归挤拍打正骨手法治疗产后耻骨联合分离病例对照研究

Case-control study on clinical effects of squeezing and clapping manipulation for treating the postpartum pubic symphysis separation

目的:观察归挤拍打正骨手法治疗产后耻骨联合分离的临床疗效。方法 :2015年6月至2017年3月纳入产后耻骨联合分离患者80例,分为治疗组和对照组,每组40例。治疗组生育年龄26~40(30.61±5.94)岁,新生儿体重3.20~4.52(3.59±0.13)kg;对照组生育年龄22~37(27.51±4.57)岁,新生儿体重3.0~5.8(3.81±0.63)kg。治疗组采用归挤拍打正骨手法,每周手法治疗1次,3周为1个疗程。对照组采用骨盆绑带制动治疗,每天骨盆固定绑带制动不少于8 h,3周为1个疗程。在病例筛选入组的当天以及治疗后1、2、3周和1个月进行临床观察,对两组VAS疼痛评分、Oswestry功能障碍指数评分(ODI)、耻骨联合分离距离进行评价。结果 :耻骨联合VAS评分与治疗前比较,治疗组治疗1周开始差异有统计学意义(P=0.013),对照组治疗1个月差异有统计学意义(P=0.042);治疗组治疗后均小于对照组(P<0.05)。ODI评分与治疗前比较,治疗组治疗1周开始差异有统计学意义(P=0.009),对照组治疗1个月差异有统计学意义(P=0.013),治疗组治疗后均小于治疗前(P<0.05)。耻骨联合距离值与治疗前比较,治疗组治疗后明显减小(P<0.05),对照组治疗后差异无统计学意义(P>0.05),两组比较,第1周(P=0.042)、第3周(P=0.005)差异有统计学意义。结论:归挤拍打正骨手法能快速恢复耻骨联合分离距离,减轻局部疼痛和改善腰骶部功能,优于骨盆绑带固定治疗。

Objective：To study the clinical effect of squeezing and clapping bone setting manipulation in treating the postpartum pubis symphysis separation. Methods：From June 2015 to March 2017,80 patients with postpartum pubic symphysis separation were randomly divided into treatment group and control group,40 patients in each group. In treatment group,the patients＇ reproductive age ranged from 26 to 40 years old with an average of（30.61 ±5.94） years old and the neonatal weight ranged from 3.2 to 4.52 kg with an average of（3.59±0.13） kg. In control group,patients＇ reproductive age ranged from22 to 37 years old with an average age of（27.51±4.57） years old and the neonatal weight ranged from 3 to 5.8 kg with an average of（3.81±0.63） kg. The patients in the treatment group were treated with the squeezing and clapping manipulation,once a week for 3 weeks. The patients in the control group were treated with pelvic bandage immobilization,and the immobilization of the pelvis was not less than 8 hours per day,3 weeks for 1 course. The VAS pain score,Oswestry dysfunction index（ODI） and separation distance of pubis were clinical observed and evaluated on the first day of treatment,1,2,3 weeks and 1 months after treatment. Results：The pubic symphysis VAS score was compared with that before treatment,in the treatment group,the difference was statistically significant at 1 week（P=0.013）; the difference was statistically significant in the control group for 1 month（P=0.042）. The two groups were less than those of the control group after treatment（P〈0.05）. The ODI score was compared with that before the treatment,in the treatment group,the difference was statistically significant at 1 week（P=0.009）,the difference was statistically significant in the control group for 1 month（P=0.013）,the two groups were less than those before treatment（P〈0.05）. The pubic symphysis distance was compared with that before treatment,the treatment group decreased significantly after treatment（P〈0.05）,there was no significant difference in the control group after treatment（P〈0.05）,the two groups were compared,the difference was statistically significant at first weeks（P=0.042） and third weeks（P=0.005）. Conclusion：The ＂squeezing and clapping＂ manipulation can quickly restore the distance between pubic symphysis separation,relieve local pain and improve lumbosacral function,and is better than pelvic bandage fixation treatment.