汪蕾蕾 周正 周紅梅
【摘要】目的:研究溫針灸治療產(chǎn)后身痛的療效。方法:選取本院于2021年1月—2022年9月收治的產(chǎn)后身痛患者80例,應(yīng)用隨機(jī)數(shù)表法分為對(duì)照組(40例)和觀察組(40例),對(duì)照組產(chǎn)后身痛患者采用神經(jīng)肌肉低頻電刺激,觀察組產(chǎn)后身痛患者采用溫針灸治療。結(jié)果:溫針灸治療下產(chǎn)后身痛患者臨床治療總有效率為92.50%,高于神經(jīng)肌肉低頻電刺激治療的80.00%,對(duì)比結(jié)果差異顯著(P<0.05)。溫針灸治療下產(chǎn)后身痛患者VAS疼痛評(píng)分為(1.13±0.26)分,低于神經(jīng)肌肉低頻電刺激治療(P<0.05)。溫針灸治療下產(chǎn)后身痛患者IgA、IgG、IgM免疫功能分別為(3.21±0.60)g/L、(16.80±2.01)g/L、(2.05±0.62)g/L,高于神經(jīng)肌肉低頻電刺激治療(P<0.05)。溫針灸治療下產(chǎn)后身痛患者肢體麻木、渾身酸痛、頭暈眼花、失眠心悸中醫(yī)證候積分分別為(0.70±0.21)分、(0.75±0.23)分、(0.63±0.17)分、(0.42±0.12)分,低于神經(jīng)肌肉低頻電刺激治療(P<0.05)。結(jié)論:溫針灸治療產(chǎn)后身痛的療效顯著優(yōu)于神經(jīng)肌肉低頻電刺激治療,因此溫針灸治療更具推廣價(jià)值。
【關(guān)鍵詞】產(chǎn)后身痛;溫針灸;VAS疼痛評(píng)分;中醫(yī)證候積分
Therapeutic effect of warm acupuncture on postpartum body pain
WANG Leilei, ZHOU Zheng, ZHOU Hongmei
Postpartum rehabilitation center, Hefei Maternal and Child Health Care Hospital, Hefei, Anhui 230000, China
【Abstract】Objective: To study the effect of warm acupuncture and moxibustion on postpartum body pain. Methods: 80 cases of postpartum body pain patients admitted to our hospital from January 2021 to September 2022 were randomly divided into the control group (40 cases) and the observation group (40 cases). The patients in the control group were treated with low-frequency neuromuscular electrical stimulation, and the patients in the observation group were treated with warm acupuncture and moxibustion. Results: The total effective rate of warm acupuncture and moxibustion in the treatment of postnatal body pain was 92.50%, which was higher than 80.00% of neuromuscular low-frequency electrical stimulation, with a significant difference (P<0.05). The VAS pain score of patients with postnatal body pain treated with warm acupuncture and moxibustion was (1.13±0.26) points, lower than that of patients treated with neuromuscular low-frequency electrical stimulation (P<0.05). The immune functions of IgA, IgG and IgM in patients with postnatal body pain treated with warm acupuncture and moxibustion were (3.21±0.60) g/L, (16.80±2.01)g/L and (2.05±0.62) g/L respectively, which were higher than those treated with neuromuscular low-frequency electrical stimulation (P<0.05). The TCM syndrome scores of limbs numbness, body aches, dizziness, insomnia and palpitations in patients with postnatal body pain treated with warm acupuncture and moxibustion were (0.70±0.21) points, (0.75±0.23) points, (0.63±0.17) points, and (0.42±0.12) points respectively, which were lower than those treated with neuromuscular low-frequency electrical stimulation (P<0.05). Conclusion: The therapeutic effect of warm acupuncture and moxibustion on postpartum body pain is significantly better than that of neuromuscular low-frequency electrical stimulation, so warm acupuncture and moxibustion is more valuable for popularization.
