摘要
目的探讨中髎、会阳穴电针联合盆底肌训练对产后压力性尿失禁(SUI)病人尿动力学及盆底肌功能的影响。方法选取84例2021年4月至2023年4月在湖南中医药大学第一附属医院收治的产后SUI病人,按随机数字表法分为观察组(n=42)和对照组(n=42)。对照组使用盆底肌训练,观察组应用盆底肌训练联合中髎、会阳穴电针治疗。比较两组病人临床疗效、治疗前后尿动力学指标、盆底肌功能、漏尿情况、生活质量评分及不良反应发生状况。结果观察组总有效率[95.24%(40/42)]显著高于对照组总有效率[78.57%(33/42)](P<0.05)。与治疗前比,观察组和对照组治疗后Ⅰ类和Ⅱ类肌纤维肌力、最大膀胱容量(MBC)、最大逼尿肌压(Pdel)、最大尿流率(Qmax)及生活质量评分均显著升高(P<0.05),Ⅰ、Ⅱ类肌纤维疲劳度显著降低(P<0.05);观察组Qmax[(30.78±3.51)mL/s比(25.23±2.57)mL/s]、Ⅰ类肌纤维肌力[(3.08±0.41)级比(2.05±0.27)级]较对照组显著升高(P<0.05)。观察组MBC、Ⅱ类肌纤维肌力、生活质量评分及Pdel较对照组均显著升高(P<0.05),疲劳度降低(P<0.05)。治疗后,两组病人漏尿量均显著少于同组治疗前(P<0.05),观察组病人漏尿量均显著少于对照组(P<0.05)。两组病人治疗期间无不良反应发生。结论中髎、会阳穴电针联合盆底肌训练治疗产后SUI临床疗效更佳,可改善尿动力学状态,提升Qmax,增强盆底肌功能,提高病人生活质量。
Objective To explore the effects of electroacupuncture at Zhongliao and Huiyang acupoints combined with pelvic floor muscle training on the urodynamics and pelvic floor muscle function in patients with postpartum stress urinary incontinence(SUI).Methods A total of 84 postpartum SUI patients admitted to The First Affiliated Hospital of Hu'nan University of Chinese Medicine from April 2021 to April 2023 were randomly assigned into an observation group(n=42)and a control group(n=42)using a random number table method.The control group received pelvic floor muscle training,while the observation group received pelvic floor muscle training combined with electroacupuncture at Zhongliao and Huiyang acupoints.We compared the clinical efficacy,urodynamic indicators before and after treatment,pelvic floor muscle tone,urinary leakage,quality of life score,and incidence of adverse reactions between the two groups.Results The total validity rate of the observation group was significantly higher than that of the control group[95.24%(40/42)vs.78.57%(33/42)](P<0.05).After treatment,the classⅠandⅡmuscle fiber strengths,maximum bladder capacity(MBC),peak detrusor pressure(Pdel),maximum urinary flow rate(Qmax),and quality of life scores in the observation group and control group were obviously higher than those before treatment(P<0.05),while muscle fiber fatigue was obviously lower than that before treatment(P<0.05).The observation group showed a significant increase in Qmax[(30.78±3.51)mL/s vs.(25.23±2.57)mL/s]and classⅠmuscle fiber strength[(3.08±0.41)vs.(2.05±0.27)]compared to the control group,with a statistically significant difference(P<0.05).The MBC,classⅡmuscle fiber strength,quality of life score,and Pdel of the observation group were significantly higher than those of the control group(P<0.05),while muscle fiber fatigue was reduced(P<0.05).After treatment,the urine leakage in both groups was obviously lower than that before treatment(P<0.05),and the urine leakage in the observation group was obviously lower than that in the control group(P<0.05).No adverse reactions occurred during the treatment of both groups.Conclusion The combination of electroacupuncture at Huiyang and Zhongliao acupoints and pelvic floor muscle training has a better clinical efficacy on postpartum stress urinary incontinence,which can improve urodynamic status,increase maximum urine flow rate,enhance pelvic floor muscle function,and improve patients'quality of life.
作者
王琼
周文娟
姚婷
石文英
曹越
王佳怡
WANG Qiong;ZHOU Wenjuan;YAO Ting;SHI Wenying;CAO Yue;WANG Jiayi(Acupuncture and Moxibustion Massage Rehabilitation Center,The First Hospital of Hu'nan University of Chinese Medicine,Changsha,Hu'nan 410007,China;Department of Gynaecology and Obstetrics,The First Hospital of Hu'nan University of Chinese Medicine,Changsha,Hu'nan 410007,China)
出处
《安徽医药》
2025年第6期1143-1147,共5页
Anhui Medical and Pharmaceutical Journal
基金
湖南省院士专家工作站(石学敏)开放基金一般项目(2019YSZJJ08)
湖南省2022年度中医药科研计划项目(D2022054)
湖南省卫生健康委科研计划项目(D202319017905)。
关键词
尿失禁
压力性
产后
中髎
会阳
电针
盆底肌训练
盆底肌
尿动力学
Urinary incontinence,stress
Postpartum
Zhongliao
Huiyang
Electroacupuncture
Pelvic floor muscle training
Pelvic floor muscle
Urodynamics
