本文選題：產(chǎn)后缺乳 + 分娩方式�。� 參考：《河南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:(1)通過比較正常泌乳產(chǎn)婦與產(chǎn)后缺乳產(chǎn)婦兩種人群的年齡、職業(yè)、產(chǎn)次、分娩方式、分娩孕周、產(chǎn)前體重指數(shù)、新生兒性別、新生兒體重、中醫(yī)體質(zhì)等的分布情況,探討其與產(chǎn)后缺乳的相關(guān)性,重點探討分娩方式及中醫(yī)體質(zhì)與產(chǎn)后缺乳的相關(guān)性,為臨床預(yù)防產(chǎn)后缺乳提供參考依據(jù),并通過對患者辨體質(zhì)、辨證型,了解該病的易發(fā)病體質(zhì)及發(fā)病后的常見證型,為有效預(yù)防產(chǎn)后缺乳提供循證學(xué)依據(jù)。(2)通過比較產(chǎn)婦產(chǎn)后第2天的血紅蛋白值在正常泌乳與產(chǎn)后缺乳兩種人群中的差異,探討產(chǎn)后血紅蛋白與產(chǎn)后乳汁分泌的相關(guān)性,為臨產(chǎn)預(yù)防產(chǎn)后缺乳提供更多的依據(jù)及指標(biāo)。方法:(1)選擇2015年4月到2016年3月在河南中醫(yī)學(xué)院一附院及鄭州市婦幼保健院病房住院符合納入標(biāo)準(zhǔn)的產(chǎn)后缺乳患者120例為病例組,并選擇正常泌乳者120例為對照組,通過現(xiàn)場問卷調(diào)查方式,對全部研究對象進(jìn)行資料的收集,住院期間收集一次,產(chǎn)后15天收集一次,然后對入選病例的產(chǎn)前體重指數(shù)、中醫(yī)體質(zhì)類型等進(jìn)行比較,計數(shù)資料,用卡方檢驗進(jìn)行統(tǒng)計學(xué)分析,計量資料,用獨立樣本t檢驗進(jìn)行統(tǒng)計學(xué)分析,P≤0.05,有統(tǒng)計學(xué)意義。(2)比較產(chǎn)后缺乳者120例的病例組與正常泌乳者120例的對照組兩組產(chǎn)婦產(chǎn)后血紅蛋白的差異,用獨立樣本t檢驗,P≤0.05,有統(tǒng)計學(xué)意義,探討血紅蛋白與產(chǎn)后泌乳的相關(guān)性,并探討產(chǎn)后缺乳者的血紅蛋白的分布規(guī)律。結(jié)果:(1)120例正常泌乳者和120例產(chǎn)后缺乳患者的年齡、民族、職業(yè)、產(chǎn)次、分娩孕周、產(chǎn)前體重指數(shù)、新生兒性別、新生兒出生體重相比較,均無差異,P0.05,無統(tǒng)計學(xué)意義。(2)120例正常泌乳者和120例產(chǎn)后缺乳患者的分娩方式相比較,120例正常泌乳者中,順產(chǎn)者占40%,剖宮產(chǎn)占60%,120例產(chǎn)后缺乳患者中順產(chǎn)者占17.5%,剖宮產(chǎn)占82.5%,有差異,P0.05,有統(tǒng)計學(xué)意義;(3)120例正常泌乳者中,平和體質(zhì)共67例,最為常見,占55.83%,8種偏頗體質(zhì)共占44.17%,分布從2.50%到12.50%。120例產(chǎn)后缺乳患者中,平和體質(zhì)共25例,僅占20.50%,8種偏頗體質(zhì)占絕大多數(shù),共占79.50%,其中氣虛體質(zhì)最多,占25.00%,陰虛體質(zhì)、陽虛體質(zhì)次之,分別占14.17%、12.50%。兩組病例體質(zhì)構(gòu)成比存在差異,P0.05,有統(tǒng)計學(xué)意義。120例產(chǎn)后缺乳患者中,肝郁氣滯證有48例,占40.0%,氣血虛弱證有51例,占42.5%,痰濁阻滯證有21例,占17.5%,可見產(chǎn)后缺乳以肝郁氣滯證和氣血虛弱證較為多見。(4)120例正常泌乳者和120例產(chǎn)后缺乳患者的血紅蛋白比較,產(chǎn)后缺乳患者的血紅蛋白95㳠CI(96.29,100.11),正常泌乳者95㳠CI(107.18,111.45),有差異,P0.05,有統(tǒng)計學(xué)意義。結(jié)論:(1)產(chǎn)婦的年齡、民族、籍貫、職業(yè)、產(chǎn)次、分娩孕周、新生兒性別、新生兒體重、體重指數(shù)與產(chǎn)后缺乳無明顯相關(guān)性。(2)產(chǎn)婦的分娩方式與產(chǎn)后缺乳有密切的關(guān)系,剖宮產(chǎn)比順產(chǎn)者能更易出現(xiàn)產(chǎn)后缺乳,在臨床中,盡量減少剖宮產(chǎn)。(3)產(chǎn)婦的中醫(yī)體質(zhì)類型與產(chǎn)后缺乳有相關(guān)性,從中醫(yī)體質(zhì)學(xué)角度提出了氣虛體質(zhì)、陰虛體質(zhì)、氣郁體質(zhì)可能是產(chǎn)后缺乳發(fā)病的易發(fā)病體質(zhì)。提示在產(chǎn)前檢查及圍產(chǎn)保健工作中可開展對孕產(chǎn)婦的體質(zhì)評估,對偏頗體質(zhì)早識別、早調(diào)理,最大可能地預(yù)防或減少產(chǎn)后缺乳的發(fā)生。中醫(yī)體質(zhì)與產(chǎn)后缺乳發(fā)病后的中醫(yī)證型存在相關(guān)性。臨證中要重視不同體質(zhì)與證候之間的內(nèi)在聯(lián)系,參考體質(zhì)類型,進(jìn)行辨證論治,貫徹“治病求本”的治療原則。(4)120例正常泌乳者和120例產(chǎn)后缺乳患者的血紅蛋白值比較,有統(tǒng)計學(xué)意義,提示血紅蛋白值與產(chǎn)后乳汁分泌有較密切的關(guān)系,提示我們在圍產(chǎn)保健工作中將血紅蛋白值與產(chǎn)后缺乳發(fā)病率聯(lián)系起來,對孕產(chǎn)婦的血紅蛋白值早評估,早治療,最大可能地預(yù)防或減少產(chǎn)后缺乳的發(fā)生。
