针灸联合生物反馈电刺激治疗气虚型产后压力性尿失禁患者的临床观察  

Therapeutic Effect of Acupuncture and Moxibustion Combined with Biofeedback Electrical Stimulation on Postpartum Stress Urinary Incontinence(Syndrome of Qi Deficiency)

作　　者：杜林山 杜美容 林茜 刘婷婷 张晓燕[1] 于恬 DU Lin-shan;DU Mei-rong;LIN Qian;LIU Ting-ting;ZHANG Xiao-yan;YU Tian(Department of Traditional Chinese Medicine,Tangshan Maternal and Child Health Hospital,Tangshan Hebei 063003)

机构地区：[1]唐山市妇幼保健院中医科,河北唐山063003

出　　处：《世界中西医结合杂志》2023年第11期2287-2291,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科学研究课题项目(2023210)。

摘　　要：目的探究针灸联合生物反馈电刺激治疗气虚型产后压力性尿失禁(Stress Urinary Incontinence,SUI)的临床疗效。方法选取2022年6月—2023年3月期间就诊于唐山市妇幼保健院的产后气虚型SUI患者90例作为研究对象,按1∶1的比例随机分为对照组和治疗组,每组各45例。两组患者均行针灸治疗,即针刺肾俞、会阳、足三里、三阴交,留针30 min,艾灸关元,灸8~10 min至局部温热感,1次/3 d。治疗组在针灸的基础上加用生物反馈电刺激治疗,1次/3 d。治疗1个月后,观察比较两组患者临床疗效、不良反应,治疗前后三项盆底肌电值[快速收缩最大值(II类肌纤维)、紧张收缩均值(I类肌纤维)、耐力收缩均值]、尿失禁问卷表简表评分(International Consultation on Incontinence Questioner-Urinary Incontinence-short Form,ICI-Q-SF)、漏尿量及中医气虚症状评分。结果治疗后两组患者快速收缩最大值、紧张收缩均值、耐力收缩均值较治疗前升高,差异有统计学意义(P<0.01);且治疗组高于对照组,差异有统计学意义(P<0.01)。治疗后两组患者生活质量ICI-Q-SF评分较治疗前降低,差异有统计学意义(P<0.01);且治疗组低于对照组,差异有统计学意义(P<0.01)。治疗后两组患者的尿垫漏尿量及中医证候评分较治疗前降低,差异有统计学意义(P<0.01);且治疗组低于对照组,差异有统计学意义(P<0.01)。治疗后治疗组总有效率88.57%(31/35)高于对照组68.57%(24/35),差异有统计学意义(P=0.041)。治疗期间,两组患者均未出现针灸处青紫及晕针、阴道不适等相关不良反应。结论针灸联合生物反馈电刺激治疗气虚型产后SUI可提高临床治疗效果,改善中医证候评分,提高生活质量且具有相当的安全性,值得推荐使用。Objective To explore the clinical efficacy of acupuncture and moxibustion combined with biofeedback electrical stimulation in the treatment of postpartum stress urinary incontinence(SUI)in the patients with the syndrome of qi deficiency.Method A total of 90 SUI patients(syndrome of qi deficiency)treated in the Tangshan Maternal and Child Health Hospital from June 2022 to March 2023 were selected and randomized into a control group and a treatment group according to the ratio of 1∶1,with 45 patients in each group.Both groups received acupuncture at Shenshu(BL23),Huiyang(BL35),Zusanli(ST36),and Sanyinjiao(SP6),with the needle left for 30 min and moxibustion at Guanyuan(CV4)for 8-10 min until local warm sensation,once every 3 days.In addition,the treatment group received biofeedback electrical stimulation,once every 3 days.After treatment for 1 month,the clinical efficacy and incidence of adverse reactions were compared between the two groups.The pelvic floor surface electromyography(EMG)results maximum value in the rapid contraction stage(type II fiber),mean value in the tension-contraction stage(type I fiber),and mean value in the endurance contraction stage〗,International Consultation on Incontinence Questioner-Urinary Incontinence-Short Form(ICI-Q-SF)score,urine leakage volume of urine pad,and TCM syndrome score were determined before and after treatment.Results After treatment,the maximum value in the rapid contraction stage,mean value in the tension-contraction stage,and mean value in endurance contraction stage in 2 groups increased(P<0.01),and the treatment group had higher values than the control group(P<0.01).The treatment in both groups decreased the ICI-Q-SF score(P<0.01),and the treatment group had lower ICI-Q-SF score than the control group after treatment(P<0.01).After treatment,the urine leakage volume of urine pad and TCM syndrome score declined(P<0.01),being lower in the treatment group than in the control group(P<0.01).The total response rate of the treatment group was 88.57%(31/35),which was

关 键 词：压力性尿失禁 气虚型 针灸 生物反馈电刺激 

分 类 号：R694.54[医药卫生—泌尿科学] R245.97[医药卫生—外科学]