应用多学科合作诊疗系统治疗孕妇常见躯体功能障碍症状临床研究  

Clinical study of multidisciplinary cooperative diagnosis and treatment system in treating common somatic dysfunction symptoms of pregnant women

作　　者：秦峰 肖利军 李丽娟[3] 张立新 刘婷 孙静 黄维维 潘秋萍 胡娟 曾妍芳 丁颖 邹雨霞 王盈力 杨林芝 陈静[7] 郭存玲 韩艳菲 苏红梅 李洋 李小莉 赵斌 王月华 覃玉霞 何晓燕[11] 王静[11] 吴万粉 欧小敏 李丹 李霖 Qin Feng;Xiao Lijun;Li Lijuan;Zhang Lixin;Liu Ting;Sun Jing;Huang Weiwei;Pan Qiuping;Hu Juan;Zeng Yanfang;Ding Ying;Zou Yuxia;Wang Yingli;Yang Linzhi;Chen Jing;Guo Cunling;Han Yanfei;Su Hongmei;Li Yang;Li Xiaoli;Zhao Bin;Wang Yuehua;Tan Yuxia;He Xiaoyan;Wang Jing;Wu Wanfen;Ou Xiaomin;Li Dan;Li Lin(General Research Group of National Maternal Physical and Mental Health Clinic,Beijing 100142,China;Scientific Research Office,Bayi Children′s Hospital,General Hospital of Beijing Military Region,Beijing 100700,China;Maternal and Child Health Center,Chinese Center for Disease Control and Prevention,Beijing 100098,China;Study Base of Psychosomatic Health Outpatient for Pregnant Women,Dagang Maternal and Child Care Center,Binhai New Area,Tianjin 300270,China;Study Base of Psychosomatic Health Outpatient for Pregnant Women,Lin′an Maternal and Child Health Care and Family Planning Service Center,Hangzhou 311300,Zhejiang Province,China;Study Base of Psychosomatic Health Outpatient for Pregnant Women,Yuexiu District Maternal and Child Care Center,Guangzhou 510055,Guangdong Province,China;Study Base of Psychosomatic Health Outpatient for Pregnant Women,Yantaishan Hospital,Yantai,Yantai 264000,Shandong Province,China;Study Base of Psychosomatic Health Outpatient for Pregnant Women,Jiaozuo Maternal and Child Health Care Hospital,Jiaozuo 454150,Henan Province,China;Study Base of Psychosomatic Health Outpatient for Pregnant Women,Shuangliu Maternal and Child Health Care Hospital,Chengdu 610200,Sichuan Province,China;Study Base of Psychosomatic Health Outpatient for Pregnant Women,Debao County Maternal and Child Health Care Hospital,Baise 533700,Guangxi Zhuang Autonomous Region,China;Study Base of Psychosomatic Health Outpatient for Pregnant Women,Yangzhou Maternal and Child Care Service Center,Yangzhou 225002,Jiangsu Province,China;Study Base of Psychosomatic Health Outpatient for Pregnant Women,Tanzhong People′s Hospital of Liuzhou,Liuzhou 545027,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]北京全国孕产妇心身健康门诊总课题组,100142 [2]北京陆军总医院附属八一儿童医院科研室,100700 [3]北京中国疾病预防控制中心妇幼保健中心,100098 [4]天津市滨海新区大港妇女儿童保健中心孕产妇心身健康门诊研究基地,300270 [5]杭州市临安区妇幼保健计划生育服务中心孕产妇心身健康门诊研究基地,311300 [6]广州市越秀区妇幼保健院孕产妇心身健康门诊研究基地,510055 [7]山东烟台市烟台山医院孕产妇心身健康门诊研究基地,264000 [8]河南焦作市妇幼保健院孕产妇心身健康门诊研究基地,454150 [9]成都市双流区妇幼保健院孕产妇心身健康门诊研究基地,610200 [10]德保县妇幼保健院孕产妇心身健康门诊研究基地,广西百色533700 [11]江苏扬州市妇幼保健院孕产妇心身健康门诊研究基地,225002 [12]广西柳州市潭中人民医院孕产妇心身健康门诊研究基地,545027

