盆底方配方颗粒联合生物反馈训练治疗产后盆底功能障碍的临床观察
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摘要
目的:研究与分析盆底方配方颗粒联合生物反馈训练治疗对产后盆底功能障碍患者的应用效果。方法:选取360例产妇,对其产后42 d～产后2个月间的盆底功能情况进行评估,经初步筛选后,有240例出现产后盆底功能障碍,并按分娩方式的不同分为阴道分娩组、剖宫产分娩组,每组各120例;分别对每组产妇再次进行随机分组,记为单一治疗组(A组)及中西医联合治疗组(B组),每组各60例。对比两种分娩方式下A、B两组的MLD B42盆底表面肌功能评分、治疗时间、治疗总费用、临床效果、压力性尿失禁及盆腔器官脱垂发生情况。结果:阴道分娩组:经治疗后, B组MLD B42盆底表面肌功能评分、治疗时间、治疗总费用、临床总有效率均明显高于A组;B组SUI(5.00%)、POP(3.33%)发生率明显低于A组SUI(16.67%)、POP(13.33%)发生率,差异均有统计学意义(P<0.05)。剖宫产分娩组:经治疗后,B组MLD B42盆底表面肌功能评分、治疗时间、治疗总费用、临床总有效率明显高于A组; B组SUI(3.33%)、POP(1.67%)发生率明显低于A组SUI(15.00%)、POP(11.67%)发生率,差异均有统计学意义(P<0.05)。治疗方案相同时,阴道分娩及剖宫产分娩两组组间对比,治疗前肌功能评分差异对比有统计学意义(P<0.05)。结论:经阴道分娩会增加产后盆底功能障碍相关症状的发生率,但经盆底方配方颗粒联合生物反馈训练治疗后,无论选择何种分娩的产妇,其盆底功能均得到显著改善,且预后效果无明显差别。
Objective: To study and analyze the effect of Pelvic Floor Formula Granule combined with biofeedback therapy on patients with postpartum pelvic floor dysfunction. Methods: A total of 360 cases of pregnant women, the postpartum pelvic floor function druing postpartum 42 days to 2 months were evaluated by preliminary screening. 240 cases had postpartum pelvic floor dysfunction, and according to the different modes of delivery were divided into vaginal delivery and cesarean section delivery groups, 120 cases in each group. Women in each group were again randomly grouped as single treatment group(A group) and western medicine combined treatment group(B group), each group 60 cases. The MLD B42 pelvic floor muscle function score, treatment time, total cost of treatment, clinical effect, stress urinary incontinence and pelvic organ prolapse in A and B groups were compared. Results: The vaginal delivery group:After treatment, B group's MLD B42 pelvic floor surface muscle function score, treatment time, the total cost of treatment and the clinical total effective rate were significantly higher than those of A group. B group's SUI(5%) and POP(3.33%) were significantly lower than A group's SUI(16.67%) and POP(13.33%), and the differences were statistically significant(P<0.05). Cesarean delivery group:After treatment, B group's MLD B42 pelvic floor surface muscle function score, treatment time, the total cost of treatment and the total clinical efficiency were significantly higher than that of A group. B group's SUI(3.33%) and POP(1.67%) were significantly lower than the A group's SUI(15%) and POP(11.67%) and the differences were statistically significant(P<0.05). When the treatment program was the same, the difference between the two groups of vaginal delivery and cesarean section was statistically significant(P<0.05). Conclusion: Vaginal delivery will increase the symptoms of postpartum pelvic floor dysfunction rate. But the granules combined with square pelvic floor biofeedback training can improves the pelvic floor function significantly for no matter how maternal childbirth. There was no significant difference in prognosis and effect.
