基于“治未病”理论探讨中医体质与产妇盆底肌力的关系

Discussion of the relationship between TCM body constitution and pelvic floor muscle strength of puerpera based on preventive medicine

目的探讨产妇盆底肌力与中医体质的相关性,从中医体质学的角度为临床盆底功能障碍性疾病的防治提供思路和依据。方法选取2019年3月~8月在山西省儿童医院(山西省妇幼保健院)进行产后42~60 d复查的产妇1060名,通过调查产妇的一般情况、体质类型以及盆底肌力的检测结果,采用单因素分析和二分类Logistics回归分析,筛选出影响盆底肌力的中医体质类型,了解太原市产妇盆底肌力与中医体质的相关性。结果在1060名产妇的体质调查中,排名前3的体质是阴虚质、气虚质和血瘀质;在盆底肌检查中Ⅰ类和Ⅱ类肌纤维肌力异常的发生率分别为45.7%和38.9%;在校正了产妇一般情况等混合因素之后,二元Logistic回归分析显示气虚质和湿热质是Ⅰ类肌纤维肌力异常的独立危险因素(P<0.05),气虚质、痰湿质和血瘀质是Ⅱ类肌纤维肌力异常的独立危险因素(P<0.05)。结论太原市产妇盆底肌力异常与中医体质中的气虚质、湿热质、痰湿质和血瘀质相关。

Objective To explore the correlation between postpartum pelvic floor muscle strength and body constitution in traditional Chinese medicine(TCM),and to provide reference for the prevention and treatment of pelvic floor dysfunction from the perspective of TCM.Methods 1060 postpartum women were selected who had their routine follow-up 42-60 days after delivery at the outpatient department of Children’s Hospital of Shanxi(Women Health Center of Shanxi)from March and August 2019 to investigate their general condition,TCM constitution and pelvic floor muscle strength.By univariate analysis and binary logistic regression analysis,TCM constitution types that affect pelvic floor muscle function were identified so as to understand the correlation between pelvic floor muscle strength and TCM constitution of puerperae in Taiyuan.Results This investigation of 1060 puerperae’s constitution in TCM showed that the top three constitution types of the postpartum women were yin-deficiency,qi-deficiency and blood-stasis types.In the pelvic floor muscle examination,the detection rates of type I and type II pelvic floor muscle fiber damage were 45.7%and 38.9%respectively.After the general condition factors of puerperae were controlled,binary logistic regression analysis showed that qi-deficiency constitution and wetness-heat constitution were risk factors for type I pelvic floor muscle damage(P<0.05),while qi-deficiency constitution,phlegm-wetness constitution and blood-stasis constitution were risk factors for type II pelvic floor muscle damage(P<0.05).Conclusion The decrease in pelvic floor muscular strength of puerperae in Taiyuan is related to qi-deficiency,wetness-heat,phlegm-wetness and blood-stasis constitution types in TCM.