,将产后痹证组产妇分为中医调理组(n=38)和非中医组(n=46),比较其干预前后中医症状积分、疼痛评分(NRS)、匹兹堡睡眠质量指数(PSQI)、晨僵持续时间、关节疼痛数目等指标变化情况,记录其临床疗效及不良反应发生率差异。结果:产后痹证组产妇顺产率显著低于正常组(35.7%vs70.7%),剖宫产率则显著高于正常组(54.8%vs 22.4%),差异均有统计学意义(P<0.05)。中医调理组治疗总有效率为84.0%,显著高于非中医组的52.2%(P<0.05)。干预4周后,两组产妇均无不良反应发生(P>0.05);中医症状积分、NRS、PSQI评分及晨僵持续时间、关节疼痛数目等评估结果均较干预前显著降低,且中医调理组<非中医组,差异均有统计学意义(P<0.05)。结论:剖宫产分娩易增加妇女产后痹证发生风险,需引起临床重视;中医综合调理能有效改善产后痹证妇女预后质量,于其病情转归有利。Objective： To investigate the effect of cesarean section surgical methods on the occurrence of postpartum arthralgia and explore the clinical application value of traditional Chinese medicine（ TCM） nursing intervention in postpartum paralysis.Methods： The clinical data of 986 cases of puerperae was analyzed retrospectively. According to the occurrence of puerperal arthralgia,they were divided into postpartum arthralgia group（ 84 cases） and normal group（ n = 902）. The delivery method was compared between the two groups. Based on receive of TCM nursing,the postpartum arthralgia group was divided into TCM nursing group（ n = 38） and non TCM group（ n = 46）. The changes of TCM symptoms score,pain score（ NRS）,Pittsburgh sleep quality index（ PSQI）,duration of morning stiffness,number of pain joints and other indexes before and after intervention were compared.The differences in clinical curative effect and the incidence of adverse reactions were recorded. Results： The rate of natural delivery in the postpartum arthralgia group was significantly lower than that in the normal group（ 35. 7% vs 70. 7%） while the rate of cesarean section was significantly higher（ 54. 8% vs 22. 4%）（ P〈0. 05）. The total response rate in TCM nursing group（ 84. 0%） was significantly higher than that in the non TCM group（ P〈0. 05）. After 4 weeks of intervention,there were no adverse reactions in the two groups（ P〉0. 05）. TCM symptom scores,NRS,PSQI scores,duration of morning stiffness and number of pain joints were significantly lower than those before intervention,and TCM nursing grou P Mnon TCM group（ P〈0. 05）. Conclusion： Cesarean section is easy to increase the risk of postpartum arthralgia,which is worthy of attention. TCM nursing can effectively improve the prognosis of women with postpartum arthralgia and is good for outcome.

关 键 词：产后痹证 剖宫产术式 中医综合调理 预后 

分 类 号：R271.43[医药卫生—中医妇科学]