脾经排刺联合自主功能锻炼治疗产后腹直肌分离:随机对照试验

Row-like needling along the spleen meridian combined with autonomous functional exercise in treatment of postpartum diastasis recti abdominis:a randomized controlled trial

目的:观察脾经排刺联合自主功能锻炼治疗产后腹直肌分离的临床疗效。方法:将72例产后腹直肌分离患者随机分为观察组(36例,剔除3例)和对照组(36例,脱落3例)。对照组予腹直肌自主功能锻炼治疗。在对照组治疗基础上,观察组联合脾经排刺治疗,在腹部脾经循行线上,以双侧大横穴为中点,取大横上3、6 cm及大横下3、6 cm,每侧共5个穴进行排刺,隔日1次,每周3次,10次为一疗程,共治疗1个疗程。观察两组患者治疗前和治疗5、10次后腹直肌分离距离(IRD)和健康状况简易调查表(SF-36)评分。结果:治疗5、10次后,观察组脐上3 cm、脐中、脐下3 cm IRD较治疗前减小(P<0.01),对照组脐上3 cm IRD较治疗前减小(P<0.05);治疗5次后,观察组脐下3 cm IRD小于对照组(P<0.05);治疗10次后,观察组脐上3 cm、脐中、脐下3 cm IRD小于对照组(P<0.01)。治疗5、10次后,观察组生理机能、生理职能、情感职能、健康变化评分及总分较治疗前升高(P<0.01),对照组生理机能、生理职能、情感职能评分及总分较治疗前升高(P<0.01)。治疗5次后,观察组一般健康状况、健康变化评分高于对照组(P<0.05,P<0.01);治疗10次后,观察组生理机能、一般健康状况、健康变化评分及总分高于对照组(P<0.01)。结论:在自主功能锻炼的基础上,脾经排刺可促进产后腹直肌分离的恢复,提升患者生活质量。

Objective To observe the clinical effect of the row-like needling along the spleen meridian combined with autonomous functional exercise in treatment of postpartum diastasis recti abdominis.Methods A total of 72 patients with postpartum diastasis recti abdominis were randomly divided into an observation group(36 cases,3 cases excluded)and a control group(36 cases,3 cases dropped out).In the control group,the autonomous functional exercise was performed on the rectus abdominis.In the observation group,on the basis of the treatment as the control group,the row-like needling along the spleen meridian was delivered.Along the distribution of the spleen meridian on the abdomen,besides Daheng(SP 15),acupuncture was operated at the sites 3 cm and 6 cm directly above and below Daheng(SP 15)bilaterally.Five points on each side were stimulated along the meridian.Acupuncture was delivered once every two days,3 interventions a week.One course of treatment,composed of 10 treatments,was required.Before treatment and after 5 and 10 treatments,the inter-rectus distance(IRD)and the score of the medical outcomes study 36-item short form health survey(SF-36)were observed in the two groups,respectively.Results After 5 and 10 treatments,the IRD at the sites 3 cm above the umbilicus,in the center of the umbilicus and below the umbilicus was reduced when compared with that before treatment in the observation group,respectively(P<0.01);and the IRD at the site 3 cm above the umbilicus was decreased in comparison with that before treatment in the control group(P<0.05).After treated for 5 times,compared with the control group,the IRD at the site 3 cm below the umbilicus was reduced in the observation group(P<0.05);and after treated for 10 times,compared with the control group,the IRD at the sites 3 cm above the umbilicus,in the center of the umbilicus and below the umbilicus was reduced in the observation group(P<0.01).After the completion of 5 and 10 treatments,the scores of physical functioning(PF),role-physical(RP),role-emotional(RE)and health change(HC),as well as the total score of SF-36 were all higher than those before treatment in the observation group(P<0.01);while in the control group,the scores of PF,RP and RE,as well as the total score of SF-36 were increased in comparison with those before treatment(P<0.01).After 5 treatments,the scores of general health(GH)and HC in the observation group were higher than those of the control group(P<0.05,P<0.01);and after 10 treatments,the score of PF,GH and HC,as well as the total score of SF-36 in the observation group were higher than those of the control group(P<0.01).Conclusion On the basis of autonomous functional exercise,the row-like needling along the spleen meridian can promote the recovery of postpartum diastasis recti abdominis and improve the quality of life of the patients.