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产后腹直肌分离症物理康复按摩规程的临床研究

Clinical study on physical rehabilitation massage process for postpartum diastasis recti abdominis

    摘要
  • 摘要:
    目的 观察产后腹直肌分离症(DRA)物理康复按摩规程的临床疗效。
    方法 选取103例产后DRA患者纳入实验组，按照产后DRA物理康复按摩规程进行治疗，另选取104例产后DRA患者纳入对照组，按照传统物理康复方法进行治疗。观察并比较2组治疗前后腹直肌间距、基本治愈率、症状消失率和患者满意率。
    结果 治疗前(产后6周时), 2组腹直肌间距比较，差异无统计学意义P>0.05); 治疗2、4周时, 2组腹直肌间距均小于治疗前，且实验组腹直肌间距小于对照组，差异有统计学意义(P < 0.05); 治疗4周时, 2组腹直肌间距均小于治疗2周时，差异有统计学意义(P < 0.05)。治疗2、4周时，实验组中度DRA(腹直肌间距>5~7 cm)患者的基本治愈率分别为88.9%、100.0%, 高于对照组中度DRA患者的36.4%、81.8%, 差异有统计学意义(P < 0.01或P < 0.05)。治疗2周时，实验组症状消失率高于对照组，差异有统计学意义(P < 0.05); 实验组症状总消失率和患者满意率高于对照组，但差异无统计学意义(P>0.05)。
    结论 根据腹直肌分离的解剖生理特点、生物力学、发病机制、修复机理和中医经络理论制订的产后DRA物理康复按摩规程，可将产后DRA手法按摩和物理治疗方案规范化，提高产后DRA患者的疗效，还为推动临床操作科学化和规范化提供了范例。

     

    Abstract:
    Objective To observe the clinical effect of physical rehabilitation massage for postpartum diastasis recti abdominis (DRA).
    Methods A total of 103 patients with DRA were recruited in experimental group, and were treated with physical rehabilitation massage process for postpartum DRA. Another 104 patients with postpartum DRA were recruited in control group, and were treated with traditional physical rehabilitation. The distance between the rectus abdominis muscles at the midline, basic cure rate, symptom disappearance rate and patients′satisfaction rate before and after treatment were observed and compared between the two groups.
    Results Before treatment (6 weeks after delivery), there was no significant difference in distance between the rectus abdominis muscles between the two groups (P>0.05). At 2 and 4 weeks of treatment, the spacing of rectus abdominis muscle in the two groups was smaller than that before treatment, and was smaller in the experimental group than that of the control group (P < 0.05). At 4 weeks of treatment, the distance between rectus abdominis muscles in the two groups was smaller than that at 2 weeks of treatment, and the difference was statistically significant (P < 0.05). The basic healing rates of patients with moderate DRA (rectus abdominis distance >5 to 7 cm) were 88.9% and 100.0% in the experimental group, which were higher than 36.4% and 81.8% in the control group(P < 0.01 or P < 0.05). After 2 weeks of treatment, the symptom disappearance rate of the experimental group was higher than that of the control group (P < 0.05). The total symptom disappearance rate and patients′satisfaction rate of the experimental group were higher than those of the control group, but there were no significant differences (P>0.05).
    Conclusion Physical rehabilitation massage for postpartum DRA according to anatomical and physiological characteristics, biomechanics, pathogenesis, repair mechanism and meridian theory of traditional Chinese medicine can standardize the postpartum DRA manual massage and physical therapy program, improve the efficacy of patients with postpartum DRA, and also provide an example for promoting the scientific and standardized clinical operation.

     

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