Meta-Analysis Of TCM In The Treatment Of Postpartum Pelvic Floor Dysfunction Diseases

Objective:By meta analysis,to evaluate the effect of TCM treatment of postpartum pelvic floor functional disorder and advantage,right into the research of TCM syndrome type and medication to choose and cave characteristics,inductive analysis for clinical treatment of postpartum pelvic floor functional disorder provides evidence-based support,explore the way of thinking in the clinical treatment of postpartum pelvic floor functional disorder.Methods:By searching Chinese and English databases,including CNKI,Wan Fang,VIP,CBM,Pubmed,Embase,Cochrane Library,A randomized controlled trial study on the treatment of postpartum pelvic floor dysfunction diseases（specifically,postpartum pelvic organ prolapse,postpartum stress urinary incontinence and postpartum sexual dysfunction）with Traditional Chinese medicine was searched from the self-built database until January 04,2022.All retrieved literatures were imported into Note Express 3.4software,and literatures were screened step by step according to inclusion and exclusion criteria formulated according to this study.Word 2019 was used to extract information such as course of disease,age,intervention measures,random method,sample size and outcome index data of the literature finally selected after screening.Then,according to the risk bias assessment tool provided by Cochrane,Rev Man5.4.1 software was used to evaluate the quality of each included article.Meta-analysis was conducted on the data obtained by this software,and the final results were summarized and analyzed.Results: A total of 2871 cases were included in this study,including 1437 cases in the experimental group and 1434 cases in the control group.Among the 26 literatures,the experimental group of 24 literatures was traditional Chinese medicine combined with physical therapy,and the experimental group of 2 literatures was traditional Chinese medicine alone.Meta-analysis results showed that TCM combined with physical therapy or TCM alone could improve the total effective rate better than physical therapy alone or western medicine combined with physical therapy（RR=1.24,95%CI[1.18,1.31],Z=8.06,P<0.00001）;Reduce TCM syndrome score（SMD=-2.97,95%Cl[-3.33,-2.60],Z=15.96,P<0.00001）;Improve the recovery rate of pelvic floor muscle strength（OR=6.36,95%CI[3.67,11.01],Z=6.61,P<0.00001）;Increased vaginal dynamic pressure（MD=14.78,95%CI[13.27,16.29],Z=19.19,P<0.00001）;Improved sexual function scale score,improve the score of FSFI（SMD=1.53,95%CI[1.25,1.81],Z=10.75,P<0.00001）and the score of PISQ-12（SMD=1.42,95%CI[0.23,2.60],Z=2.33,P=0.02）;Reduced urinary incontinence scale score,decreased the score of urinary incontinence ICI-Q-SF scale（SMD=-2.23,95%CI[-2.52,-1.94],Z=15.05,P<0.00001）;Improve the score of pelvic floor dysfunction questionnaire（SMD=-1.44,95%CI[-1.73,-1.15],Z=9.69,P<0.00001）.Conclusion:（1）This study found that in the clinical randomized controlled trials of TCM treatment of postpartum pelvic floor dysfunction diseases,most of the experimental groups used TCM treatment combined with physical therapy,and few used TCM therapy alone.（2）TCM combined with physical therapy has significant efficacy in the treatment of postpartum pelvic floor dysfunction diseases,which has good effects in reducing TCM syndrome score,improving pelvic floor muscle strength recovery rate and improving vaginal dynamic pressure.（3）TCM combined with physical therapy for postpartum PFD can improve the scores of SEXUAL function FSFI scale and PISQ-12scale;Decreased the score of ICI-Q-SF scale for urinary incontinence;Improved Pelvic floor Disorders Impact Questionnaire（PFIQ）-7 score.（4）TCM combined with physical therapy has a better therapeutic effect on postpartum pelvic floor dysfunction than physical therapy alone for POSTPARTUM PFD.（5）Buzhong Yiqi Decoction is mostly used in the oral Chinese medicine treatment of postpartum pelvic floor dysfunction diseases.The high frequency acupuncture points for the treatment of postpartum pelvic floor dysfunction diseases are Guanyuan,Qihai,Zusanli and Zhongji.（6）The literature included in this study is of low quality,and the literature is a single-center study with a small sample.In the future,large-sample multi-center study is still needed to verify the results of this study,and corresponding basic research is also needed to explore the possible therapeutic mechanism.