穴位贴敷联合生物电反馈治疗产后子宫复旧不良临床研究

发布时间：2019-05-18 14:29

【摘要】：研究背景产后子宫复旧不良是产后常见的并发症,其对妇女身心健康所产生的不良影响已引起妇产科学界的广泛关注,我国每年2000多万名产妇里面,其在产褥期自行恢复的过程中,很多在不同程度上存在着产后子宫复旧不良的情况,该现象在国外的报道也有上升趋势,故产后子宫复旧不良的相关研究也逐渐重视和深入。现代医学对产后子宫复旧不良的治疗手段繁多,例如注射缩宫素或口服药物(如产复康颗粒、新生化颗粒、益母草片)、口服中药(如生化汤)、针灸、按摩推拿、微波或红外线理疗、超短波理疗等,而产妇要兼顾婴儿哺乳,效果各人不一,虽有一定疗效,但各存利弊,因此,进一步寻找舒适无创的促进产后子宫复旧的康复手段十分必要。随着科学的发展,不断有新药物、新疗法、新思路的涌现。穴位贴敷法联合生物电反馈疗法的中西医结合治疗手段是基于舒适无创的基础上提出的一个方向,具有其独特优势,目前这方面的研究相对较少。现拟用穴位贴敷法联合生物电反馈疗法,探讨其治疗产后子宫复旧不良的临床疗效及作用机理,旨在为此治疗方法提供理论依据。研究目的研究遵循临床科研设计、衡量、评价(DME)原则和方法,运用临床随机对照试验,应用穴位贴敷法联合生物电反馈疗法治疗产后子宫复旧不良,通过观察阴道流血量、阴道流血持续时间、盆腔子宫B超等指标来评估子宫复旧情况,评估其疗效及安全性,并为其进一步临床应用及推广提供理论依据,为广大产后妇女提供健康服务。研究方法本研究应用前瞻性平行随机对照临床试验,将符合纳入标准的研究对象(产后子宫复旧不良患者)90例,随机分为治疗组①(穴位贴敷法)、治疗组②(生物电反馈疗法)、治疗组③(穴位贴敷法+生物电反馈疗法)各30例,观察阴道流血量、阴道流血持续时间、子宫复旧情况的变化。建立数据库,统计分析数据,判定穴位贴敷法联合生物电反馈疗法治疗产后子宫复旧不良的疗效,并三组进行对比。研究结果三组病例治疗后子宫径线均有一定改善,治疗后两两比较,子宫径线之和：治疗组③治疗组②治疗组①,组间差异两两比较均有显著统计学意义(P0.05)。三组病例治疗后均有助于宫内异常回声／暗区消失或缩小,治疗后疗效比较,疗效总有效例数：治疗组③治疗组②治疗组①；但经Kruskal-Wallis检验,疗效总有效率组间差异无统计学意义(PO.05)。三组病例治疗后均有助于减少阴道流血量,治疗后疗效比较,疗效总有效例数：治疗组③治疗组②治疗组①；但经Kruskal-Wallis检验,疗效总有效率组间差异无统计学意义(P0.05)。三组病例治疗后均有助于缩短阴道流血持续时间,治疗后流血持续时间比较：治疗组③治疗组②治疗组①；组间差异两两比较均有显著统计学意义(P0.05)。结论穴位贴敷法、生物电反馈疗法均对促进产后子宫复旧及缩短阴道流血时间、减少阴流血量有疗效,特别以穴位贴敷法联合生物电反馈疗法疗效突出。穴位贴敷法联合生物电反馈疗法治疗产后子宫复旧不良疗效显著,值得临床推广和应用。
[Abstract]:It is a common complication of the post-partum hysterectomy in the background of the study. The negative effects on the physical and mental health of women have attracted wide attention in the field of obstetrics and gynecology. In the process of self-recovery of the puerperium during the puerperium, There are many cases of post-partum hysterectomy in different degrees, and there is a tendency for the phenomenon to rise in the abroad, so the related research on the post-partum uterine involution is also gradually paid attention to and in-depth. The modern medicine has various treatment methods for postpartum uterine involution, such as injection of oxytocin or oral medicine (such as fukang granule, new biochemical granule, motherwort tablet), oral Chinese medicine (such as Sheng Hua Tang), acupuncture, massage, massage, microwave or infrared physiotherapy, ultra-short wave physical therapy, etc., It is necessary to further search for comfort and non-invasiveness to promote the rehabilitation of post-partum uterus. With the development of science, there are new drugs, new therapies and new ideas. The combination therapy of the traditional Chinese and western medicine combined with the bioelectric feedback therapy is based on the comfort and non-invasiveness, and has its unique advantages, and the research in this area is relatively low. It is proposed to combine bioelectric feedback therapy with the point-to-point application method to discuss the clinical effect and mechanism of the treatment of post-partum uterine complex, which is aimed at providing a theoretical basis for the treatment. The purpose of the study was to follow the principles and methods of clinical scientific research design, measurement and evaluation (DME), and to use the clinical and randomized controlled trial to apply the point-to-point application method and the bioelectric feedback therapy to treat the post-partum uterine complex, by observing the vaginal bleeding and the duration of the vaginal bleeding, In order to provide the theoretical basis for the further clinical application and extension of the uterus, it provides the theoretical basis for the further clinical application and extension of the uterus, and provides the health service for the women in the post-natal period. Methods A prospective, parallel, randomized controlled clinical trial was applied to the study, and 90 cases were randomly divided into the treatment group (acupoint application method) and the treatment group (bioelectric feedback therapy). The changes of the vaginal bleeding, the duration of the vaginal bleeding and the old of the uterus were observed in 30 cases of the treatment group (acupoint application method + bioelectric feedback therapy). To establish a database, to analyze the data, to determine the efficacy of the combined bioelectric feedback therapy combined with bioelectric feedback therapy in the treatment of post-partum uterine complex, and to compare the three groups. The results showed that there were some improvement in the size of the uterine diameter after the treatment, and the difference between the two groups in the treatment group was significantly higher than that of the treatment group (P <0.05). In the treatment group, the total effective rate of the treatment group was not statistically significant (PO.05). In the treatment group, the total effective rate of the treatment group was lower than that of the treatment group (P0.05). After the treatment, the duration of the vaginal bleeding was shortened, and the duration of the post-treatment bleeding was compared with that of the treatment group in the treatment group. The difference between the two groups was significant (P0.05). Conclusion The acupoint application method and the bioelectric feedback therapy can improve the old and shorten the bleeding time of the vagina, reduce the bleeding amount of the vagina, especially the combination of the acupoint application and the bioelectric feedback therapy. The combination of acupoint application and bioelectric feedback therapy has significant curative effect on the treatment of post-partum uterine complex, and it is worthy of clinical popularization and application.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.3

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