Clinical observation on the efficacy of pelvic organ prolapse treatment combined with pelvic floor function training and moxibustion at Baihui acupoint
盆底功能训练联合艾灸百会穴治疗盆腔脏器脱垂的临床疗效观察

摘要

盆腔脏器脱垂（Pelvic Organ Prolapse, POP）是临床常见妇科疾病，多发于产后及中老年女性，核心病理为盆底支持组织薄弱致器官下移、功能异常，严重影响生活质量。需明确的是，怀孕与分娩是POP最核心诱因——孕期增大子宫（重量从50g增至1000-1200g）持续压迫盆底肌，致肌纤维微小撕裂、弹性下降；分娩时胎儿对盆底肌肉、韧带的剧烈牵拉（尤其第二产程延长、胎儿过大时），易造成肛提肌等支持结构撕裂或过度伸展，产后恢复不良则直接导致盆底支持功能缺损。临床数据显示，经阴道分娩的女性POP发生率是剖宫产女性的3.2倍，且第二产程超过120分钟者，产后5年内POP风险提升47%[1]。当前生物反馈电刺激、单纯盆底训练等治疗，存在患者接受度低、依从性差等问题。艾灸百会穴具“益气温阳、升阳举陷”功效，操作简便且安全性高，相关研究表明其不良反应发生率不足2%，远低于药物治疗[3]。本文结合临床研究，从POP中西医发病机制（重点深化怀孕分娩病理）、治疗困境切入，分析艾灸百会穴的理论依据与作用机制，阐述其联合盆底功能训练的临床价值，为优化治疗方案提供参考。

Abstract

Pelvic organ prolapse (POP) is a common gynecological disease, frequently occurring in postpartum and middle-aged and elderly women. The core pathology is the weakening of pelvic floor support tissues, leading to organ displacement and functional abnormalities, severely impacting quality of life. It is important to clarify that pregnancy and childbirth are the core contributing factors to POP—during pregnancy, the enlarged uterus (increasing in weight from 50g to 1000-1200g) continuously compresses the pelvic floor muscles, causing micro-tears of muscle fibers and decreased elasticity; during childbirth, the fetus exerts intense traction on the pelvic floor muscles and ligaments (especially during prolonged second stage of labor or when the fetus is too large), easily causing tears or overstretching of supporting structures such as the levator ani muscle; poor postpartum recovery directly leads to pelvic floor support dysfunction. Clinical data show that the incidence of POP in women who deliver vaginally is 3.2 times that of women who have cesarean section, and the risk of POP increases by 47% within 5 years after delivery for women whose second stage of labor lasts more than 120 minutes[1]. Current treatments such as biofeedback electrical stimulation and simple pelvic floor training have problems such as low patient acceptance and poor compliance. Moxibustion at Baihui acupoint has the effects of "tonifying qi and warming yang, raising yang and lifting prolapse", and is easy to operate and has high safety. Related studies have shown that its adverse reaction rate is less than 2%, which is far lower than that of drug treatment[3]. This article combines clinical research, starts from the pathogenesis of POP in traditional Chinese and Western medicine (focusing on deepening the pathology of pregnancy and childbirth) and treatment dilemmas, analyzes the theoretical basis and mechanism of action of moxibustion at Baihui acupoint, and elaborates on its clinical value in combination with pelvic floor function training, so as to provide a reference for optimizing treatment plan.