盆底肌锻炼改善中老年女性绝经相关症状的临床研究  

Clinical study of improvement on menopausal symptoms in middle aged and elderly women by pelvic floor muscle training

作　　者：樊卫敏 梅小会[2] 陈记娜 董富云 张丽文[2] 陈亚萍[2] 周金华[1] 陈汝君 Fan Weimin;Mei Xiaohui;Chen Jina;Dong Fuyun;Zhang Liwen;Chen Yaping;Zhou Jinhua;Chen Rujun(Department of Gynecology,First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu Province,China;Department of Gynecology,Shanghai Fifth People′s Hospital,Fudan University,Shanghai 200240,China)

机构地区：[1]苏州大学附属第一医院妇科,江苏215006 [2]复旦大学附属上海市第五人民医院妇科,200240

出　　处：《中华妇幼临床医学杂志（电子版）》2022年第1期94-101,共8页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：上海市闵行区卫生健康委员会科研课题(2019MW05)。

摘　　要：目的评价盆底肌锻炼(PFMT)对中老年女性绝经相关症状(MS)的作用。方法选择2020年1月至2021年1月,因出现MS于复旦大学附属上海市第五人民医院更年期门诊,或盆底中心就诊的165例中老年女性为研究对象。按照生殖衰老分期系统(STRAW+10)分期结果,将其分为绝经前期组(n=45,为STRAW+10的-3b~-2阶段),绝经早期组(n=62,为STRAW+10的-1~+1b阶段),绝经晚期组(n=58,为STRAW+10的+1c~+2阶段)。采用前瞻性研究方法,对各组受试者进行PFMT干预12周,并采用绝经指数(KI)量表、绝经期等级评定量表(MRS)、绝经期泌尿生殖系统综合征(GSM)症状评分量表及国际尿失禁咨询委员会尿失禁问卷简表(ICIQ-UI SF)(以下简称为4个量表),对PFMT干预效果进行综合评估。采用Mann-Whitney U检验,对受试者PFMT干预前、后各量表评分结果进行统计学比较。本研究经复旦大学附属上海市第五人民医院伦理委员会批准[审批文号:(2019)伦审(149)],并与所有受试者签署临床研究知情同意书。结果①绝经前期组采取PFMT干预后,对受试者的4个量表评分均低于干预前,并且差异均有统计学意义(P<0.05);MRS中的躯体感觉及泌尿生殖道评分、ICIQ-UI SF中对日常生活影响评分,均低于干预前,并且差异均有统计学意义(P<0.05)。②绝经早期组采取PFMT干预后,受试者的KI量表、GSM症状评分量表及ICIQ-UI SF评分,均低于干预前,并且差异均有统计学意义(P<0.05);MRS中的心理感觉评分,GSM症状评分量表中的阴道干燥及阴道刺痛评分,ICIQ-UI SF中的尿失禁频率及对日常生活影响评分,均低于干预前,并且差异均有统计学意义(P<0.05);而MRS中的泌尿生殖道症状评分[3分(0~3分)],则高于干预前[3分(0~3分)],并且差异有统计学意义(Z=-2.710、P=0.007)。③绝经晚期组采取PFMT干预后,对受试者的4个量表评分均低于干预前,并且差异均有统计学意义(P<0.05);MRS中的躯体感觉、心理感觉及Objective To evaluate effects of pelvic floor muscle training(PFMT)on menopausal symptoms(MS)in middle aged and elderly women.Methods From January 2020 to January 2021,a total of 165 middle aged and elderly women who were treated in menopause clinic or pelvic floor center of Shanghai Fifth People′s Hospital,Fudan University due to MS were selected as research subjects.According to stages of reproductive aging workshop+10(STRAW+10),they were divided into premenopausal group(n=45,with-3b to-2 stage of STRAW+10),early menopausal group(n=62,with-1 to+1b stage of STRAW+10)and late menopausal group(n=58,with+1C to+2 stage of STRAW+10).Using prospective research methods,PFMT intervention measure was performed on subjects in each group for 12 weeks.The intervention effects of PFMT was comprehensively evaluated by Kupperman Index(KI)Scale,Menopause Rating Scale(MRS),Genitourinary Syndrome of Menopause(GSM)Symptom Score Scale and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form(ICIQ-UI SF)(hereinafter referred to as four scales).Mann-Whitney U test was used to statistically compare scores of various scales between before and after PFMT intervention.This study was approved by the Ethics Committee of Shanghai Fifth People′s Hospital,Fudan University[Approval No.(2019)lunshen(149)].All subjects signed the clinical study informed consent forms.Results①Scores of four scales after PFMT intervention in premenopausal group were all lower than those before intervention,and the differences were statistically significant(P<0.05).Scores of somatosensory and urogenital tract in MRS,and scores of impact on daily life in ICIQ-UI SF after PFMT intervention,were all lower than those before intervention,and the differences were statistically significant(P<0.05).②Scores of KI Scale,GSM Symptom Score Scale and ICIQ-UI SF after PFMT intervention in early menopausal group were all lower than those before intervention,and the differences were statistically significant(P<0.05).Scores of psychologica

关 键 词：围绝经期 绝经前期 绝经后期 骨盆底 尿失禁 绝经期症状 盆底肌锻炼 女(雌)性 

分 类 号：R47[医药卫生—护理学]