妊娠相关下腰痛的流行病学特征及治疗进展

Epidemiological Characteristics and Therapeutic Progress of Pregnancy-related Low Back Pain

妊娠相关下腰痛(pregnancy-related low back pain,PLBP)是妊娠期及产后一种较为常见的病理状态,以疼痛和功能障碍为主要的临床表现。一些患者、家属甚至专科医生都认为PLBP是一种可以预料的功能状态,不需要治疗干预。因此,许多患有这种疼痛综合征的孕产妇没有得到足够重视和及时治疗。然而,PLBP对孕产妇的生活、工作、社会交往甚至精神心理都可能产生许多负面影响。目前对于该病的患病率尚没有统一的认识,不同的调查研究之间得出的数据有较大的差异,而国内还没有关于产后下腰痛的相关调查研究,对于PLBP危险因素的认识还存在一定的分歧。此外,对于其病理生理的研究还不够深入,目前关于PLBP发病机制的研究主要集中于腰椎生理曲度、椎间盘、核心肌群及耻骨松弛素等因素的变化。虽然对于该病的治疗有许多不同的方法,常见的包括产科护理、经皮神经电刺激、脊柱手法治疗、运动疗法、药物治疗、针刺治疗等,但目前仍然没有公认的最佳的治疗方案。特别是对于妊娠期间下腰痛的治疗,更是受到了许多限制。本文通过查阅国内外文献,对PLBP的流行病学特点及治疗现状进行综述,期望为该病的预防和治疗提供更为全面的信息。

Pregnancy-related low back pain（ PLBP） is a common complaint among maternal. Pain and dysfunction are the main clinical manifestations. PLBP is considered to be normal and expected status during pregnancy by many patients,their families or doctors. And they think treatment is not needed. PLBP has been ignored and untreated. However,PLBP may have many negative impacts on their daily life,work,social communications or psychological health,which poses a serious care and economic burden to their family and the society. Since research for the prevalence of PLBP is no unified understanding. And there exists great difference among different study. Research on the prevalence of PLBP has not been carried out yet in China. At present,there is some difference about the risk factors of PLBP. The study about the pathogenesis of PLBP is not deep and complete that mainly concentrates on the change of lumbar physiological curvature,intervertebral disc,core muscles and relaxin. Although,there are a number of treatments,such as obstetric care,TENS,chiropractic treatment,exercise,drugs,and acupuncture. They cannot produce a recognized the best treatment plan. In particular,there are many restrictions on the treatment of low back pain during pregnancy. This article reviews the epidemiological characteristics and treatment progress of PLBP. We hope to provide more information for prevention and treatment of PLBP.