TEAS联合核心训练干预产后腹直肌分离及腰背痛的可行性

中华养生保健 ›› 2024, Vol. 42 ›› Issue (3): 62-66.

TEAS联合核心训练干预产后腹直肌分离及腰背痛的可行性

徐冠彪¹, 李金霞^1,*, 谢晶军², 郭小青¹, 王娅玲¹, 潘中强¹, 傅瑞阳¹

1.浙江中医药大学附属湖州中医院针灸推拿科,浙江湖州,313000;
2.湖州市第一人民医院康复科,浙江湖州,313000

出版日期:2024-02-01 发布日期:2024-01-23
通讯作者: ^*李金霞,E-mail：lijinxia31@163.com。
作者简介:徐冠彪（1986—）,男,汉族,籍贯：浙江省湖州市,本科,中医师,研究方向：针灸康复疗法治疗伤筋病的临床与基础研究。
基金资助:
浙江省中医药科技计划项目（2020ZA111）

The Teasibility of TEAS Combined with Core Machine Training for Postpartum Rectus Abdominis Muscle Separation and Low Back Pain

XUN Guan-biao¹, LI Jin-xia^1,*, XIE Jing-jun², GUO Xiao-qing¹, WANG Ya-ling¹, PAN Zhong-qiang¹, FU Rui-yang¹

1. Department of Acupuncture and Massage, Traditional Chinese Medical Hospital of Huzhou City, Huzhou Zhejiang 313000, China;
2. Department of Rehabilitation Medicine, First People’s Hospital of Hospital of Huzhou City, Huzhou Zhejiang 313000, China

Online:2024-02-01 Published:2024-01-23

摘要/Abstract

摘要： 目的观察TEAS联合核心训练干预产后腹直肌分离与腰背痛的的可行性。方法选择2020年1月—2022年12月浙江中医药大学附属湖州中医院90例产后腰痛患者作为研究对象,对腹直肌分离程度与腰背疼痛评分进行Pearson相关性分析。将90例产后腰痛患者随机分成三组,分别为对照组、治疗1组、治疗2组,每组30例。对照组采用常规的产后自然恢复法;治疗1组在对照组的基础上加予核心训练,1次/d,5次/周,4周为1个疗程,连续1个疗程;治疗2组在治疗1组的基础上采用TEAS疗法,1次/d,5次/周,4周为1个疗程,连续1个疗程。治疗前及1个疗程结束后,评估腹直肌分离程度（IRD）、腰背疼痛症状（SF-MPQ）、身体质量指数（BMI）,并观察治疗前后这些指标的变化。结果治疗结束后,各组IRD、SF-MPQ评分及BMI较治疗前明显下降,下降幅度以治疗2组最为明显,差异有统计学意义（P<0.05）。IRD与SF-MPQ评分之间呈正相关（r=0.320,P<0.05）。结论腹直肌分离与腰背痛具有相关性,TEAS联合核心训练干预可有效缩小产后腹直肌分离程度,减轻腰背疼痛,降低身体质量指数,该疗法具有临床可行性。

关键词: 经皮穴位电刺激, 核心训练, 产后病, 腹直肌分离, 腰背痛

Abstract: Objective To analyze the correlation between rectus abdominis separation and low back pain after delivery and the feasibility of Transcutaneous Electrical Acupoint Stimulation (TEAS) combined with core training intervention. Methods Selecting 90 postpartum low back pain patients from Huzhou Traditional Chinese Medicine Hospital affiliated with Zhejiang University of Chinese Medicine as the research subjects, Pearson correlation analysis was conducted between the degree of rectus abdominis separation and the score of low back pain. They were randomly divided into 3 groups: control group, treatment group 1 and treatment group 2 (30 cases in each group). Control group: conventional postpartum natural recovery method. Treatment group 1: on the basis of the control group, core muscle training, once a day, 5 times a week, 4 weeks as a course of treatment, consecutive 1 course of treatment. Treatment group 2: On the basis of treatment group 1, TEAS was used, once a day, 5 times a week, 4 weeks as a course of treatment, one course of treatment. The degree of rectus abdominis muscle separation (IRD), low back pain symptoms (SF-MPQ) and Body Mass Index (BMI) were evaluated before and after treatment, and the changes of these indexes were observed before and after treatment. Results After treatment, the degree of rectus abdominis muscle separation (IRD), low back pain symptoms (SF-MPQ) and Body Mass Index (BMI) were significantly decreased in each group (P<0.05), and the decrease was most significant in the two groups (P<0.05). There was a positive correlation between the degree of rectus abdominis diastasis and low back pain score （r=0.320, P<0.05）. Conclusion Rectus abdominis diastasis is associated with low back pain. TEAS combined with core muscle training can effectively improve postpartum rectus abdominis muscle separation, reduce low back pain, and reduce the Body Mass Index. It indicated that the therapy could be feasible for clinical.