【Key Words】Postpartum body pain; Warm acupuncture; VAS pain score; TCM syndrome score
產(chǎn)后身痛為中醫(yī)病名,是指產(chǎn)婦在產(chǎn)褥期內(nèi)出現(xiàn)肢體或關(guān)節(jié)酸楚、疼痛、麻木、重著的情況[1]。西醫(yī)學(xué)中產(chǎn)褥期中因風(fēng)濕、類風(fēng)濕引起的關(guān)節(jié)痛、產(chǎn)后坐骨神經(jīng)痛、多發(fā)性肌炎、產(chǎn)后血栓性靜脈炎等情況與中醫(yī)學(xué)中的產(chǎn)后身痛類似,需及時(shí)診治,診斷和治療及時(shí)則預(yù)后良好,若診治不及時(shí)則容易導(dǎo)致產(chǎn)婦痿痹殘疾[2-3]。中醫(yī)認(rèn)為產(chǎn)后身痛是產(chǎn)后營(yíng)血虧虛、經(jīng)脈失養(yǎng)或風(fēng)寒濕邪乘虛而入、稽留關(guān)節(jié)、經(jīng)絡(luò)所致,血虛、風(fēng)寒、血瘀、腎虛為主要病因,因此治療應(yīng)分別按照血虛證、風(fēng)寒證、血瘀證、腎虛證進(jìn)行辨證論治,也可以采用針灸治療[4]。本院于2021年1月—2022年9月收治的80例產(chǎn)后身痛患者,觀察溫針灸治療產(chǎn)后身痛的療效。報(bào)告如下。
1.1 一般資料
于2021年1月—2022年9月本院收治的產(chǎn)后身痛患者中隨機(jī)選取80例,以隨機(jī)數(shù)表法分為兩組。觀察組40例,年齡20~37歲,平均年齡(27.54±3.41)歲;對(duì)照組40例,年齡20~39歲,平均年齡(28.26±3.60)歲。一般資料對(duì)比差異無統(tǒng)計(jì)學(xué)意義(P>0.05)。
納入標(biāo)準(zhǔn):①經(jīng)診斷為產(chǎn)后身痛的患者;②自愿參與本實(shí)驗(yàn)者。排除標(biāo)準(zhǔn):①心功能不全者;②拒絕采用針灸治療者;③肝腎功能嚴(yán)重異常者;④免疫系統(tǒng)疾病者;⑤合并骨關(guān)節(jié)炎疾病者。
1.2 方法
對(duì)照組產(chǎn)后身痛患者采用神經(jīng)肌肉低頻電刺激,觀察組產(chǎn)后身痛患者采用溫針灸治療。
(1)神經(jīng)肌肉低頻電刺激治療。運(yùn)用生物刺激反饋儀S440(南京偉思醫(yī)療科技股份有限公司)選取疼痛位置,神經(jīng)肌肉低頻電刺激20min,隔日一次,持續(xù)治療一個(gè)月。(2)溫針灸治療。采用捻轉(zhuǎn)補(bǔ)法對(duì)患者膈俞穴、肝俞穴、脾俞穴、腎俞穴、肩髃穴、合谷穴、曲池穴、足三里穴、委中穴、昆侖穴、風(fēng)池穴、天宗穴、大椎穴、命門穴、環(huán)跳穴、秩邊穴向疼痛部位斜刺,平補(bǔ)平泄,得氣后留針30min,在針柄處點(diǎn)燃2cm艾段,每周連續(xù)溫針灸5次后休息2d,7d一個(gè)療程,持續(xù)治療一個(gè)月。
1.3 觀察指標(biāo)
對(duì)比兩組產(chǎn)后身痛患者的臨床治療效果、VAS疼痛評(píng)分、免疫功能指標(biāo)、中醫(yī)證候積分。
(1)臨床治療效果中:中醫(yī)證候積分下降70%以上為顯效,下降50%~70%為有效,下降50%以下為無效,顯效和有效之和為總有效率[5]。(2)VAS疼痛評(píng)分滿分10分,采用視覺模擬方法評(píng)價(jià)。(3)免疫功能指標(biāo)包括IgA、IgG、IgM。④中醫(yī)證候積分根據(jù)肢體麻木、渾身酸痛、頭暈眼花、失眠心悸嚴(yán)重程度進(jìn)行評(píng)價(jià),無癥狀0分、輕度1分、中度2分、重度癥狀3分[6]。
