Objective To evaluate the effects of acupuncture at tonifying points combined with pelvic floor muscle training on postpartum pelvic floor function and sexual quality of life. Methods A total of 104 postpartum women treated at our hospital between June 2023 and June 2024 were enrolled. Participants were randomly assigned (1∶1) to a control group (n=52) or an intervention group (n=52). The control group received pelvic floor muscle training alone, whereas the intervention group received additional acupuncture at tonifying points. Follow-up assessments were conducted at 1 and 3 months. Outcomes included pelvic floor electromyography, muscle strength scores, sexual function, and the incidence of pelvic floor disorders. Results After 1 month, both groups showed increased mean and maximal pelvic floor muscle voltage as well as muscle strength scores compared with baseline, with greater improvements in the intervention group. Sexual quality of life improved in both groups, but the intervention group had higher Female Sexual Function Index (FSFI) scores, greater intercourse frequency, and longer duration. The incidence of sexual dysfunction, pelvic organ prolapse, and stress urinary incontinence was significantly lower in the intervention group. At 3 months, the intervention group reported no cases of sexual dysfunction or pelvic organ prolapse, compared with 15.38% and 17.31% in the control group. Stress urinary incontinence was less frequent in the intervention group, but the difference was not significant. The overall effective rate was higher in the intervention group. Mild muscle soreness occurred in 5.77% of the intervention group and 3.85% of the control group, with no significant difference in safety. Conclusion Acupuncture combined with pelvic floor muscle training improves postpartum pelvic floor function and sexual quality of life. Benefits increase over time, with significant reductions in sexual dysfunction, urinary incontinence, and organ prolapse. This combined intervention shows clear time-dependent effects and favorable clinical value.
Key words
acupuncture at qi-tonifying points /
pelvic floor muscle training /
postpartum /
pelvic floor function /
sexual quality of life
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References
[1] 马一虎, 白璐, 王珊珊, 等. 妊娠期相关女性盆底功能障碍性疾病研究进展[J]. 陕西医学杂志, 2022, 51(8): 1033-1037.
[2] 蔡丽萍, 张巧玲. 盆底肌肉训练联合电刺激对产后盆底功能障碍患者盆底肌力变化及盆腔器官脱垂改善效果的影响[J]. 中国妇幼保健, 2023, 38(4): 613-616.
[3] 朱可天, 徐蔚, 吴秀英. 电刺激生物反馈对盆底功能障碍患者盆底肌力电生理指标及性生活质量的影响[J]. 中国妇幼保健, 2023, 38(1): 12-15.
[4] 周云, 阿依努尔·艾则孜, 何艳, 等. 骶四针疗法配合盆底肌锻炼对产后压力性尿失禁患者盆底功能及性生活质量的影响[J]. 中国性科学, 2022, 31(2): 134-137.
[5] 樊卫敏, 梅小会, 陈记娜, 等. 盆底肌锻炼对不同绝经状态下中老年女性轻度盆腔器官脱垂盆底功能的影响[J]. 实用妇产科杂志, 2022, 38(1): 58-63.
[6] 高盼, 孟瑶, 李璐, 等. 生物反馈联合针刺治疗产妇产后盆底功能障碍性疾病疗效观察[J]. 海南医学, 2022, 33(20): 2642-2645.
[7] 中国妇幼健康研究会第一届妇产科精准医疗专业委员会, 华克勤, 鲁永鲜, 等. 老年女性盆底功能障碍性疾病个体优化诊疗技术体系的专家共识[J]. 实用妇产科杂志, 2024, 40(6): 447-452.
[8] 国家中医药管理局. 中医病证诊断疗效标准[S]. 南京: 南京大学出版社, 1994: 186.
[9] 韩继荣, 张喻, 王萍. 盆底肌电刺激联合Kegel盆底肌锻炼治疗产后尿失禁的效果及对盆底肌张力的影响[J]. 海南医学, 2023, 34(14): 2025-2028.
[10] 李青, 远丽, 徐青. 女性性功能指数调查量表FSFI的使用现状与评分方法[C]. 第9届北京国际康复论坛论文集. 北京: 中国康复研究中心, 2014: 480-485.
[11] 中华医学会妇产科学分会妇科盆底学组. 女性压力性尿失禁诊断和治疗指南 (2017)[J]. 中华妇产科杂志, 2017, 52(5): 289-293.
[12] 蓝湘鑫, 张远丽, 李霞, 等. 美国妇产科医师协会《女性性功能障碍管理指南》解读[J]. 中国实用妇科与产科杂志, 2020, 36(7): 4.
[13] 张晓红, 王建六. 盆腔器官脱垂国际量化分期[J]. 中国医刊, 2005, 40(8): 3.
[14] WANG Y, ZHANG S, PENG P, et al.The effect of myofascial therapy on postpartum rectus abdominis separation, low back and leg pain, pelvic floor dysfunction: a systematic review and meta-analysis[J]. Medicine (Baltimore), 2023, 102(44): 5761-5763.
[15] 屈勤芳, 张蓓蓓, 张洁. 普拉提联合凯格尔盆底康复训练对产后盆底肌功能及性功能的影响[J]. 中国性科学, 2022, 31(1): 121-124.
[16] RODRIGUES S, SILVA P, BORGES AC, et al.Effect of perineal massage and warm compresses technique in postpartum pelvic floor dysfunction. A secondary analysis from a randomised controlled trial[J]. Reprod Sci, 2024, 31(4): 1006-1016.
[17] 祝莉, 陈桂儿, 江小霞. 产后盆底功能锻炼对经阴道分娩产妇盆底功能性功能及生活质量的影响[J]. 中国妇幼保健, 2022, 37(11): 1966-1969.
[18] 吉冬梅, 程顺梅, 李柳香. 针灸联合补中益气丸对子宫脱垂患者盆底肌肉和性生活质量的影响研究[J]. 山西医药杂志, 2022, 51(6): 687-689.
[19] 汪金娇, 师建慧, 李永坤. 内关穴和足三里穴位刺激对腹腔镜结直肠癌根治术麻醉及术后胃肠功能的影响[J]. 中华中医药学刊, 2024, 42(3): 168-171.
[20] 郭艳, 鲍以嘉, 顾志娟. 三阴交穴位按摩联合低频脉冲反馈电刺激对产后压力性尿失禁患者盆底功能, 尿失禁次数的影响[J]. 世界中西医结合杂志, 2023, 18(9): 1826-1830.
[21] 候转转, 许世兵, 俞惠达, 等. 通督调任针刺法治疗气血亏虚型颈性眩晕随机对照研究[J]. 中华中医药杂志, 2023, 38(3): 1387-1391.
[22] 古金晓, 谢颖桢, 于海青, 等. 基于”异病同治”理论探讨中风后尿失禁及尿潴留的针刺选穴规律[J]. 浙江中医药大学学报, 2022, 46(12): 1404-1411.
[23] 黄静, 胡锦波, 王斌. 脾俞穴影像解剖及针刺安全深度研究[J]. 针灸临床杂志, 2023, 39(9): 10-13.
[24] 赵曼丹, 陶莹, 黄飞麒, 等. 针灸联合盆底肌康复训练对女性压力性尿失禁膀胱功能, 尿动力学及盆底功能的回顾研究[J]. 中华中医药学刊, 2024, 42(2): 55-59.
[25] 曾兰芬, 曾燕静, 邱文慧, 等. 四维超声评价针刺联合盆底肌训练治疗产后压力性尿失禁的临床疗效[J]. 世界中西医结合杂志, 2023, 18(9): 1865-1869.
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