Key words: Transcutaneous Electrical Acupoint Stimulation (TEAS), core muscle training, postpartum disease, diastasis recti abdominis, low back pain

中图分类号:

R247.9

徐冠彪, 李金霞, 谢晶军, 郭小青, 王娅玲, 潘中强, 傅瑞阳. TEAS联合核心训练干预产后腹直肌分离及腰背痛的可行性[J]. 中华养生保健, 2024, 42(3): 62-66.

XUN Guan-biao, LI Jin-xia, XIE Jing-jun, GUO Xiao-qing, WANG Ya-ling, PAN Zhong-qiang, FU Rui-yang. The Teasibility of TEAS Combined with Core Machine Training for Postpartum Rectus Abdominis Muscle Separation and Low Back Pain[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(3): 62-66.

参考文献

[1] BENJAMIN D R, FRAWLEY H J, NORA S, et al.Relationship between diastasis of the rectus abdominis muscle (DRAM) and musculoskeletal dysfunctions, pain and quality of life: a systematic review[J]. Physiotherapy, 2019,105(1):24-34.
[2] FERNAMDES DA MOTA P G, PASCOAL A G, CARITA A I, et al. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain[J]. Man Ther, 2015, 20(1):200-205.
[3] BO K, HILDE G, TENNFJORD M K, et al.Pelvic floor muscle function, pelvic floor dysfunction and diastasis recti abdominis: Prospective cohort study[J]. Neurourol Urodyn, 2017,36(3):716-721.
[4] SPERSTAD J B, TENNFJORD M K, HILDE G, et al.Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence,risk factors and report of lumbopelvic pain[J]. Br J Sports Med, 2016,50(17):1092-1096.
[5] MOTA P, PASCOAL AG, CARITA AI, et al.Normal width of the inter-recti distance in pregnant and postpartum primipa rous women[J]. Musculoskelet Sci Pract,2018,35(2):34-37.
[6] SPERATAD J B, TENNFJORD M K, HILDE G, et al.Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence,risk factors and report of lumbopelvic pain[J]. Br J Sports Med, 2016,50(17):1092-1096.
[7] 竺佳晟,李金辉. 产后腹直肌分离的评估与治疗研究进展[J].中华物理医学与康复杂志,2019,41(10):793-796.
[8] 牛蕾蕾,徐俊,蔡西国,等.产后早期神经肌肉电刺激治疗腹直肌分离的疗效观察[J].中华物理医学与康复杂志,2020,42(12):1078-1080.
[9] OLSSON A, KIWANUKA O, WILHELMSSON S, et al. Surgical repair of diastasis recti abdominis provides long-term improvement of abdominal core function and quality of life: a 3-year follow-up[J]. BJS Open, 2021, 5(5):zrab085.
[10] CARLSTEDT A, BRINGMAN S, EGBERTH M, et al.Management of diastasis of the rectus abdominis muscles: recommendations for swedish national guidelines[J]. Scand J Surg, 2021,110(3):452-459.
[11] SZMIT M, KRAJEWSKI R, RUDNICKI J, et al.Application and efficacy of transcutaneous electrical acupoint stimulation (TEAS) in clinical practice: A systematic review[J]. Adv Clin Exp Med,2023,32(9):1063-1074.
[12] CHIEN L W, LIN M H, CHUNG H Y, et al.Transcutaneous electrical stimulation of acupoints changes body composition and heart rate variability in postmenopausal women with obesity[J]. Evid Based Complement Alternat Med, 2010, 2011(2011):862121.
[13] SAKAI S, HORI E, UMENO K, et al.Specific acupuncture sensation correlates with EEGs and autonomic changes in human subjects[J]. Autonomic Neuroscience2007,133(2):158-169.
[14] HILLS N F, GRAHAM R B, LINDA M L.Comparison of Trunk Muscle Function Between Women With and Without Diastasis Recti Abdominis at 1 Year Postpartum[J]. Physical Therapy, 2018, 98(10):891-901.
[15] LAFRAMBOISE F C, SCHLAFF R A, Baruth M.Postpartum Exercise Intervention Targeting Diastasis Recti Abdominis[J]. Int J Exerc Sci,2021,14(3):400-409.