棒击推拿联合电刺激生物反馈治疗成年女性压力性尿失禁:盆底肌表面肌电值的变化  

Therapeutic effect of Rod Tuina combined with electrical stimulation biofeedback on stress urinary incontinence in adult women:changes in surface electromyography values of pelvic floor muscles

作　　者：王铁刚[1,2] 潘丽娜 王海 杨添淞 孙忠人[1] Wang Tiegang;Pan Lina;Wang Hai;Yang Tiansong;Sun Zhongren(Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang Province,China;Daqing Hospital of Traditional Chinese Medicine,Daqing 163311,Heilongjiang Province,China;The First Clinical Medical College,Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang Province,China)

机构地区：[1]黑龙江中医药大学,黑龙江省哈尔滨市150040 [2]大庆市中医医院,黑龙江省大庆市163311 [3]黑龙江中医药大学第一临床医学院,黑龙江省哈尔滨市150040

出　　处：《中国组织工程研究》2022年第35期5693-5699,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金资助项目面上项目(82074539),项目负责人:杨添淞;第四批全国中医(临床、基础)优秀人才研修项目(国中医药人教发[2017]24号),项目参与人:王海。

摘　　要：背景:棒击推拿治疗压力性尿失禁临床有效,但与电刺激生物反馈的联合治疗方案尚未见报道。目的:评估棒击推拿联合电刺激生物反馈疗法对成年女性压力性尿失禁的临床疗效。方法:收集2021年1-9月在大庆市中医医院女性康复门诊就诊的尿失禁确诊患者72例,使用随机数字法对患者进行分组,每组36例,治疗组患者接受棒击推拿及电刺激生物反馈联合治疗,对照组患者仅接受电刺激生物反馈治疗,两组患者均接受20 d的治疗。治疗前、后分别接受盆底肌表面肌电图检查、1 h尿垫试验、国际尿失禁咨询委员会尿失禁问卷简表评分及改良牛津肌力分级测试,比较两组治疗前、治疗后20 d观察指标的变化情况,评估患者病情及疗效,并在疗程结束后6,12周进行随访。结果与结论:(1)治疗20 d后,两组患者在表面肌电、1 h尿垫试验、国际尿失禁咨询委员会尿失禁问卷评分及牛津肌力分级方面均有改善,且治疗组改善程度较对照组更高(P<0.05);(2)疗程结束后治疗组总有效率(92%)高于对照组(67%),其疗效差异有显著性意义(P<0.05);(3)经过6,12周随访,治疗组的尿失禁问卷简表评分依旧优于对照组,其差异有显著性意义(P<0.05);(4)提示棒击推拿联合电刺激生物反馈疗法能有效减少患者的尿失禁频率及程度,提高盆底肌肌力,改善盆底功能,且棒击推拿联合生物反馈电刺激方案还能改善患者压力性尿失禁的伴随症状,维持更长的治疗效果;(5)此外引入神经肌肉电生理指标评估疗效较为客观,棒击推拿联合电刺激生物反馈作为中西医结合治疗尿失禁的治疗方案,有一定深入研究和推广价值。BACKGROUND:Rod Tuina is an effective treatment for stress urinary incontinence.However,the combination of Rod Tuina and electrical stimulation biofeedback therapy has not been repo rted.OBJECTIVE:To evaluate the clinical efficacy of Rod Tuina combined with electrical stimulation biofeedback therapy in the treatment of stress urinary incontinence in adult women.METHODS:A total of 72 female patients with urinary incontinence diagnosed in the Female Rehabilitation Outpatient Clinic of Daqing Hospital of Traditional Chinese Medicine from January 2021 to September 2021 were enrolled.These patients were randomly divided into treatment group(n=36)and control group[n=36).Patients in the treatment group received the combined therapy of Rod Tuina and electrical stimulation biofeedback,while those in the control group received electrical stimulation biofeedback only.Treatment in each group lasted for 20 days.Surfa ce electromyogra p hy of pelvic floor muscles,1-hour pad test,International Consultation on Incontinence Questionnaire-U rinary Incontinence Short Form(ICIQ-UI SF),and modified Oxfo rd muscle strength test were conducted befo re and after treatment.The changes of above observation indexes before and 20 days after treatment were compared between groups to evaluate the condition and effica cy of the patients.Follow-ups were conducted at 6 and 12 weeks after the course of treatment.RESULTS AND CONCLUSION:After 20 days of treatment,surface electromyography,1-hour pad test,ICIQ-UI SF score and Oxford muscle strength classification were improved in both groups,and the improvement was more significant in the treatment group than the control group(P<0.05).After the treatment course,the total effective rate in the treatment group(92%)was significantly higher than that in the control group(67%;P<0.05).Follow-up results indicated that the ICIQ.-UI SF score was significantly better in the treatment group than the control group(P<0.05).To conclude,Rod Tuina combined with electrical stimulation biofeedback therapy can effective

关 键 词：压力性尿失禁 棒击法 内功推拿 电刺激生物反馈 盆底肌 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]