针灸配合盆底肌功能训练治疗良性前列腺增生术后压力性尿失禁疗效观察  

Observations on the Efficacy of Acupuncture and Moxibustion plus Pelvic Floor Muscle Training for Stress Urinary Incontinence After Benign Prostatic Hyperplasia Surgery

作　　者：洪媚[1] 宋双临[1] 谢玺[1] 王于勇[1] HONG Mei;SONG Shuang-lin;XIE Xi;WANG Yu-yong(Hangzhou First People’s Hospital,Hangzhou 310000,China)

机构地区：[1]杭州市第一人民医院

出　　处：《上海针灸杂志》2020年第2期206-211,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：浙江省中医药科技计划项目(2017ZB070)

摘　　要：目的观察针灸配合盆底肌功能训练治疗经尿道前列腺钬激光剜除术(holmium laser enucleation of the prostate,HoLEP)后压力性尿失禁的临床疗效。方法将60例在HoLEP术后出现压力性尿失禁的良性前列腺增生患者随机分为治疗组和对照组,每组30例。对照组行盆底肌功能训练,治疗组采用电针及自制隔药饼灸的针灸方法,联合盆底肌功能训练。于治疗前后观察两组的国际尿失禁咨询委员会问卷量表(ICIQ-SF)、漏尿次数及1 h尿垫试验结果,评价临床疗效,比较两组尿失禁的改善情况。结果治疗组治愈率和总有效率分别为60.0%和93.3%,明显高于对照组的33.3%和73.3%(P<0.05)。治疗组治疗后ICIQ-SF评分、漏尿次数及1 h尿垫试验漏尿量与治疗前和同期对照组相比均显著降低(P<0.01)。治疗期间,所有患者均未发现明显的不良反应及不良事件。结论针灸配合盆底肌功能训练治疗良性前列腺增生术后压力性尿失禁疗效确切且安全性好,可以提高治愈率,缩短尿失禁的时间,减少尿失禁的漏尿量,从而明显改善患者生活质量。Objective To investigate the clinical efficacy of acupuncture and moxibustion plus pelvic floor muscle training in treating stress urinary incontinence after transurethral holmium laser enucleation of the prostate(HoLEP).Method Sixty patients with benign prostatic hyperplasia who had stress urinary incontinence after HoLEP were randomized to treatment and control group,30 cases each.The control group did pelvic floor muscle training and the treatment group received electroacupuncture and moxibustion on self-made herbal cake in addition.The clinical therapeutic effects were evaluated by the use of the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF),the frequency of urine leakage and the result of 1-hour pad test.The reducing effects on urinary incontinence were compared between the two groups.Result The cure rate and the total efficacy rate were 60.0%and 93.3%,respectively,in the treatment group,which were significantly higher than 33.3%and 73.3%,respectively,in the control group(P<0.05).After treatment,the ICIQ-SF score,the frequency of urine leakage and 1-hour pad test leakage amount decreased significantly in the treatment group compared with before and with the control group(P<0.01).No obvious adverse reactions and adverse events occurred in all the patients during treatment.Conclusion Acupuncture and moxibustion plus pelvic floor muscle training have a definite therapeutic effect on stress urinary incontinence after benign prostatic hyperplasia surgery with high safety.They can increase the cure rate,shorten the duration of urinary incontinence and decrease the amount of urine leakage so as to markedly improve the patients’quality of life.

关 键 词：针灸疗法 尿失禁 压力性 盆底肌功能训练 前列腺增生 经尿道前列腺钬激光剜除术(HoLEP) 国际尿失禁咨询委员会问卷量表 

分 类 号：R246.2[医药卫生—针灸推拿学]