温针灸八髎穴联合补元固肾推拿手法治疗轻中度女性压力性尿失禁临床研究  

Clinical efficacy of warm acupuncture at Baliao point combined with Buyuan Gushen massage for mild to moderate female stress urinary incontinence

作　　者：孙玉萍 周泽霖 陈韵龙 黄春梅[4] 沈姿 SUN Yuping;ZHOU Zelin;CHEN Yunlong;HUANG Chunmei;SHEN Zi(Department of Traditional Chinese Medicine Rehabilitation,Shenzhen Pingshan People's Hospital,Shenzhen,Guangdong 518118;The First Clinical College,Guangzhou University of Chinese Medicine,Guangzhou,Guangdong 510405;Department of Child Rehabilitation,Nanhai Women and Children's Hospital Affiliated to Guangzhou University of Chinese Medicine,Foshan,Guangdong 528200;The Fifth Clinical College,Guangzhou University of Chinese Medicine,Guangzhou,Guangdong 510405)

机构地区：[1]广东省深圳市坪山区人民医院中医康复科,广东深圳518118 [2]广州中医药大学第一临床医学院,广东广州510405 [3]广州中医药大学附属南海妇产儿童医院儿童康复科,广东佛山528200 [4]广州中医药大学第五临床医学院,广东广州510405

出　　处：《河北中医》2022年第8期1347-1351,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：广东省中医药局2020年度科研项目(编号:20202165)。

摘　　要：目的观察温针灸八髎穴联合补元固肾推拿手法治疗轻中度女性压力性尿失禁(SUI)的临床疗效。方法将82例轻中度女性SUI患者按照随机数字表法分为2组,对照组41例予凯格尔(Kegel)运动训练,持续1个月;针推组41例在对照组治疗基础上采用温针灸八髎穴联合补元固肾推拿手法,每2 d治疗1次,共治疗15次。2组均治疗1个月,比较2组治疗前后国际尿失禁调查委员会问卷表简表(ICIQ-SF)评分、1 h尿垫试验漏尿量、尿动力学指标[充盈时段膀胱压力(Pves)、最大尿意膀胱容量(VMCC)、最大尿流率(Qmax)、残余尿量(PVR)],并统计临床疗效。结果针推组总有效率87.80%(36/41),对照组总有效率58.54%(24/41),针推组疗效优于对照组(P<0.05)。2组治疗后ICIQ-SF各单项评分及总分均较本组治疗前降低(P<0.05),且针推组治疗后均低于对照组(P<0.05)。2组治疗后1 h尿垫试验漏尿量低于本组治疗前(P<0.05),且针推组1 h尿垫试验漏尿量治疗后低于对照组(P<0.05)。针推组治疗后PVR、Pves及对照组治疗后PVR均较本组治疗前降低(P<0.05),2组治疗后Qmax、VMCC均升高(P<0.05),且针推组治疗后Qmax、VMCC均高于对照组(P<0.05),PVR、Pves均低于对照组(P<0.05)。结论温针灸八髎穴联合补元固肾推拿能够有效改善轻中度女性SUI患者的生活质量、漏尿量以及尿动力学水平。Objective To observe the clinical efficacy of warm acupuncture at Baliao point combined with Buyuan Gushen massage for mild to moderate female stress urinary incontinence(SUI).Methods Totally 82 female patients with mild to moderate SUI were randomly assigned into the acupuncture and massage group(n=41)and the control group(n=41).The control group was treated with Kegel exercise for 1 month,and the acupuncture and massage group with warm acupuncture at Baliao point combined with Buyuan Gushen massage based on the control group for 15 times(treatment once every 2 days).The treatment period was 1 month,aiming to compare International Consultation on Incontinence questionnaire short form(ICIQ-SF)score,leakage of urine in 1 h urinal pad test,urodynamic indicators(bladder pressure at filling phase[Pves],volume at maximal cystometric capacity[VMCC],maximum flow rate of urination[Qmax],post-void residual urine volume[PVR]);the curative effect was assessed.Results The overall effective rate was higher in the acupuncture and massage group(87.80%[36/41])compared with the control group(58.54%[24/41]),(P<0.05).After treatment,ICIQ-SF scores in groups were decreased(P<0.05),which were decreased in the acupuncture and massage group compared with the control group(P<0.05);leakage of urine in 1 h urinal pad test in groups were decreased(P<0.05),the acupuncture and massage group was more prevalent(P<0.05);PVR and Pves in the acupuncture and massage group were decreased(P<0.05),and PVR in the control group was decreased(P<0.05);Qmax and VMCC in groups were increased(P<0.05);higher Qmax and VMCC,and lower PVR and Pves were detected in the acupuncture and massage group than those in the control group(all P<0.05).Conclusion For female patients with mild to moderate SUI,warm acupuncture at Baliao point combined with Buyuan Gushen massage can effectively improve the quality-of-life,leakage volume and urodynamics levels.

关 键 词：尿失禁 压力性 女性 穴 八髎 温针疗法 推拿 

分 类 号：R694.54[医药卫生—泌尿科学] R245[医药卫生—外科学] R244.1[医药卫生—临床医学]