补中益气汤加减治疗前列腺切除术后压力性尿失禁的临床观察  

Clinical effect of modified BuzhongYiqi Decoction for stress urinary incontinence after prostatectomy

作　　者：黄辉虎[1] 黄卫 王仕钦[1] 彭玉平[1] 朱礼乐 王之仕 邢益涛 HUANG Huihu;HUANG Wei;WANG Shiqin;PENG Yuping;ZHU Lile;WANG Zhishi;XING Yitao(Department of Urology,Hainan Traditional Chinese Medicine Hospital,Haikou,Hainan 570203)

机构地区：[1]海南省中医院泌尿外科,海南海口570203

出　　处：《河北中医》2023年第4期589-592,596,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：海南省卫生计生行业科研项目(编号:19A200084)。

摘　　要：目的观察补中益气汤加减治疗前列腺切除术后压力性尿失禁的临床效果。方法将84例前列腺切除术后压力性尿失禁患者按照随机数字表法分为2组,对照组42例予西医常规治疗,治疗组42例在对照组基础上联合补中益气汤加减治疗。2组均治疗1个月后统计疗效,比较2组治疗前后国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)(包括漏尿频率、漏尿量及漏尿对生活影响)评分、中医证候(包括夜尿次数、残余尿量、下肢乏力、疲惫、腰膝腿软、畏寒、舌苔及脉象)评分、1 h尿垫试验漏尿量及尿动力学指标[包括最大尿流速(Qmax)、残余尿量(PRV)、最大逼尿肌压(Pdet)及最大膀胱容量(MCC)]变化情况,比较2组治疗期间不良反应发生情况。结果治疗组总有效率95.2%(40/42),不良反应总发生率7.1%(3/42),对照组总有效率76.2%(32/42),不良反应总发生率4.8%(2/42),2组不良反应总发生率比较差异无统计学意义(P>0.05),但治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后ICI-Q-SF漏尿频率、漏尿量、漏尿对生活影响评分及总分均降低(P<0.05),且治疗组治疗后ICI-Q-SF漏尿频率、漏尿量、漏尿对生活影响评分及总分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后Qmax、Pdet及MCC均升高(P<0.05),PRV均降低(P<0.05),且治疗组治疗后Qmax、Pdet及MCC均高于对照组(P<0.05),PRV低于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医证候夜尿次数、残余尿量、下肢乏力、疲惫、腰膝腿软、畏寒、舌苔、脉象评分均降低(P<0.05),且治疗组治疗后中医证候各项评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后1 h尿垫试验漏尿量均减少(P<0.05),且治疗组治疗后1 h尿垫试验漏尿量少于对照组(P<0.05)。结论补中益气汤加减治疗前列腺切除术后压力性尿失禁临床疗效确切,可有效改善患者尿失禁症状,提高控尿、排�Objective To observe the clinical effect of modified BuzhongYiqi Decoction for stress urinary incontinence(SUI)after prostatectomy.Methods Eighty-four patients with SUI after prostatectomy were randomly assigned into the treatment group(n=42)and the control group(n=42).All patients were managed by conventional Western medicine,and those in the treatment group were additionally treated with modified BuzhongYiqi Decoction.The efficacy was counted after 1 month of treatment,aiming to compare the international consultation on incontinence questionnaire-urinary incontinence short form(ICI-Q-SF)(leakage frequency,leakage volume,impact of urine leakage on life)scores,traditional Chinese medicine(TCM)syndrome(nocturia frequency,residual urine volume,fatigue of lower limbs,fatigue,weakness of waist,knees and legs,chills,tongue coating and pulse condition)scores,the urine leakage volume during the 1 h pad test,urodynamic indicators(maximum urinary flow rate[Qmax],postvoid residual urine volume[PRV],maximum detrusor pressure[Pdet],maximum cystometric capacity[MCC]).The curative effect and adverse reactions were assessed.Results The overall effective rate was higher in the treatment group compared with the control group(95.2%[40/42]vs76.2%[32/42],P<0.05).The difference was not statistically significant in the total incidence of adverse reactions between the treatment group and the control group(7.1%[3/42]vs 4.8%[2/42],P>0.05).After treatment,ICI-Q-SF scores in groups were decreased(P<0.05),the reduction in the treatment group was more common(P<0.05).Qmax,Pdet and MCC in groups were increased(P<0.05),while PRV was decreased(P<0.05).The treatment group were superior to the control group for Qmax,Pdet and MCC,PRV(all P<0.05).TCM symptom scores in groups were decreased(P<0.05),which were notably decreased in the treatment group than in the control group(P<0.05).The urine leakage volume during the 1 h pad test in groups was decreased(P<0.05),which in the treatment group was more prevalent relative to the control group(P<0.05).Con

关 键 词：前列腺切除术 尿失禁 手术并发症 中药疗法 补中益气汤 

分 类 号：R697.3[医药卫生—泌尿科学]