1.4 統(tǒng)計(jì)學(xué)方法
采用SPSS 21.0統(tǒng)計(jì)學(xué)軟件進(jìn)行數(shù)據(jù)分析。計(jì)數(shù)資料采用(%)表示,進(jìn)行x2檢驗(yàn),計(jì)量資料采用(x±s)表示,進(jìn)行t檢驗(yàn),P<0.05為差異具有統(tǒng)計(jì)學(xué)意義。
2.1 兩組產(chǎn)后身痛患者臨床治療效果對(duì)比
溫針灸治療下產(chǎn)后身痛患者臨床治療總有效率高于神經(jīng)肌肉低頻電刺激治療,對(duì)比結(jié)果差異顯著(P<0.05),見表1。
2.2 兩組產(chǎn)后身痛患者VAS疼痛評(píng)分對(duì)比
溫針灸治療下產(chǎn)后身痛患者VAS疼痛評(píng)分低于神經(jīng)肌肉低頻電刺激治療、低于治療前,神經(jīng)肌肉低頻電刺激治療下產(chǎn)后身痛患者VAS疼痛評(píng)分低于治療前,對(duì)比結(jié)果差異顯著(P<0.05),見表2。
2.3兩組產(chǎn)后身痛患者免疫功能指標(biāo)對(duì)比
溫針灸治療下產(chǎn)后身痛患者IgA、IgG、IgM高于神經(jīng)肌肉低頻電刺激治療,對(duì)比結(jié)果差異顯著(P<0.05),見表3。
2.4 兩組產(chǎn)后身痛患者中醫(yī)證候積分對(duì)比
溫針灸治療下產(chǎn)后身痛患者肢體麻木、渾身酸痛、頭暈眼花、失眠心悸中醫(yī)證候積分低于神經(jīng)肌肉低頻電刺激治療,對(duì)比結(jié)果差異顯著(P<0.05),見表4。
神經(jīng)肌肉低頻脈電刺激利用不斷變化的波形、波幅及頻率,對(duì)機(jī)體肌肉組織產(chǎn)生不同程度的刺激,使肌肉組織盡快恢復(fù)舒縮、振動(dòng)功能。低頻電刺激通過不同頻率電流刺激,使疼痛肌肉恢復(fù)規(guī)律的收縮、舒張功能,使筋膜規(guī)律運(yùn)動(dòng);低頻脈電刺激可相應(yīng)刺激患者皮膚感受器,釋放部分乙酰膽堿及組胺等生物活性,以此擴(kuò)張血管,促進(jìn)局部組織血液循環(huán),改善患者因生產(chǎn)引起的肌肉、關(guān)節(jié)水腫、疼痛等癥狀。
本文實(shí)驗(yàn)結(jié)果表明:溫針灸治療下產(chǎn)后身痛患者臨床治療總有效率為92.50%,高于神經(jīng)肌肉低頻電刺激治療,可見溫針灸治療身痛患者臨床治療效果顯著提高。溫針灸治療下產(chǎn)后身痛患者VAS疼痛評(píng)分為(1.13±0.26)分,低于神經(jīng)肌肉低頻電刺激的治療,可見溫針灸治療替代神經(jīng)肌肉低頻電刺激治療后產(chǎn)后身痛患者疼痛情況顯著減輕。溫針灸治療下產(chǎn)后身痛患者IgA、IgG、IgM免疫功能分別為(3.21±0.60)g/L、(16.80±2.01)g/L、(2.05±0.62g)/L,高于神經(jīng)肌肉低頻電刺激治療,可見溫針灸治療替代神經(jīng)肌肉低頻電刺激治療后產(chǎn)后身痛患者免疫功能顯著好轉(zhuǎn)。溫針灸治療下產(chǎn)后身痛患者肢體麻木、渾身酸痛、頭暈眼花、失眠心悸中醫(yī)證候積分分別為(0.70±0.21)分、(0.75±0.23)分、(0.63±0.17)分、(0.42±0.12)分,低于神經(jīng)肌肉低頻電刺激治療,可見溫針灸治療替代神經(jīng)肌肉低頻電刺激治療后產(chǎn)后身痛患者臨床癥狀顯著好轉(zhuǎn)。
綜上所述,溫針灸治療產(chǎn)后身痛的療效顯著優(yōu)于神經(jīng)肌肉低頻電刺激治療,因此溫針灸治療更具推廣價(jià)值。
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