中医参与孕产妇健康管理效果评价

Effectiveness evaluation of traditional Chinese medicine in maternal health management

目的探讨中医参与孕产妇健康管理效果，为孕产妇健康，提高母婴生活质量提供依据。方法选取2011年9月～2014年8月在武汉市斫口区妇幼保健院和斫口区10家社区卫生服务中心建册的孕产妇4072例，设孕前体质辨识到产后42天全程中医健康管理的孕产妇2564例为研究对象，按接受中医健康教育及执行中医健康管理措施的情况分为中医管理组1129例和对照组1435例。对照组进行常规的孕妇保健随访，中医管理组建立健康档案，进行孕前体质辨识，孕期及产后健康状况评估，针对体质类型和评估情况进行起居调养、药膳食疗、情志调摄、动静养生等中医指导，并对相关指标及执行情况进行记录评价。结果中医管理组的孕妇孕期体重增长异常率、先兆流产、妊娠贫血的发生率明显低于对照组，差异有统计学意义（P〈0．01）；妊娠期高血压疾病及妊娠糖尿病的发生率中医管理组低于对照组，差异有统计学意义（P〈0．05）；分娩期中医管理组巨大儿的发生率明显低于对照组，差异有统计学意义（P〈0．01）；低体重儿的发生率中医管理组低于对照组，差异有统计学意义（P〈0．05）；新生儿患新生儿黄疸和新生儿肺炎几率明显低于对照组，差异有统计学意义（P〈0．01）。产褥期中医管理组产后缺乳及产后抑郁症的发生率明显低于对照组，差异有统计学意义（P〈0．01）。结论对孕产妇实施全程个体化、针对性的中医健康管理，加强认知及时干预，可有效控制并发症的发生，提高母婴生活质量。

Objective To explore the effect of traditional Chinese medicine （TCM） in maternal health management, provide a ba- sis for maternal health and improving maternal and infantile quality of life. Methods A total of 4 072 pregnant women building cards in Ma- ternal and Child Health Care Hospital of Qiaokou District and ten community health service centers in Qiaokou District in Wuhan from Sep- tember 2011 to August 2014 were selected; 2 564 pregnant women receiving the whole TCM health management from the recognition of TCM constitution before pregnancy to 42 days after delivery were selected as study objects, then they were divided into TCM management group （ 1 129 pregnant women） and control group （ 1 435 pregnant women） according to the acceptance of TCM healthy management and executive condition of TCM health management measures. The pregnant women in control group received conventional maternal health care and follow- up, while the pregnant women in TCM management group established health records, the recognition of TCM constitution before pregnancy, pregnant and postnatal health assessment~ TCM guidance （daily nursing, medicative diet for food therapy, emotion transfer, combining ac- tive motions and stable breathing） were conducted targeting to TCM constitution types and assessment condition; the related indexes and ex- ecutive condition were recorded and evaluated. Results The incidence rates of abnormal body weight gain during pregnancy, threatened a- bortion, and anemia in pregnancy in TCM management group were statistically significantly lower than those in control group （P〈0. 01 ） ; the incidence rates of hypertensive disorder complicating pregnancy （HDCP） and gestational diabetes mellitus （GDM） in TCM management group were statistically significantly lower than those in control group （ P〈0. 05 ） ; the incidence rate of macrosomia in TCM management group was statistically significantly lower than that in control group （P〈0.01） ; the incidence rate of low birth weight infants in TCM manage- ment group was statistically significantly lower than that in control group （ P〈0.05 ） ; the incidence rates of neonatal jaundice and neonatal pneumonia in TCM management group were statistically significantly lower than those in control group （P〈0. 01 ） ; the incidence rates of post- partum lack of milk and postpartum depression in TCM management group were statistically significantly lower than those in control group （P〈0. 01 ） . Conclusion Conducting individualized and corresponding TCM health management and strengthening timely intervention of cognition can effectively control complications of pregnant women and improve maternal and infantile quality of life.