[Abstract]:Objective: (1) compared with normal lactation and maternal postpartum hypogalactia two maternal age, occupation, parity, mode of delivery, gestational age, prenatal BMI, neonatal sex, birth weight, distribution of constitution of TCM, and investigate its correlation with postpartum hypogalactia, focusing on the relationship between the mode of delivery and the constitution of traditional Chinese medicine and postpartum hypogalactia, provide a reference basis for clinical prevention of postpartum hypogalactia, and through to the patients constitution, syndrome differentiation type, understand the common syndromes of the disease incidence and after the onset of the constitution, provides evidence-based basis for the effective prevention of postpartum hypogalactia. (2) the lack of differences between the two kinds of milk the crowd in the normal lactation and postpartum postpartum second days by comparing the values of hemoglobin, hemoglobin and investigate the relationship between postpartum postpartum milk secretion, postpartum hypogalactia provide more basis and targets for prevention of parturient. Methods: (1) 2015 4 From May to March 2016 in the ward of maternal and Child Health Hospital of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine and Zhengzhou city hospital in accordance with the inclusion criteria of postpartum hypogalactia patients 120 cases as the case group, and select the normal lactation in 120 cases as control group, through questionnaire, data of all subjects were collected during hospitalization were collected once collected, postpartum once for 15 days, then prenatal body mass index for patients, comparing the TCM constitution types of count data, statistical analysis, measurement data using the chi square test was used for statistical analysis, independent samples t test, P = 0.05, there was statistical significance. (2) comparison of postpartum hypogalactia cases group 120 cases with normal lactation in 120 cases of control group differences in two groups of maternal postpartum hemoglobin, with independent sample t test, P = 0.05, a statistically significant correlation between hemoglobin and postpartum lactation, and to explore the production 鍚庣己涔寵，

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