Background and Purpose
Puerperal wind disorder, also referred to as ‘Sanhupung’ in the Korean language, is a complex syndrome that encompasses a range of systemic and local symptoms that occur after childbirth or miscarriage. A recent report revealed that almost 13.2% (153 out of 1162) of outpatients seen over the course of one year were diagnosed with this disorder. Despite being a significant concern, definitive studies on the incidence and prevalence of Sanhupung in the general population are limited. Although the number of mothers giving birth is declining, the clinical importance of Sanhupung remains, especially as the age of childbirth increases and cases that occur after miscarriage continue. Traditional treatment and care approaches are limited in treating this disorder due to societal changes, such as the increase in elderly pregnancies and cesarean deliveries, as well as early return to work post-childbirth and prolonged repetitive use, such as computer works. Recommendations based on clinical information for the treatment of Sanhupung that reflect these societal changes are needed in the clinical field of Korean medicine. As a result, the National Institute for Korean Medicine Development (NIKOM) and the Korea Clinical Guideline Development Committee of the Society of Korean Medicine Obstetrics & Gynecology have recently recognized the need to develop a clinical guideline for Sanhupung. Therefore, the Clinical Practice Guidelines have been developed with the aim of assisting healthcare providers in making evidence-based decisions in clinical fields.
Overview of disease
The term “Sanhupung” has traditionally been used in the private sector to collectively describe various symptoms experienced by women who do not receive proper postpartum care following childbirth or miscarriage. It has also been recognized as a disease that reflects cultural specificity, similar to Hwa-byung.
After childbirth, a woman’s whole body, particularly her reproductive system, gradually recovers from the changes caused by pregnancy and delivery to reach a state of non-pregnancy. However, other systemic recovery may still be incomplete, leading to increased mental and physical fatigue due to factors such as childcare, housework, stress, and lack of sleep. Improper postpartum care can, therefore, result in the development of various postpartum diseases, including Sanhupung.
Endocrine changes during pregnancy can be considered a background factor in the development of Sanhupung. Hormones, such as estrogen and relaxin, increase during pregnancy, while pelvic joint mobility increases during childbirth. The systemic effect of hormones at this time also increases the mobility of other joints, making the joints of the entire body vulnerable to external physical stress. Additionally, weight gain from pregnancy can strain the joints of the waist, knee, and ankle, while the excessive use of hands and wrists during childcare, housework, and breastfeeding can damage the muscles, tendons, ligaments, and nerves, leading to pain. The delivery posture in the lithotomy position can also contribute to pain in the lower back and sacroiliac joints.
The diagnosis of Sanhupung is typically made based on the identification of subjective symptoms and the exclusion of other diseases. The main symptoms of this disorder may include localized joint pain and sensory disorders, such as coldness or numbness. Systemic symptoms include joint pain, muscle soreness, and sensory disorders throughout the body, as well as a feeling of wind entering the body, worsened symptoms in cold environments, and a dislike of the cold. Additional accompanying symptoms include fatigue, sweating, and dizziness.
