针灸联合补中益气汤加减治疗产后盆底功能障碍的效果  

Effect of acupuncture combined with modified Buzhong Yiqi Decoction in the treatment of postpartum pelvic floor dysfunction

作　　者：肖华 杨静 崔佑萍 杜欣[2] XIAO Hua;YANG Jing;CUI You-ping;DU Xin(Department of Obstetrics and Gynecology,the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445000,Hubei,China;Department of Gynecology,Hubei Maternal and Child Health&Care Hospital,Wuhan 430000,Hubei,China)

机构地区：[1]恩施土家族苗族自治州中心医院妇产科,湖北省恩施市445000 [2]湖北省妇幼保健院妇科,湖北省武汉市430000

出　　处：《广西医学》2022年第16期1885-1889,共5页Guangxi Medical Journal

基　　金：湖北省卫生健康委员会第一批联合基金项目(WJ2019H190)。

摘　　要：目的探讨针灸联合补中益气汤加减治疗产后盆底功能障碍(PFD)的效果。方法选择116例产后PFD患者,根据随机数字表法分为对照组54例和观察组62例。两组均在常规治疗基础上给予针灸治疗,观察组同时给予补中益气汤加减治疗,均治疗4周。比较两组治疗前后盆底肌肉强度,血清弹性蛋白酶抑制因子(Elafin)、骨桥蛋白(OPN)水平,并采用盆底功能障碍症状问卷(PFDI-20)、盆腔脏器脱垂/尿失禁性功能问卷(PISQ-12)分别评价两组患者生活质量和性生活质量。结果治疗4周后,观察组治疗总有效率高于对照组(分别为95.16%、83.33%,P<0.05);两组患者Ⅰ类肌纤维、Ⅱ类肌纤维持续收缩压均变大、收缩持续时间延长,血清Elafin水平上升,OPN水平下降,且观察组上述指标均优于对照组(均P<0.05);两组PFDI-20各量表评分及总分降低,PISQ-12评分升高,且观察组上述评分均优于对照组(均P<0.05)。结论针灸联合补中益气汤加减治疗产后PFD疗效较好,较单一针灸治疗可更好地促进盆底肌肌肉力量的恢复,改善患者症状,提高患者生活质量及性生活质量。Objective To explore the effect of acupuncture combined with modified Buzhong Yiqi Decoction in the treatment of patients with postpartum pelvic floor dysfunction(PFD).Methods A total of 116 postpartum PFD patients were selected and assigned to control group(54 cases)or observation group(62 cases)by the random number table method.Both groups were given acupuncture therapy on the basis of routine treatment;simultaneously,the observation group was given modified Buzhong Yiqi Decoction therapy,for a 4-week treatment.The pre-and post-treatment pelvic floor muscle strength,levels of serum elastase inhibitor(Elafin),and osteopontin(OPN)were compared between the two groups;furthermore,the Pelvic Floor Distress Inventory-Short Form 20(PFDI-20)and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-Short Form 12(PISQ-12)were performed to evaluate patients′qualities of life and sexual life,respectively.Results After 4 weeks of treatment,the total effective rate of treatment in the observation group was higher than that in the control group(95.16%and 83.33%,respectively;P<0.05).Both groups exhibited larger sustained systolic blood pressures of typeⅠand typeⅡmuscle fibers,prolonged duration of contraction,an elevation of serum Elafin level,a decline of OPN level,and the observation group yielded superior indices mentioned above to compare with the control group(all P<0.05).Both groups interpreted decreased scores of various scales of PFDI-20 and a decreased total score,as well as an elevation score of PISQ-12,and the aforementioned scores were superior in the observation group to those in the control group(all P<0.05).Conclusion Acupuncture combined with modified Buzhong Yiqi Decoction in treating postpartum PFD exerts a good efficacy,which can preferably promote the recovery of pelvic floor muscle strength,ameliorate patients′symptoms,and improve patients′qualities of life and sexual life as compared with acupuncture therapy alone.

关 键 词：盆底功能障碍 针灸 补中益气汤 产后 肌肉强度 生活质量 性生活质量 

分 类 号：R711.5[医药卫生—妇产科学]