产后盆腔肌筋膜疼痛两种综合治疗疗效比较

 目的 比较经阴道触发点与手法按摩分别联合经皮神经电刺激治疗产后盆腔肌筋膜疼痛(myofascial pelvic pain,MFPP)的效果。方法 选取2018- 05至 2019-11医院顺产后6~9周的产妇,根据MFPP诊断标准纳入509例患者,随机分为观察组(257例)和对照组(252例),观察组采用经阴道触发点联合经皮骶3神经电刺激治疗,对照组采用经皮电刺激联合按摩治疗。记录患者治疗前、治疗后痛觉评分,统计治疗有效率。结果 两组患者治疗1个月后VAS评分、性交痛程度均较治疗前明显降低,差异有统计学意义(P＜0.05)。治疗1个月后,两组VAS评分、性交痛程度差异无统计学意义;治疗后观察组盆底肌力明显高于对照组,差异有统计学意义(P＜0.05);观察组总有效率99.22%明显优于对照组的94.05%,差异有统计学意义(P＜0.01)。结论 经阴道触发点联合经皮骶3神经电刺激治疗产后MFPP患者效果显著,且操作简便、安全可靠。

Comparison of two comprehensive therapies for postpartum myofascial pelvic pain

Objective To compare the therapeutic effect of transvaginal trigger points and manual massage combined with transcutaneous electrical nerve stimulation against postpartum pelvic myofascial pain (MFPP).Methods Women who had delivered in our hospital 6 to 9 weeks before between May 2018 and November 2019 were selected,509 of whom met the MFPP diagnostic criteria and were included. They were randomly divided into the observation group (257 cases) and the control group (252 cases) The observation group was treated with transvaginal trigger points combined with transcutaneous sacral nerve 3 electrical stimulation, while the control group was treated with transcutaneous electrical stimulation combined with massage. The patient’s pain scores were recorded before and after treatment. The effective rate was calculated in both groups.Results The VAS score and the degree of sexual intercourse pain of patients in the two groups were significantly lower after one month of treatment, and the difference was statistically significant (P<0.05). After one month of treatment, there was no statistically significant difference in VAS scores or degrees of intercourse pain between the two groups. The pelvic floor muscle strength in the observation group was significantly superior to that of the control group after treatment, with significant differences(P<0.05). The total effective rate of the observation group (99.22%) was significantly better than that of the control group (94.05%), and the difference was statistically significant(P<0.01).Conclusions Transvaginal trigger points combined with percutaneous sacral 3 nerve electrical stimulation are effective in the treatment of postpartum MFPP patients, and it is a safe, user-friendly and reliable approach.