Objective: To study and analyze the effect of Pelvic Floor Formula Granule combined with biofeedback therapy on patients with postpartum pelvic floor dysfunction. Methods: A total of 360 cases of pregnant women, the postpartum pelvic floor function druing postpartum 42 days to 2 months were evaluated by preliminary screening. 240 cases had postpartum pelvic floor dysfunction, and according to the different modes of delivery were divided into vaginal delivery and cesarean section delivery groups, 120 cases in each group. Women in each group were again randomly grouped as single treatment group(A group) and western medicine combined treatment group(B group), each group 60 cases. The MLD B42 pelvic floor muscle function score, treatment time, total cost of treatment, clinical effect, stress urinary incontinence and pelvic organ prolapse in A and B groups were compared. Results: The vaginal delivery group:After treatment, B group's MLD B42 pelvic floor surface muscle function score, treatment time, the total cost of treatment and the clinical total effective rate were significantly higher than those of A group. B group's SUI(5%) and POP(3.33%) were significantly lower than A group's SUI(16.67%) and POP(13.33%), and the differences were statistically significant(P<0.05). Cesarean delivery group:After treatment, B group's MLD B42 pelvic floor surface muscle function score, treatment time, the total cost of treatment and the total clinical efficiency were significantly higher than that of A group. B group's SUI(3.33%) and POP(1.67%) were significantly lower than the A group's SUI(15%) and POP(11.67%) and the differences were statistically significant(P<0.05). When the treatment program was the same, the difference between the two groups of vaginal delivery and cesarean section was statistically significant(P<0.05). Conclusion: Vaginal delivery will increase the symptoms of postpartum pelvic floor dysfunction rate. But the granules combined with square pelvic floor biofeedback training can improves the pelvic floor function significantly for no matter how maternal childbirth. There was no significant difference in prognosis and effect.
引文
[1] 邓红艳,代锡莲,周琼,等.电刺激联合生物反馈法治疗产后女性性功能障碍的临床研究[J].现代生物医学进展,2015,15(24):4702-4705.
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[5] 梁日新.盆底肌功能锻炼与电刺激联合生物反馈对产后盆底功能障碍的干预效果[J].中国妇幼卫生杂志,2015,6(1):53-55.
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[7] 曹芳.产后盆底功能锻炼对经阴道分娩产妇盆底功能恢复及生活质量的影响[J].中国计划生育学杂志,2017,25(2):116-119.
[8] Oblasser C,Mccourt C,Hanzal E,et al.Vibrating vaginal balls toimprove pelvic floor muscle performance in women after childbirth:a protocol for a randomised controlled feasibili tytrial[J].J Adv Nurs,2016,72(4):900-914.
[9] 邹艳芬,刘利平.肌电刺激联合盆底肌功能锻炼在治疗产后盆底功能障碍患者中的应用[J].中国妇幼健康研究,2017,28(6):697-699,709.
[10] 刘叶君,张璞.补中益气丸联合盆底康复治疗仪治疗产后盆底功能障碍的临床观察[J].中医药导报,2017,23(2):99-100,103.
[11] Kolberg TM,Hilde G,Staer-Jensen J,et al.Effect of postpartum pelvic floor muscle training on vaginal symptoms and sexual dysfunction-secondary analysis of a randomised trial[J].BJOG,2016,123(4):634-642.
[12] 林蓓蓓,祖月娥,范幸,等.仿生物电刺激联合生物反馈治疗女性产后性功能障碍的疗效分析[J].中国性科学,2016,25(3):62-64.
[13] 王璐璐,蒋希菁,胡婷,等.举元煎颗粒剂联合生物反馈电刺激在产后盆底功能障碍性疾病中的应用价值[J].中华全科医学,2017,15(11):1918-1921.
[14] 孙利,沈孟荣,陈东颖,等.生物反馈电刺激联合盆底肌锻炼对产后早期压力性尿失禁患者的疗效[J].安徽医学,2017,38(1):81-83.
[15] Moossdorff-Steinhauser HF,Albers-Heitner P,Weemhoff M,et al.Factors influencing postpartum women’s willingness to participate in a preventive pelvic floor muscle training program:aweb-based survey[J].Eur J Obstet Gynecol Reprod Biol,2015,195(8):182-187.
[16] 袁少民.早期盆底康复治疗对产后盆底功能障碍的疗效观察[J].河北医学,2016,22(6):1008-1009.
[17] 张仁琦,李燕,王娟,等.剖宫产与自然分娩的产后盆底生物反馈治疗结果分析[J].中国妇幼保健,2017,32(18):4350-4352.
[18] 闫梅,王晓银,温琦,等.不同分娩方式产后盆底障碍的的盆底康复治疗近期疗效观察[J].四川医学,2017,38(11):1295-1300.
[19] Hagen S,Glazener C,Mcclurg D,et al.Pelvic floor muscle training for secondary prevention of pelvic organ prolapse(PREVPROL):a multicentre randomised controlled trial[J].Lancet,2017,389(167):393-402.
[20] 李芳兵,张丹丹,高琴,等.电刺激联合生物反馈疗法在产后女性性功能障碍治疗中的疗效分析[J].中国性科学,2017,26(9):49-52.
[21] 李洁盈,孙文妹,郑秋梅,等.生物反馈电刺激结合盆底肌训练治疗产后盆底功能障碍的作用[J].中国妇幼保健,2017,32(20):4945-4947.
