中药督脉熏蒸疗法联合凯格尔运动康复训练对初产妇产后盆底功能恢复及生活质量的影响
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R271.43;R714.6

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湖州市科技计划项目(2023GY64)


Effect of Chinese Medicine Fumigation at Governor Vessel Combined with Kegel Motion Rehabilitation Exercise on Recovery of Pelvic Floor Function and Quality of Life in Primiparas After Delivery
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    摘要:

    目的:观察中药督脉熏蒸疗法联合凯格尔运动康复训练在改善初产妇产后盆底功能方面的临床效 果。方法:纳入2023年5月—2024年5月于安吉县妇幼保健院分娩的120例初产妇作为研究对象,随机分为对 照组、观察组各60例。2组均从产后42天开始实施凯格尔运动康复训练,观察组加予中药督脉熏蒸疗法治疗, 2组均治疗2周。治疗前后评定盆底肌力,检测盆底肌电压、盆底肌疲劳度、盆底形态超声指标,评定生活质 量[盆底障碍影响简易问卷(PFIQ-7) 评分、盆腔脏器脱垂/尿失禁性功能问卷(PISQ-12) 评分]。评价尿失 禁症状的改善效果。结果:治疗后,观察组改善尿失禁症状的总有效率高于对照组(P<0.05)。2组盆底肌力 情况均较治疗前改善(P<0.05),观察组盆底肌力改善情况优于对照组(P<0.05)。2组盆底肌Ⅰ、Ⅱ类肌纤 维电压均较治疗前增加,盆底肌Ⅰ、Ⅱ类肌纤维疲劳度均较治疗前下降,差异均有统计学意义(P<0.05);观 察组盆底肌Ⅰ、Ⅱ类肌纤维电压均高于对照组,盆底肌Ⅰ、Ⅱ类肌纤维疲劳度均低于对照组,差异均有统计 学意义(P<0.05)。2组膀胱颈移动度、尿道旋转角均较治疗前减小,尿道内口漏斗形成率均较治疗前降低, 差异均有统计学意义(P<0.05)。观察组膀胱颈移动度、尿道旋转角均小于对照组,尿道内口漏斗形成率低于 对照组,差异均有统计学意义(P<0.05)。2组PFIQ-7评分、PISQ-12评分均较治疗前减少(P<0.05)。观察 组PFIQ-7评分、PISQ-12评分均低于对照组(P<0.05)。结论:在凯格尔运动康复训练基础上进行中药督脉熏 蒸,可有效缓解初产妇产后盆底功能障碍导致的尿失禁症状,改善盆底肌力和盆底肌疲劳状况,修复盆底肌, 提高产后康复水平和生活质量。

    Abstract:

    Abstract:Objective:To observe the clinical effect of Chinese medicine fumigation at Governor Vessel combined with Kegel motion rehabilitation exercise on the improvements in pelvic floor function in primiparas after delivery. Methods:A total of 150 primiparas who gave birth at Anji Women's and Children's Hospital from May 2023 to May 2024 were randomly divided into the control group (60 cases) and the observation group (60 cases). Both groups were given Kegel motion rehabilitation exercise from 42 days after delivery,and the observation group was additionally treated with Chinese medicine fumigation at Governor Vessel. Both groups were treated for two weeks. Before and after treatment,the muscle strength of pelvic floor muscle was evaluated;the voltage of pelvic floor muscle,fatigue degree of pelvic floor muscle and ultrasound indicators of pelvic floor morphology were detected;the quality of life [scores of Pelvic Floor Impairment Questionnaire-7 (PFIQ-7) and Pelvic Floor Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-12 (PISQ-12)] and the improvement effect on urinary incontinence symptoms were evaluated. Results:After treatment,the total effective rate of improving urinary incontinence symptoms in the observation group was higher than that in the control group (P<0.05). The muscle strength of pelvic floor muscle in the two groups were improved when compared with those before treatment (P<0.05), the improvements in the muscle strength of pelvic floor muscle in the observation group were better than those in the control group (P<0.05). The voltage of typeⅠandⅡ muscle fiber of pelvic floor muscle in the two groups was elevated when compared with that before treatment,and the fatigue degree of type Ⅰ and Ⅱ muscle fiber of pelvic floor muscle was decreased when compared with that before treatment,differences being significant (P<0.05);the voltage of typeⅠandⅡmuscle fiber of pelvic floor muscle in the observation group was higher than that in the control group,and the fatigue degree of typeⅠandⅡmuscle fiber of pelvic floor muscle was lower than that in the control group,differences being significant (P<0.05). The bladder neck mobility and urethral rotation angle in the two groups were reduced when compared with those before treatment,and the formation rate of internal urethral orifice funnel dwindled when compared with those before treatment,differences being significant (P<0.05). The bladder neck mobility and urethral rotation angle in the observation group were smaller than those in the control group,and the formation rate of internal urethral orifice funnel in the observation group was lower than that in the control group,differences being significant (P<0.05). The scores of PFIQ-7 and PISQ-12 in the two groups were down-regulated when compared with those before treatment (P<0.05), and the above two scores in the observation group were lower than those in the control group (P<0.05). Conclusion: In addition to Kegel motion rehabilitation exercise, Chinese medicine fumigation at Governor Vessel can effectively alleviate the urinary incontinence symptoms caused by pelvic floor dysfunction in primiparas after delivery,improve the muscle strength and fatigue degree of pelvic floor muscle, repair the pelvic floor muscle, and improve the postpartum rehabilitation condition and the quality of life.

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肖燕,许程洁,郭玲玲,王秋红.中药督脉熏蒸疗法联合凯格尔运动康复训练对初产妇产后盆底功能恢复及生活质量的影响[J].新中医,2025,57(14):135-140

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