雷火灸治疗血瘀型剖宫产后恶露不绝的疗效及对血液流变学和泌乳时效性的影响

Therapeutic Effect of Applying Thunder-fire Moxibustion in the Treatment of Lochia after Blood Stasis Type Cesarean Section and Its Effect on Hemorheology and Lactation Timeliness

目的:观察雷火灸治疗血瘀型剖宫产后恶露不绝的疗效及对血液流变学和泌乳时效性的影响。方法:选取我院收治的92例剖宫产后血性恶露持续3周以上的患者,随机分为对照组和观察组,各46例。对照组服用新生化颗粒,每袋6g,每次2袋,每日3次,连续服用2周,观察组在此基础上使用雷火灸治疗,于少腹部及任脉部使用移动灸,于内关、血海、三阴交、子宫使用雀啄灸,每次30min,间隔2日治疗,共治疗5次,时间为2周。比较两种方法的疗效和中医症状积分,观察血液流变学指标(全血高切相对粘度、全血低切相对粘度、血浆粘度值、血沉、红细胞比容)、子宫复旧情况(子宫三径乘积、底部下降程度)、恶露持续时间及开始乳足时间。结果:观察组临床总有效率为91.30%,优于对照组临床总有效率73.91%(P<0.05)。观察组及对照组患者的血液流变学指标、子宫复旧及中医症状积分均较治疗前有所改善(P<0.05),且观察组在血浆粘度值、血沉、子宫三径乘积、子宫底部下降程度及中医症状积分方面改善优于对照组(P<0.05),在恶露持续及开始乳足时间方面,观察组患者均优于对照组(P<0.05或P<0.01)。结论:雷火灸治疗血瘀型剖宫产后恶露不绝的疗效优于单用新生化颗粒,该灸法及配穴思路值得临床借鉴。

Objective:To study the effect of Thunder-fire Moxibustion on lochia after cesarean section of blood stasis type and its effect on hemorheology and lactation time.Methods:Ninety-two patients with haemorrhagic lochia after cesarean section lasting more than 3 weeks were randomly divided into a controlled group and an observation group,46 cases in each group.The controlled group was treated with New Shenghua Granules,6 g in each bag,2 bags each time,3 times a day for 2 weeks.The observation group was treated with Thunder-fire Mmoxibustion,mobile moxibustion on less abdomen and Renmai,and bird pecking moxibustion on Neiguan,Xuehai,Sanyinjiao and uterus,30 minutes each time,2 days apart.The treatment lasted 5 times for 2 weeks.Compared the curative effect of the two methods and TCM symptom score,observed the hemorheological indexes(whole blood high shear relative viscosity,whole blood low shear relative viscosity,plasma viscosity value,erythrocyte sedimentation rate,hematocrit),uterine involution(uterine three-diameter product,bottom descent),lochia duration and lactation time.Results:The total clinical effective rate of the observation group was 91.30%,which was better than 73.91% of the controlled group(P<0.05).The hemorheological indexes,uterine involution and TCM symptom scores of the observation group and the controlled group were improved compared with those before treatment(P<0.05),and the improvement of plasma viscosity,erythrocyte sedimentation rate,uterine three-diameter product,uterine bottom descent and TCM symptom score of the observation group was better than that of the controlled group(P<0.05),and the observation group was better than the controlled group in the persistence of lochia and the time of lactation(P<0.05 or P<0.01).Conclusion:Thunder-fire moxibustion is more effective than New Shenghua Granule alone in treating lochia after cesarean section of blood stasis type.The moxibustion method and acupoint-matching ideas are worthy of clinical reference.