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目的探讨举元煎颗粒剂联合生物反馈电刺激治疗产后盆底功能障碍性疾病(pelvic floor dysfunction,PFD)的临床疗效及其对盆底肌力的改善作用。方法选取浙江中西医结合医院产后盆底肌力≤3级的产妇605例作为研究对象,按照自愿选择的原则分为观察组298例及对照组307例,观察组应用举元煎联合生物反馈电刺激治疗,对照组采用单纯生物反馈电刺激治疗,比较2组阴道收缩肌电值、阴道收缩持续时间及阴道动态压力的差异,分析压力性尿失禁症状及中医气虚症候的变化情况。结果治疗后,2组压力性尿失禁发生率分别为0.34%(1/298)及0.98%(3/307),显著低于治疗前的6.38%(19/298)及7.17%(22/307),2组治疗前后组内比较差异均有统计学意义(P<0.05),但治疗后2组间差异无统计学意义(P>0.05)。2组治疗后阴道收缩肌电值、阴道收缩持续时间及阴道动态压力均高于治疗前(P<0.05),治疗后2组间比较,观察组上述3项指标明显高于对照组(P<0.05),2组治疗后各中医气虚症候积分均较治疗前下降(P<0.05),治疗后2组间比较,观察组患者神疲、自汗症候积分低于对照组(P<0.05),而在气短、乏力及懒言方面,2组间差异无统计学意义(P>0.05),观察组中医气虚症候总积分亦明显低于对照组(P<0.01)。结论举元煎联合生物反馈电刺激能有效地促进产后盆底肌功能的康复,提高产后PFD的治疗效果,值得进一步应用。
Objective To investigate the clinical efficacy of “Yuanyuanjian Granule” combined with biofeedback stimulation in the treatment of postpartum pelvic floor dysfunction (PFD) and its effect on pelvic floor muscle strength. Methods 605 cases of postpartum pelvic floor maternal strength less than level 3 were selected as the research object. According to the principle of voluntary choice, 298 cases of the observation group and 307 cases of the control group were selected. The observation group was treated with the combination of YuanRuanJian and biofeedback The control group was treated with simple biofeedback stimulation. The differences of vaginal constriction, vaginal contraction pressure and dynamic vaginal pressure were compared between the two groups to analyze the symptoms of stress urinary incontinence and the changes of symptoms of Qi deficiency in TCM. Results After treatment, the incidence of stress urinary incontinence in two groups was 0.34% (1/298) and 0.98% (3/307) respectively, significantly lower than that of 6.38% (19/298) and 7.17% (22/307 ). There were significant differences in the two groups before and after treatment (P <0.05), but there was no significant difference between the two groups after treatment (P> 0.05). The vaginal contraction EMG, duration of vaginal contraction and vaginal dynamic pressure in the two groups were significantly higher than those before treatment (P <0.05). After treatment, the above three indexes in the observation group were significantly higher than those in the control group (P < 0.05). After treatment, the points of deficiency of Qi in each TCM were decreased compared with before treatment (P <0.05). After treatment, the scores of symptoms of Shenpi and spontaneous perspiration in observation group were lower than those in control group (P <0.05) However, there was no significant difference between the two groups in shortness of breath, weakness and laziness (P> 0.05). The total score of TCM syndromes in the observation group was also significantly lower than that in the control group (P <0.01). Conclusion Yuanyuan combined with biofeedback electrical stimulation can effectively promote the recovery of pelvic floor muscle function and improve the therapeutic effect of postpartum PFD, which is worthy of further application.