脊柱微调手法对产后腰椎-骨盆复合体疼痛的疗效及对腰椎骨盆参数影响研究

doi:10.3969/j.issn.1000-8535.2024.03.012

广州医药 ›› 2024, Vol. 55 ›› Issue (3): 289-294.DOI: 10.3969/j.issn.1000-8535.2024.03.012

脊柱微调手法对产后腰椎-骨盆复合体疼痛的疗效及对腰椎骨盆参数影响研究

李振^1,2, 张喜林², 安洋阳¹, 周旭¹, 马红敏¹

1 上海市杨浦区中医医院推拿科（上海 200090）;
2 上海中医药大学附属岳阳中西医结合医院推拿科（上海 200437)

收稿日期:2023-11-15 出版日期:2024-03-20 发布日期:2024-04-12
通讯作者: 张喜林,E-mail:xinlinz@163.com
基金资助:
上海市杨浦区科学技术委员会杨浦区卫生健康委员会联合课题（YPQ202109）

Clinical study on the effect of spine fine adjustment manipulation on postpartum lumbopelvic pain and its role in adjusting lumbar lordosis and pelvic incidence

LI Zhen^1,2, ZHANG Xilin², AN Yangyang¹, ZHOU Xu¹, MA Hongmin¹

1 Tuina Department,Yangpu District Hospital of Traditional Chinese Medicine,Shanghai 200090,China;
2 Tuina Department,Yueyang Hospital of Integrative Traditional Chinese and western Medicine Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China

Received:2023-11-15 Online:2024-03-20 Published:2024-04-12

摘要/Abstract

摘要： 目的探讨脊柱微调手法治疗产后腰椎-骨盆复合体疼痛的临床疗效及对腰椎前凸曲度（LL）和骨盆入射角度（PI）的调整作用,为产后腰椎-骨盆复合体疼痛的治疗提供理论依据。方法选取2022年7月—2023年7月在上海市杨浦区中医医院推拿科和上海中医药大学附属岳阳中西医结合医院推拿科门诊治疗的产后腰椎-骨盆复合体疼痛患者共82例,随机分为对照组和治疗组,每组41例。对照组采用传统理筋推拿手法,治疗组采用脊柱微调手法治疗,两组疗程均为8周,观察临床疗效,比较两组患者的疼痛数字评分法（NRS）、Oswestry功能障碍指数（ODI）、LL和PI在治疗前后组间与组内的变化。结果治疗组总有效率为95.12%,对照组总有效率为75.60%,治疗组优于对照组（P<0.05）。治疗后,两组NRS评分、ODI评分较治疗前均有下降,且治疗组优于对照组（P<0.05）。治疗后,两组LL和PI测量较治疗前均无明显变化,治疗组与对照组比较差异无统计学意义（P>0.05）。结论脊柱微调手法能有效减轻患者疼痛、提升日常活动功能,但对腰椎曲度、骨盆入射角未产生移位影响,安全性高。

关键词: 产后腰椎-骨盆复合体疼痛, 脊柱微调手法, 传统理筋推拿

Abstract: Objective To explore the clinical efficacy of spinal fine adjustment manipulation in the treatment of postpartum lumbopelvic pain（PLPP） and its role in adjusting lumbar lordosis and pelvic incidence,and to provide theoretical basis for the treatment of PLPP. Methods A total of 82 patients with PLPP who were treated in the outpatient clinics of the Tuina Department of Yangpu District Hospital of Traditional Chinese Medicine and the Tuina Department of Yueyang Hospital of Integrative Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine from July 2022 to July 2023 were selected and randomly divided into the control group and the treatment group,with 41 cases in each group．The control group was treated with the traditional tendon manipulation and the treatment group was treated with spinal fine adjustment manipulation,and the course of treatment for both groups was 8 weeks．Clinical efficacy was observed,and the changes of pain Numerical Rating Scale（NRS）,Oswestry disability index（ODI）,lumbar lordosis（LL）,and pelvic incidence（PI）of the two groups were compared between the two groups and within the two groups before and after the treatment. Results The total effective rate was 95.12% in the treatment group and 75.60% in the control group,and the treatment group was superior to the control group（P<0.05）．After treatment,the NRS and ODI of both groups were lower than before treatment,and the treatment group was better than the control group（P<0.05）． After treatment,there was no significant change in LL and PI in both groups compared to pre-treatment．There was no significant difference between the treatment group and the control group（P>0.05）. Conclusions Spinal fine adjustment manipulation can effectively reduce the pain of patients and improve the function of daily activities,but it has no displacement effect on LL and PI,which is safe and suitable for clinical promotion and application．

Key words: postpartum lumbopelvic pain, spinal fine adjustment manipulation, traditional tendon massage

李振, 张喜林, 安洋阳, 周旭, 马红敏. 脊柱微调手法对产后腰椎-骨盆复合体疼痛的疗效及对腰椎骨盆参数影响研究[J]. 广州医药, 2024, 55(3): 289-294.

LI Zhen, ZHANG Xilin, AN Yangyang, ZHOU Xu, MA Hongmin. Clinical study on the effect of spine fine adjustment manipulation on postpartum lumbopelvic pain and its role in adjusting lumbar lordosis and pelvic incidence[J]. Guangzhou Medical Journal, 2024, 55(3): 289-294.