出　　处：《中华妇幼临床医学杂志（电子版）》2018年第1期51-56,共6页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：中国博士后科学基金资助项目(2012M521923)~~

摘　　要：目的探讨多学科合作模式的生理调控、心理调节、音乐调理(PPM)临床诊疗系统,对于治疗孕妇常见躯体功能障碍症状的临床效果。方法选择2017年11月至12月,在天津市滨海新区大港妇女儿童保健中心等9家医疗机构的孕产妇心身健康门诊研究基地,进行产前检查时,发现有恶心、呕吐、胃胀、便秘、尿频及心悸6项常见躯体功能障碍症状的93例孕妇为研究对象。采取抽签方式,将受试者随机分为观察组(n=45)及对照组(n=48)。观察组受试者在孕期健康教育基础上,应用PPM诊疗系统进行治疗,对照组受试者则仅进行孕期健康教育。采用成组t检验,对2组孕妇治疗前《汉密顿焦虑量表(HAMA)》评分值进行比较。采用χ~2检验,对2组孕妇的年龄、学历、职业、产妇类型、孕龄及治疗3周后自主神经系统(ANS)功能状态构成比进行比较。采用Mann-Whitney U秩和检验,对2组孕妇治疗3周后的6项常见躯体功能障碍症状治疗疗效进行比较。本研究遵循的程序符合病例收集医疗机构人体试验委员会制定的伦理学标准,得到其伦理委员会批准,征得受试者知情同意,并与之签署临床研究知情同意书。结果 (1)治疗前,2组孕妇ANS功能状态均为紊乱状态。2组孕妇的年龄、学历、职业、产妇类型及孕龄构成比比较,以及治疗前HAMA评分值比较,差异均无统计学意义(P>0.05)。(2)观察组孕妇恶心症状的治疗显效率、有效率及无效率分别为80.8%(21/26)、19.2%(5/26)及0,对照组孕妇分别为12.5%(3/24)、41.7%(10/24)及45.8%(11/24);观察组孕妇呕吐症状的治疗显效率、有效率及无效率分别为89.5%(17/19)、10.5%(2/19)及0,对照组孕妇分别为17.6%(3/17)、64.8%(11/17)及17.6%(3/17);观察组孕妇胃胀症状的治疗显效率、有效率及无效率分别为100.0%(13/13)、0及0,对照组孕妇分别为14.3%(1/7)、28.6%(2/7)及57.1%(4/7);观察组孕妇便秘症状的治疗显效率、有效率�To explore the clinical effects of clinical diagnosis and treatment system of physiological regulation,psychological adjustment,music conditioning(PPM)under multidisciplinary cooperative model in treating common somatic dysfunction symptoms of pregnant women.Methods A total of 93 pregnant women with 6 common somatic dysfunction symptoms including nausea,vomit,gastric distention,constipation,frequent micturition and palpitation were chosen as research subjects.All of these pregnant women received prenatal examination in the Study Base of Psychosomatic Health Outpatient for Pregnant Women of 9 medical institutes such as Dagang Maternal and Child Care Center in Binhai New Area,Tianjin,etc.,from November to December 2017.The subjects were randomly divided into observation group(n=45)and control group(n=48)by lotting method.On the basis of prenatal health education,PPM diagnosis and treatment system was adopted for treatment of subjects in observation group,while subjects in control group only took prenatal health education.Independent-samples t test was taken to compare the Hamilton Anxiety Scale(HAMA)score before treatment between two groups.Chi-square test was taken to compare the constituent ratios of age,educational background,occupation,parturient type,gestational age and functional status of autonomic nerves system(ANS)of the pregnant women after 3 weeks of treatment between two groups.Mann-Whitney U rank sum test was taken to compare clinical effects of 6 common somatic dysfunction symptoms after 3 weeks of treatment between two groups.Procedures adopted in this research which was approved by the ethical committee were in line with ethical standards made by Institutional Review Board of the aforementioned 9 medical institutes.After obtaining informed consent of the subjects,informed clinical research consent was signed with each of them.Results①Before treatment,ANS functional status of pregnant women in two groups were all in disorder.There were no significant differences between two groups of pregnant women

关 键 词：多学科合作 心理生理性障碍 躯体型障碍 孕妇 

分 类 号：R714.2[医药卫生—妇产科学]