[22] 李梅.系统化盆底康复锻炼在产后康复训练中的应用效果[J].实用临床医药杂志,2016,20(18):147-149.
[2] 蒋新华,莫丽萦,王小兰.中西医结合治疗产后盆底功能障碍性疾病的临床疗效及对生活质量的影响[J].中华中医药学刊,2017,35(9):2426-2428.
[3] 王梅,罗新.高龄产妇盆底康复治疗研究现状[J].中国计划生育和妇产科,2017,9(5):11-14.
[4] Mathe M,Valancogne G,Atallah A,et al.Early pelvic floor muscle training after obstetrical anal sphincter injuries for the reduction of anal incontinence[J].Eur J Obstet Gynecol Reprod Biol,2016,199(6):201-206.
[5] 梁日新.盆底肌功能锻炼与电刺激联合生物反馈对产后盆底功能障碍的干预效果[J].中国妇幼卫生杂志,2015,6(1):53-55.
[6] 徐扬,刘娟,左玲,等.生物反馈电刺激治疗对不同分娩方式产后盆底功能障碍的效果[J].实用临床医药杂志,2015,19(21):119-120.
[7] 曹芳.产后盆底功能锻炼对经阴道分娩产妇盆底功能恢复及生活质量的影响[J].中国计划生育学杂志,2017,25(2):116-119.
[8] Oblasser C,Mccourt C,Hanzal E,et al.Vibrating vaginal balls toimprove pelvic floor muscle performance in women after childbirth:a protocol for a randomised controlled feasibili tytrial[J].J Adv Nurs,2016,72(4):900-914.
[9] 邹艳芬,刘利平.肌电刺激联合盆底肌功能锻炼在治疗产后盆底功能障碍患者中的应用[J].中国妇幼健康研究,2017,28(6):697-699,709.
[10] 刘叶君,张璞.补中益气丸联合盆底康复治疗仪治疗产后盆底功能障碍的临床观察[J].中医药导报,2017,23(2):99-100,103.
[11] Kolberg TM,Hilde G,Staer-Jensen J,et al.Effect of postpartum pelvic floor muscle training on vaginal symptoms and sexual dysfunction-secondary analysis of a randomised trial[J].BJOG,2016,123(4):634-642.
[12] 林蓓蓓,祖月娥,范幸,等.仿生物电刺激联合生物反馈治疗女性产后性功能障碍的疗效分析[J].中国性科学,2016,25(3):62-64.
[13] 王璐璐,蒋希菁,胡婷,等.举元煎颗粒剂联合生物反馈电刺激在产后盆底功能障碍性疾病中的应用价值[J].中华全科医学,2017,15(11):1918-1921.
[14] 孙利,沈孟荣,陈东颖,等.生物反馈电刺激联合盆底肌锻炼对产后早期压力性尿失禁患者的疗效[J].安徽医学,2017,38(1):81-83.
[15] Moossdorff-Steinhauser HF,Albers-Heitner P,Weemhoff M,et al.Factors influencing postpartum women’s willingness to participate in a preventive pelvic floor muscle training program:aweb-based survey[J].Eur J Obstet Gynecol Reprod Biol,2015,195(8):182-187.
[16] 袁少民.早期盆底康复治疗对产后盆底功能障碍的疗效观察[J].河北医学,2016,22(6):1008-1009.
[17] 张仁琦,李燕,王娟,等.剖宫产与自然分娩的产后盆底生物反馈治疗结果分析[J].中国妇幼保健,2017,32(18):4350-4352.
[18] 闫梅,王晓银,温琦,等.不同分娩方式产后盆底障碍的的盆底康复治疗近期疗效观察[J].四川医学,2017,38(11):1295-1300.
[19] Hagen S,Glazener C,Mcclurg D,et al.Pelvic floor muscle training for secondary prevention of pelvic organ prolapse(PREVPROL):a multicentre randomised controlled trial[J].Lancet,2017,389(167):393-402.
[20] 李芳兵,张丹丹,高琴,等.电刺激联合生物反馈疗法在产后女性性功能障碍治疗中的疗效分析[J].中国性科学,2017,26(9):49-52.
[21] 李洁盈,孙文妹,郑秋梅,等.生物反馈电刺激结合盆底肌训练治疗产后盆底功能障碍的作用[J].中国妇幼保健,2017,32(20):4945-4947.
[22] 李梅.系统化盆底康复锻炼在产后康复训练中的应用效果[J].实用临床医药杂志,2016,20(18):147-149.