缩泉丸合补中益气汤加减对良性前列腺增生术后尿失禁患者尿流动力学的影响  

Influence of Addition and Subtraction Therapy of Suoquan Wan Combined with Buzhong Yiqi Decoction on Urodynamics of Patients with Urinary Incontinence after Operation of Benign Prostatic Hyperplasia

作　　者：彭玉平[1] 黄卫 黄辉虎[1] 邢益涛 PENG Yuping;HUANG Wei;HUANG Huihu;XING Yitao(Hainan Hospital of Traditional Chinese Medicine,Haikou 570203 Hainan,China)

机构地区：[1]海南省中医院,海南海口570203

出　　处：《中药新药与临床药理》2021年第3期428-434,共7页Traditional Chinese Drug Research and Clinical Pharmacology

基　　金：海南省重点研发计划项目(ZDYF2018229)。

摘　　要：目的探讨缩泉丸合补中益气汤加减治疗良性前列腺增生(BPH)术后尿失禁患者的临床疗效及对尿流动力学、膀胱功能和生活质量的影响。方法将82例患者按随机数字表分为对照组(40例)和观察组(42例)。2组均行盆底肌功能训练治疗,对照组给予缩泉胶囊治疗;观察组给予缩泉丸和补中益气汤加减治疗,疗程为8周,并随访2个月。观察2组患者治疗前后国际尿失禁咨询问卷简表(ICIQ-SF)评分、1 h尿垫试验、72 h排尿日记、中医证候积分、生活质量指数(QoL)评分和尿流动力学参数指标的变化情况;并观察其临床疗效及安全性。结果 (1)治疗期间,对照组和观察组各因转院脱落、失访2例,对照组违背方案1例,最终对照组纳入患者37例,观察组纳入患者40例。(2)治疗后,2组患者的ICIQ-SF各因子评分、总分、以及1 h尿垫试验的漏尿量和中医证候积分较治疗前均明显降低(P<0.01),且观察组的评分及漏尿量均少于对照组(P<0.01)。(3)治疗后,2组患者72 h的总排尿次数、总漏尿事件次数、总排尿量、夜间护理人员被叫次数和QoL评分均较治疗前明显减少(P<0.01),且观察组患者的漏尿改善程度及评分均少于对照组(P<0.01)。(4)治疗后,2组患者除残余尿量(RUV)少于治疗前(P<0.01),其他尿动力学参数[最大尿流率(Q_(max))、强烈尿感容量(SD)、膀胱收缩指数(BCI)、最大尿道闭合压(MUCP)、最大尿流率时的逼尿肌压力(Pdet-Q_(max))和膀胱顺应性(BC)]均高于治疗前(P<0.01),且观察组的尿流动力学各参数的改善效果优于对照组(P<0.01);(5)治疗后,观察组总有效率为100.00%(40/40),对照组总有效率为94.59%(35/37),经秩和检验,观察组临床疗效优于对照组(P<0.05);2个月随访发现观察组患者规律排尿率和膀胱功能满意率分别为90.00%(36/40)、87.50%(35/40),高于对照组的70.27%(26/37)、64.86%(24/37),差异有统计学意义(P<0.05);治疗期间未发现与治疗相关的Objective To discuss the influence of Suoquan Wan combined with Buzhong Yiqi decoction on clinical efficacy and urodynamics,bladder function and quality of life in patients with urinary incontinence after operation of benign prostatic hyperplasia(BPH).MethodsEighty two patients were randomly divided into control group(40 cases)and observation group(42 cases). Both groups were given pelvic floor muscle function training. Patients in control group were given with Suoquan capsules. Patients in observation group were treated with addition and subtraction therapy of Suoquan Wan combined with Buzhong Yiqi decoction. The treatment was continued for 8 weeks urinary incontinence-short form(ICIQ-SF),one-hour urine pad test,72-hour urination diary,traditional Chinesemedicine syndrome score,urodynamic parameters and quality of life index(QoL)were performed before and aftertreatment in two groups. And the clinical efficacy and safety of drug treatment were observed.Results(1)During thetreatment period,two cases were lost after transfer from the control group and two other cases were lost to follow-upfrom the observation group. And one case was found to disobey the treatment plan in the observation group. Finally,the control group included thirty-seven patients and the observation group included forty patients.(2) After thetherapy, scores of ICIQ-SF factors, ICIQ-SF total score, urine leakage of one-hour pad test and traditionalChinese medicine syndrome scores of both groups were obviously lower than those before therapy(P<0.01)(.3)Aftertreatment,the total number of urination,total number of leakage events,total urination,numbers of nurse nighttime awakenings,QoL scores of the two groups at 72 hours were significantly reduced compared with before treatment(P<0.01). And the improvement and score of urine leakage in the observation group were less than those in thecontrol group(P<0.01)(.4)After treatment,the residual urine volume(RUV)of the two groups was less than thatbefore treatment(P<0.01). Other urodynamic parameters [maxim

关 键 词：良性前列腺增生 术后尿失禁 缩泉丸 补中益气汤 膀胱功能 生活质量 尿流动力学 

分 类 号：R285.6[医药卫生—中药学]