产后缺乳与体质等因素的相关性

发布时间：2018-04-15 06:26

  本文选题：产后缺乳 + 分娩方式　； 参考：《河南中医药大学》2016年硕士论文

【摘要】：目的:(1)通过比较正常泌乳产妇与产后缺乳产妇两种人群的年龄、职业、产次、分娩方式、分娩孕周、产前体重指数、新生儿性别、新生儿体重、中医体质等的分布情况,探讨其与产后缺乳的相关性,重点探讨分娩方式及中医体质与产后缺乳的相关性,为临床预防产后缺乳提供参考依据,并通过对患者辨体质、辨证型,了解该病的易发病体质及发病后的常见证型,为有效预防产后缺乳提供循证学依据。(2)通过比较产妇产后第2天的血红蛋白值在正常泌乳与产后缺乳两种人群中的差异,探讨产后血红蛋白与产后乳汁分泌的相关性,为临产预防产后缺乳提供更多的依据及指标。方法:(1)选择2015年4月到2016年3月在河南中医学院一附院及郑州市妇幼保健院病房住院符合纳入标准的产后缺乳患者120例为病例组,并选择正常泌乳者120例为对照组,通过现场问卷调查方式,对全部研究对象进行资料的收集,住院期间收集一次,产后15天收集一次,然后对入选病例的产前体重指数、中医体质类型等进行比较,计数资料,用卡方检验进行统计学分析,计量资料,用独立样本t检验进行统计学分析,P≤0.05,有统计学意义。(2)比较产后缺乳者120例的病例组与正常泌乳者120例的对照组两组产妇产后血红蛋白的差异,用独立样本t检验,P≤0.05,有统计学意义,探讨血红蛋白与产后泌乳的相关性,并探讨产后缺乳者的血红蛋白的分布规律。结果:(1)120例正常泌乳者和120例产后缺乳患者的年龄、民族、职业、产次、分娩孕周、产前体重指数、新生儿性别、新生儿出生体重相比较,均无差异,P0.05,无统计学意义。(2)120例正常泌乳者和120例产后缺乳患者的分娩方式相比较,120例正常泌乳者中,顺产者占40%,剖宫产占60%,120例产后缺乳患者中顺产者占17.5%,剖宫产占82.5%,有差异,P0.05,有统计学意义;(3)120例正常泌乳者中,平和体质共67例,最为常见,占55.83%,8种偏颇体质共占44.17%,分布从2.50%到12.50%。120例产后缺乳患者中,平和体质共25例,仅占20.50%,8种偏颇体质占绝大多数,共占79.50%,其中气虚体质最多,占25.00%,阴虚体质、阳虚体质次之,分别占14.17%、12.50%。两组病例体质构成比存在差异,P0.05,有统计学意义。120例产后缺乳患者中,肝郁气滞证有48例,占40.0%,气血虚弱证有51例,占42.5%,痰浊阻滞证有21例,占17.5%,可见产后缺乳以肝郁气滞证和气血虚弱证较为多见。(4)120例正常泌乳者和120例产后缺乳患者的血红蛋白比较,产后缺乳患者的血红蛋白95�jCI(96.29,100.11),正常泌乳者95�jCI(107.18,111.45),有差异,P0.05,有统计学意义。结论:(1)产妇的年龄、民族、籍贯、职业、产次、分娩孕周、新生儿性别、新生儿体重、体重指数与产后缺乳无明显相关性。(2)产妇的分娩方式与产后缺乳有密切的关系,剖宫产比顺产者能更易出现产后缺乳,在临床中,尽量减少剖宫产。(3)产妇的中医体质类型与产后缺乳有相关性,从中医体质学角度提出了气虚体质、阴虚体质、气郁体质可能是产后缺乳发病的易发病体质。提示在产前检查及围产保健工作中可开展对孕产妇的体质评估,对偏颇体质早识别、早调理,最大可能地预防或减少产后缺乳的发生。中医体质与产后缺乳发病后的中医证型存在相关性。临证中要重视不同体质与证候之间的内在联系,参考体质类型,进行辨证论治,贯彻“治病求本”的治疗原则。(4)120例正常泌乳者和120例产后缺乳患者的血红蛋白值比较,有统计学意义,提示血红蛋白值与产后乳汁分泌有较密切的关系,提示我们在围产保健工作中将血红蛋白值与产后缺乳发病率联系起来,对孕产妇的血红蛋白值早评估,早治疗,最大可能地预防或减少产后缺乳的发生。
[Abstract]:Objective: (1) compared with normal lactation and maternal postpartum hypogalactia two maternal age, occupation, parity, mode of delivery, gestational age, prenatal BMI, neonatal sex, birth weight, distribution of constitution of TCM, and investigate its correlation with postpartum hypogalactia, focusing on the relationship between the mode of delivery and the constitution of traditional Chinese medicine and postpartum hypogalactia, provide a reference basis for clinical prevention of postpartum hypogalactia, and through to the patients constitution, syndrome differentiation type, understand the common syndromes of the disease incidence and after the onset of the constitution, provides evidence-based basis for the effective prevention of postpartum hypogalactia. (2) the lack of differences between the two kinds of milk the crowd in the normal lactation and postpartum postpartum second days by comparing the values of hemoglobin, hemoglobin and investigate the relationship between postpartum postpartum milk secretion, postpartum hypogalactia provide more basis and targets for prevention of parturient. Methods: (1) 2015 4 From May to March 2016 in the ward of maternal and Child Health Hospital of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine and Zhengzhou city hospital in accordance with the inclusion criteria of postpartum hypogalactia patients 120 cases as the case group, and select the normal lactation in 120 cases as control group, through questionnaire, data of all subjects were collected during hospitalization were collected once collected, postpartum once for 15 days, then prenatal body mass index for patients, comparing the TCM constitution types of count data, statistical analysis, measurement data using the chi square test was used for statistical analysis, independent samples t test, P = 0.05, there was statistical significance. (2) comparison of postpartum hypogalactia cases group 120 cases with normal lactation in 120 cases of control group differences in two groups of maternal postpartum hemoglobin, with independent sample t test, P = 0.05, a statistically significant correlation between hemoglobin and postpartum lactation, and to explore the production 鍚庣己涔宠，

本文编号：1752932