参考文献

[1] VLEEMING A,ALBERT H B,OSTGAARD H C,et al.European guidelines for the diagnosis and treatment of pelvic girdle pain[J].Eur Spine J,2008,17(6):794-819.
[2] 伍茂玉. 隔姜灸“关元”穴治疗产后腰痛的临床研究[D].福州:福建中医药大学,2012.
[3] KANAKARIS N K,ROBERTS C S,GIANNOUDIS P V.Pregnancy related pelvic girdle pain:an update[J].BMC Med,2011(9):15.
[4] LEADBETTER R E,MAWER D,LINDOW S W.The development of a scoring system for symphysis pubis dysfunction[J].J Obstet Gynaecol,2006,26(1):20-23.
[5] CAO D Y,PICKAR J G .Effect of spinal manipulation on the development of history-dependent responsiveness of lumbar paraspinal muscle spindles in the cat[J].J Can Chiropr Assoc,2014,58(2):149-159.
[6] DEERING R,PASHIBIN T,CRUZ M,et al.Fatiguing trunk flexor exercise decreases pain sensitivity in postpartum women[J].Front Physiol,2019(10):315.
[7] MACKENZIE J,MURRAY E,LUSHER J.Women's experiences of pregnancy related pelvic girdle pain:A systematic review[J].Midwifery,2018(56):102-111.
[8] 李振,张喜林.产后腰椎-骨盆复合体疼痛综合征的研究进展[J].国际妇产科学杂志,2020,47(5):579-583.
[9] SAY L,CHOU D,GEMMILL A,et al.Global causes of maternal death:A WHO systematic analysis[J].Lancet Glob Health,2014,2(6):e323-e333.
[10] ten HOOPE-BENDER P,LOPES S T,NOVE A,et al.Midwifery2030:a woman's pathway to health.What does this mean?[J].Midwifery,2016(32):1-6.
[11] DUNN G,EGGER M J,SHAW J M,et al.Trajectories of lower back,upper back,and pelvic girdle pain during pregnancy and early postpartum in primiparous women[J].Womens Health(Lond),2019,15:1745506519842757.
[12] GOOSSENS N,GERAERTS I,VANDENPLAS L,et al.Body perception disturbances in women with pregnancy-related lumbopelvic pain and their role in the persistence of pain postpartum[J].BMC Pregnancy Childbirth,2021,21(1):219.
[13] ELDEN H,LUNDGREN I,ROBERTSON E.Life's pregnant pause of pain:pregnant women's experiences of pelvic girdle pain related to daily life:a Swedish interview study[J].Sex Reprod Healthc,2013,4(1):29-34.
[14] 周艳红,蒋艳敏,钟俊敏,等.孕期盆底肌锻炼联合产后盆底功能康复治疗对产后女性盆底功能障碍的防治效果[J].广州医药,2022,53(1):91-95.
[15] CARVALHO M E,LIMA L C,de LIRA TERCEIRO C A,et al.Low back pain during pregnancy[J].Rev Bras Anestesiol,2017,67(3):266-270.
[16] SAKAMOTO A,GAMADA K.Altered musculoskeletal mechanics as risk factors for postpartum pelvic girdle pain:a literature review[J].J Phys Ther Sci,2019,31(10):831-838.
[17] GLUPPE S,ELLSTRÖM ENGH M,BØ K.Primiparous women's knowledge of diastasis recti abdominis,concerns about abdominal appearance,treatments,and perceived abdominal muscle strength 6-8 months postpartum.A cross sectional comparison study[J].BMC Womens Health,2022,22(1):428.
[18] STARZEC-PROSERPIO M,WGRZYNOWSKA M,SYS D,et al.Prevalence and factors associated with postpartum pelvic girdle pain among women in Poland:a prospective,observational study[J].BMC Musculoskelet Disord,2022,23(1):928.
[19] 刘立梅,黄海燕,蔡莲娆.凯格尔(kegel)锻炼法结合生物反馈电刺激对产后盆底康复管理效果的影响[J].广州医药,2020,51(3):42-46.
[20] PERRY M.Low back pain:tackling a common problem[J].Pract Nurs,2013,24(7):356-358.
[21] SMITH C A,HILL E,DENEJKINA A,et al.The effectiveness and safety of complementary health approaches to managing postpartum pain:A systematic review and meta-analysis[J].Integr Med Res,2022,11(1):100758.
[22] ULLMAN R,SMITH LA,BURNS E,MORI R,et al.Parenteral opioids for maternal pain relief in labour[J].Cochrane Database Syst Rev,2010(9):CD007396.
[23] CHING WONG S S,CHEUNG C W.Analgesic efficacy and adverse effects of meperidine in managing postoperative or labor pain:A narrative review of randomized controlled trials[J].Pain Physician,2020,23(2):175-201.
[24] HEITMANN K,SCHJØTT J.Safe mother medicine:Aiming to increase women's empowerment in use of medications during pregnancy and breastfeeding[J].Matern Child Health J,2020,24(5):531-536.
[25] SMITH C A,LEVETT K M,COLLINS C T,et al.Relaxation techniques for pain management in labour[J].Cochrane Database Syst Rev,2018,3(3):CD009514.
[26] LI Y P,CUI X,LIU S C,et al.Neuromuscular electrical stimulation for treating postpartum low back pain[J].Medicine(Baltimore),2018,97(28):e11426.
[27] MALHERBE J A J,DAVEL S.An Atraumatic sacral fracture with lumbosacral radiculopathy complicating the early postpartum period:A case report[J].Am J Case Rep,2019,6(20):794-799.
[28] 吴铅淡,翁文水,李中钦,等.腰-盆-髋整体调整治疗产后腰痛临床研究[J].光明中医,2022,37(23):4240-4243.

脊柱微调手法对产后腰椎-骨盆复合体疼痛的疗效及对腰椎骨盆参数影响研究

Clinical study on the effect of spine fine adjustment manipulation on postpartum lumbopelvic pain and its role in adjusting lumbar lordosis and pelvic incidence

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