Clinical study on prenatal pelvic floor exercise combined with postpartum Juyuan Decoction granule in preventing postpartum pelvic floor dysfunction
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摘要: 目的 探讨产前盆底锻炼联合产后服用举元煎颗粒剂对产后盆底障碍性疾病(pelvic floor dysfunction,PFD)的预防效果。 方法 选取2016年1月—2018年5月在杭州市红十字会医院接受产检、分娩的412例孕产妇作为研究对象,按照随机数字表法分为对照组(206例,采用产前盆底锻炼)和试验组(206例,在对照组基础上,产后服用举元煎颗粒剂)。治疗4周后,观察比较2组盆底功能(包括盆底肌电值、阴道动态压力、阴道持续收缩时间及盆底肌张力)的变化,比较2组治疗前后中医气虚症候的变化及压力性尿失禁症状改善情况。 结果 2组治疗后盆底肌电值、阴道动态压力、阴道持续收缩时间、盆底肌张力均较治疗前有明显升高,差异有统计学意义(均P<0.01);且试验组治疗后的盆底功能改善程度明显优于对照组,差异有统计学意义(均P<0.01);2组治疗后中医证候积分、尿失禁评分均较治疗前明显降低,差异有统计学意义(均P<0.01);试验组治疗后的神疲、气短、自汗评分、总积分及尿失禁评分均明显低于对照组,差异有统计学意义(均P<0.05)。 结论 产前盆底锻炼联合产后服用举元煎颗粒剂能够有效改善孕产妇的盆底功能及尿失禁症状,对于PFD的防治效果较好,具有临床应用价值。Abstract: Objective To explore the preventive effect of prenatal pelvic floor exercise and postpartum Juyuan Decoction granule on postpartum pelvic floor disorders(PFD). Methods From January 2016 to May 2018, 412 pregnant and parturient women who underwent birth examination in our hospital were selected as the main subjects. The women were divide into control group(n=206, take antenatal pelvic floor exercise) and the experimental group(n=206, on the basis of the control group, administrating additional Juyuan Decoction granule after the delivery) according to random number table method. After 4 weeks of treatment, the pelvic floor function such as pelvic floor electromyography, vagina dynamic pressure, vaginal continuous contraction time and pelvic floor muscle tension were observed and compared between the two groups. The TCM qi deficiency and the improvement of stress urinary incontinence were compared before and after treatment. Results The values of pelvic floor electromyography, the dynamic pressure of vagina, the duration of vaginal contraction and the tension of pelvic floor muscle were significantly improved after the treatment(all P<0.01). However, the improvement of pelvic floor function in the experimental group was significantly better than that in the control group(all P<0.01). The scores of TCM syndromes and urinary incontinence in the two groups were significantly lower than those before the treatment(all P<0.01). The scores of fatigue, shortness of breath, self-sweating, total score and urinary incontinence in the experimental group were significantly lower than those in the control group(all P<0.01). Conclusion Prenatal pelvic floor exercise combined with postpartum JuYuan Decoction granule can effectively improve the pelvic floor function and urinary incontinence symptoms of pregnant and parturient women. It has good effect on prevention and treatment of PFD, and has clinical application value.
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Key words:
- Pelvic floor exercises /
- Juyuan Decoction /
- Prevention effect /
- Pelvic floor dysfunction /
- Postpartum
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