孕婦體質與第一孕期常見不適症狀之相關性研究

本研究目的在探討第一孕期婦女體質與不適症狀的相關性。為一項描述性、相關性研究，以方便取樣，在高雄市四所地區教學醫院的婦產科門診，收集第一孕期的婦女235位。研究工具為結構式問卷，內容包括人口學資料、中醫體質評估量表、壓力視覺量表及第一孕期不適症狀評估表。結果發現：（一）懷孕前後陽氣虛、陰血虛及痰濕瘀滯體質皆有顯著差異；（二）陽氣虛體質與感到壓力而影響進食、宗教信仰、就寢時間有顯著差異，與BMI值呈顯著負相關，與壓力程度呈顯著正相關；（三）陰血虛體質與感到壓力而影響進食及就寢時間呈顯著差異，與BMI值呈顯著負相關，與壓力程度有顯著正相關；與平性豆類（豆漿、紅豆等）飲食呈顯著負相關；（四）痰濕瘀滯體質與感到壓力而影響進食及就寢時間有顯著差異，與壓力程度呈顯著正相關；與寒涼性主食（麵食等）、寒涼性豆類（豆腐、綠豆等）及平性豆類飲食呈顯著負相關；（五）噁心感、乳房脹痛、疲倦、陰道分泌物增加、眩暈及情緒起伏不定等懷孕不適症狀，與壓力程度有顯著差異；（六）乳房脹痛與就寢時間呈顯著正相關；疲倦與菸酒嗜好、運動狀況及就寢時間有顯著正相關；（七）頻尿、疲倦、陰道分泌物增加、眩暈及情緒起伏不定等不適症狀越嚴重，越容易偏向陽氣虛及陰血虛體質；而乳房脹痛、頻尿、疲倦、陰道分泌物增加、鼻塞、眩暈及情緒起伏不定等不適症狀越嚴重，也越容易偏向痰濕瘀滯體質。（八）壓力程度為噁心感、疲倦、陰道分泌物增加及情緒起伏不定的預測因子；陰血虛體質為頻尿不適的預測因子；陽氣虛體質為噁心感的預測因子；痰濕瘀滯體質為情緒起伏不定之重要預測因子。本研究結果對於妊娠舒適與孕育健康的下一代，可提供實證資料；建議健康照護者可提升中醫體質的知能，運用適當的評估工具，了解孕婦的體質及不適症狀，提供合宜的護理，使胎兒在良好的母體體質中生長，增進母兒健康。

關鍵字

孕婦體質；陽氣虛體質；陰血虛體質；痰濕瘀滯體質；第一孕期不適症狀

並列摘要

This study aimed at exploring the correlations between Chinese medical constitution and discomfort of women during the first trimester of pregnancy. A descriptive correlational design was utilized, and a convenience sampling was adopted to recruit 235 women during the first trimester of pregnancy from obstetrics and gynecology outpatient departments of four regional teaching hospitals in Kaohsiung City. Structured questionnaires including Demographic Data Sheet, Traditional Chinese Medical Constitutional Scale (TCMCS), Visual Analogue Scale, and Evaluation of Uncomfortable Symptoms During the First Trimester of Pregnancy were used for the study. The results indicated that (1) significant differences were revealed among all the three yang-qi deficient, yin-xie deficient, and tan-shi-yu-zhi constitutions toward before and during pregnancy; (2) significant differences existed among yang-qi deficient constitution, loss of appetite due to stress, religion, and bedtime; yang-qi deficient constitution had a significantly negative correlation with BMI value, but had a significantly positive relationship with stress levels; (3) significant differences were identified among yin-xie deficient constitution, loss of appetite due to stress, and bedtime; yin-xie deficient constitution had significantly negative correlations with BMI value and neutral beans (soy milk, azuki beans, etc.), but had a significantly positive relationship with stress levels; (4) significant differences were noticed among tan-shi-yu-zhi constitution, loss of appetite due to stress, and bedtime; tan-shi-yu-zhi constitution had a significantly positive correlation with stress levels, but had significantly negative relationships with staple foods with cold and cool properties (noodles, etc.), beans with cold properties (tofu, mung beans, etc.), and neutral beans; (5) significant differences were found between discomfort of pregnancy (nausea, swelling pain in breasts, fatigue, heavy vaginal discharge, dizziness as well as mood swings) and stress levels; (6) swelling pain in breasts had a significantly positive correlation with bedtime, and fatigue was correlated with cigarette smoking and alcohol drinking, exercise training, and bedtime; (7) the more severe discomforts (frequent urination, fatigue, heavy vaginal discharge, dizziness and mood swings) these women had, the more yang-qi deficient or yin-xie deficient constitution they tended to be; however, the more severe discomforts (swelling pain in breasts, frequent urination, fatigue, heavy vaginal discharge, nasal congestion, dizziness and mood swings) these women had, the more tan-shi-yu-zhi constitution they tended to be; (8) the critical predictive factor of nausea, fatigue, heavy vaginal discharge, and mood swings was stress levels; that of frequent urination was yin-xie deficient constitution; that of nausea was yang-qi deficient constitution; that of mood swings was tan-shi-yu-zhi constitution. Results of this study could be an evidence-based research not only for comfort nursing of pregnancy but also for health guiding of reproduction. The study suggests that healthcare workers develop abundant knowledge of Chinese medical constitution, apply appropriate evaluation tools, understand pregnant women’s constitution as well as their symptoms of discomfort, and provide effective nursing management so as to ensure the health of fetus and mother.