盆骶调筋针法联合肌筋膜手法治疗产后骨盆痛临床研究  

The clinical study of pelvic sacral acupuncture combined with myofascial manipulation in the treatment of postpartum pelvic pain

作　　者：程娇 陈从山[1] 张远洋[1] 邱志伟 王艳 张小勇 Cheng Jiao;Chen Congshan;Zhang Yuanyang;Qiu Zhiwei;Wang Yan;Zhang Xiaoyong(Department of Massage,Taihe Hospital,Shiyan City,Shiyan 442000,China)

机构地区：[1]十堰市太和医院推拿科,十堰442000

出　　处：《国际中医中药杂志》2022年第11期1243-1247,共5页International Journal of Traditional Chinese Medicine

基　　金：2021年度十堰市科技局科研项目(21Y17);湖北省卫生健康委员会2021-2022年度中医药科研立项(ZY2021M057)。

摘　　要：目的评价盆骶调筋针法联合肌筋膜手法治疗产后骨盆痛的疗效。方法将符合入选标准的2019年12月-2021年10月本院86例产后骨盆痛患者,采用随机数字表法分为对照组44例和观察组42例,对照组给予肌筋膜手法治疗,观察组在对照组基础上给予盆骶调筋针法。2组均治疗4周。分别于治疗前后进行中医证候评分,采用VAS量表评估疼痛程度,Oswestry功能障碍指数(ODI)评估腰椎功能障碍程度,盆底障碍影响简易问卷7(PFIQ-7)评估盆底功能,盆底功能障碍问卷(PFDI20)评估生活质量;采用ELISA法检测血清胰岛素样生长因子-1(IGF-1)、TGF-β1水平,评价临床疗效。结果观察组总有效率为95.24%(40/42)、对照组为79.55%(35/44),2组比较差异有统计学意义(χ^(2)=4.74,P=0.030)。治疗后,观察组ODI、VAS、PFIQ-7及PFIQ-20评分均低于对照组(t值分别为13.79、14.05、10.61、10.10,P值均<0.001);下腰痛、肢体疼痛、步态跛行评分低于对照组(t值分别为11.73、12.16、10.89,P值均<0.001);血清TGF-β1[(163.81±28.05)μg/L比(124.56±19.23)μg/L,t=5.76]、IGF-1[(64.52±9.14)μg/L比(49.86±7.62)μg/L,t=5.06]水平高于对照组(P<0.01)。结论盆骶调筋针法联合肌筋膜手法可有效改善产后骨盆痛患者的骨盆功能,缓解盆腔疼痛程度,提高疗效。Objective To evaluate the efficacy of pelvic sacral tendon regulating acupuncture combined with myofascial manipulation in the treatment of postpartum pelvic pain.Methods A total of 86 patients with postpartum pelvic pain in our hospital from December 2019 to October 2021 who met the inclusion criteria were divided into control group(n=44)and observation group(n=42)by random number table method.The control group was treated with myofascial manipulation,while the observation group was treated with pelvic sacral tendon acupuncture on the basis of the control group.Both groups were treated for 4 weeks.The VAS was used to evaluate the degree of pain,Oswestry Disability Index(ODI)to evaluate the degree of lumbar dysfunction,pelvic floor dysfunction Questionnaire 7(PFIQ-7)to evaluate the pelvic floor function,and pelvic floor dysfunction Questionnaire(PFDI20)to evaluate the quality of life.Serum levels of insulin-like growth factor-1(IGF-1)and TGF-β1 were detected by ELISA to evaluate the clinical efficacy.Results The total effective rate was 95.24%(40/42)in the observation group and 79.55%(35/44)in the control group,and the difference was statistically significant(χ^(2)=4.74,P=0.030).After treatment,the ODI,VAS,PFIQ-7 and PFIQ-20 scores of the observation group were significantly lower than those in the control group(t=13.79,14.05,10.61,10.10,all Ps<0.001).The scores of low back pain,limb pain and gait claudication were significantly lower than those in the control group(t=11.73,12.16 and 10.89,respectively,all Ps<0.001).The serum levels of TGF-β1[(163.81±28.05)μg/L vs.(124.56±19.23)μg/L,t=5.76]and IGF-1[(64.52±9.14)μg/L vs.(49.86±7.62)μg/L,t=5.06]were significantly higher than those in the control group(P<0.01).Conclusion The pelvic sacral tendon acupuncture combined with myofascial manipulation can improve the pelvic function of patients with postpartum pelvic pain,relieve the degree of pelvic pain,and improve the curative effect.

关 键 词：骨盆痛 产后期 盆骶调筋针法 肌筋膜手法 临床疗效 

分 类 号：R271.43[医药卫生—中医妇科学]