Clinical effects of integrated Chinese medicine therapy for postpartum pelvic floor dysfunction: a prospective patient-preference cohort study.

OBJECTIVE

To evaluate the therapeutic efficacy of Dabu-Yuanjian Tisheng formula combined with acupoint stimulation for postpartum pelvic floor dysfunction (PFD) compared with single-modality and standard rehabilitation.

METHODS

This prospective, patient-preference observational study enrolled 212 postpartum women diagnosed with PFD, who chose one of four management options after standardized counseling. Group A received Dabu-Yuanjian Tisheng formula alone, Group B acupoint stimulation alone, Group C the combined therapy, and Group D standard electrical stimulation with biofeedback. Quota sampling targeted 53 participants per group. The 8-week intervention evaluated changes in POP-Q staging, urinary incontinence symptoms (ICIQ-SF), vaginal dynamic pressure, and traditional Chinese medicine (TCM) syndrome scores; pelvic floor muscle strength (Modified Oxford Scale) was assessed to characterize severity. Between-group comparisons used ANCOVA for continuous variables and proportional-odds models for ordinal outcomes, adjusted for prespecified covariates and baseline values. Missing data were handled via multiple imputation.

RESULTS

A total of 212 participants (53 per group) were analyzed. Baseline characteristics were generally comparable. All groups showed significant pre- to post-treatment improvement across major outcomes (all p < 0.00001). After adjustment, selecting the combined therapy (Group C) was associated with the most favorable improvements across measured outcomes. Vaginal dynamic pressure improved more in Group C than in Group A (mean + 3.59, p < 0.00001) and Group B (+ 2.21, p = 0.0340); Group D improved more than Group A (+ 2.30, p = 0.0277). For bladder neck-symphysis distance (BSD), Group C improved more than Group A (+ 0.172, p = 0.00209) and Group B (+ 0.246, p < 0.00001). Reductions in ICIQ-SF and TCM scores showed similar patterns, with Group C achieving the largest gains (all p < 0.00001). POP-Q staging distribution differed significantly among groups (p < 0.00001), favoring Group C. Sensitivity analyses confirmed robustness, with > 97% power for detecting clinically relevant differences.

CONCLUSION

In this patient-preference cohort, the choice of Dabu-Yuanjian Tisheng formula combined with acupoint stimulation was associated with greater improvements in postpartum PFD outcomes compared to single-modality or standard rehabilitation. However, because treatment allocation was non-randomized and residual confounding cannot be excluded, these findings should be interpreted as supportive comparative evidence rather than definitive proof of superiority.