Effect Of Acupuncture At Geshu (BL17) Acupoint And Yanggang (BL48) Acupoint On Diaphragm Excursion And Pelvic Floor Function Of Postpartum

Objective:To observe the variability of diaphragm excursion between non-childbearing and postpartum women,to analyze the correlation between diaphragm excursion and pelvic floor function in the postpartum period,and to explore the effects of acupuncture on diaphragm excursion and pelvic floor function in the postpartum period at Geshu(BL17)acupoint and Yanggang(BL48)acupoint.Methods:(1)Using the method of cross-sectional survey,30 postpartum and 30 non-childbearing women were recruited,and the diaphragm excursion(calm breathing and deep breathing)was measured by ultrasound imaging technique in the two groups of subjects,and the differences between the diaphragm excursion of the two groups were compared.(2)Across-sectional survey was used to select 68 patients who attended the outpatient clinic and acupuncture rehabilitation ward of the Department of Acupuncture and Moxibustion Rehabilitation at Quanzhou Hospital of Traditional Chinese Medicine,Fujian University of Traditional Chinese Medicine from January 2022 to January 2023.The patients’ diaphragm excursion(calm breathing,deep breathing)was measured using ultrasound imaging,pelvic floor electromyography was used to assess the pelvic floor muscles(fast,integrated,and slow RMS),and the severity of pelvic floor dysfunction was assessed using the Pelvic Floor Dysfunction Questionnaire,and the correlation between diaphragm excursion and pelvic floor function in patients with postpartum pelvic floor dysfunction was analyzed.(3)Based on the principle of randomized controlled trial,68 patients with postpartum pelvic floor dysfunction in the second part were randomly divided into observation group and control group,34 patients in each group,and both groups were given postpartum pelvic floor rehabilitation training.The diaphragm excursion(calm breathing,deep breathing),pelvic floor electromyographic assessment(fast,integrated and slow muscle RMS)and PFDI-20 scores under ultrasound were used as efficacy evaluation indexes,and each efficacy index was systematically analyzed at two time points before and after treatment.Results:(1)There was a statistical difference between the diaphragm excursion during calm breathing and deep breathing in the unproductive group and the postpartum group,and the diaphragm excursion during calm breathing and deep breathing in the postpartum group was smaller than that in the unproductive group(P<0.05).(2)The results of the correlation study between diaphragm excursion and pelvic floor function:diaphragm excursion during calm breathing and deep breathing was positively correlated with fast muscle RMS(r=0.597,P<0.01;r=0.612,P<0.01);diaphragm excursion during calm breathing and deep breathing was positively correlated with combined muscle RMS(r=0.574,P<0.01;r=0.579,P< 0.01);diaphragm excursion during calm breathing and deep breathing was positively correlated with slow muscle RMS(r=0.548,P<0.01;r=0.530,P<0.01);diaphragm excursion during calm breathing and deep breathing was negatively correlated with PFDI-20 scores(r=-0.499,P<0.01;r=-0.480,P<0.01).(3)Comparative findings of diaphragm excursion:(1)comparison within the group before and after treatment: the diaphragm excursion during calm breathing and deep breathing increased in both groups after 2 weeks of treatment,and the differences were statistically significant(P<0.05);(2)comparison between groups after treatment: the differences in diaphragm excursion during calm breathing and deep breathing were statistically significant(P<0.05),and the diaphragm excursion during calm breathing and deep breathing in the observation group were The diaphragm excursion during calm breathing and deep breathing in the observation group was better than that in the control group.(4)Pelvic floor electromyography assessment(Glazer Protocol)results:(1)intra-group comparison before and after treatment: the RMS of fast,combined and slow muscles increased in both groups after 2 weeks of treatment,and the differences were statistically significant(P<0.05);(2)inter-group comparison after treatment: the differences in RMS of fast,combined and slow muscles were statistically significant(P<0.05),and the RMS of fast,combined and slow muscles in the observation group were better than those in the control group.RMS was better than that of the control group.(5)Pelvic Floor Distress Inventory short form(PFDI-20)results:(1)intra-group comparison before and after treatment: the PFDI-20 scores increased in both groups after 2 weeks of treatment,and the differences were statistically significant(P<0.05);(2)There was no significant difference in PFDI-20 score between the two groups after 2 weeks of treatment(P >0.05).Conclusions:(1)Compared with women who did not have children,women had less diaphragmatic excursion during calm breathing and deep breathing after delivery.(2)Diaphragmatic excursion during both calm breathing and deep breathing was positively correlated with pelvic floor muscle strength and negatively correlated with PFDI-20 score;the more diaphragmatic excursion,the better the pelvic floor muscle strength and the lower the PFDI-20 score.(3)Acupuncture at Geshu(BL17)acupoint and Yanggang(BL48)acupoint combined with pelvic floor rehabilitation training can effectively improve diaphragm excursion,thus improving pelvic floor function in patients with postpartum pelvic floor dysfunction.