针灸联合生物反馈电刺激治疗产后压力性尿失禁疗效及对ICI-Q-SF评分和盆底肌表面电信号的影响  

Effect of Acupuncture and Moxibustion Combined with Biofeedback Electrical Stimulation on Postpartum Stress Urinary Incontinence and Influence on ICIQ-SF Score and Surface Electrical Signals of Pelvic Floor Muscle

作　　者：刘婷婷 林椠 杜林山 杜美容 LIU Tingting;LIN Qian;DU Linshan;DU Meirong(Tangshan Maternal and Child Health Hospital,Tangshan 063000,Hebei,China)

机构地区：[1]唐山市妇幼保健院,河北唐山063000

出　　处：《辽宁中医药大学学报》2024年第6期176-181,共6页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：河北省中医药类科学研究课题(2023210)。

摘　　要：目的探讨针灸联合生物反馈电刺激治疗产后压力性尿失禁(postpartum stress urinary incontinence,PSUI)的疗效及对国际尿失禁咨询委员会尿失禁问卷表(Incontinence Questionnaire of the International Incontinence Advisory Committee,ICI-Q-SF)评分和盆底肌表面电信号的影响。方法选取2022年6月—2023年6月于本院就诊的PSUI患者264例,随机分为对照组(n=132)和研究组(n=132),对照组采取生物反馈电刺激治疗,研究组采取针灸联合生物反馈电刺激治疗,均治疗8周,观察两组治疗疗效,对比治疗前后漏尿量、盆底功能、肌力、肌纤维疲劳度、ICI-Q-SF得分、盆底肌表面电信号、尿动力学水平[最大尿道闭合压(MUCP)、最大尿流率(MFR)、达峰时间(Tmax)、咳嗽点膀胱内压(CLPP)]。采用GEE模型评价两种治疗方法对患者ICI-Q-SF评分和盆底肌表面电信号的影响。结果对照组总有效率为74.24%,研究组总有效率为91.67%,两组临床疗效比较差异有统计学意义(P<0.05)。与治疗前比较,治疗4周、6周、8周后两组患者阴道收缩压、静息压、盆底肌表面电信号水平(活力)及尿动力学水平均有显著升高,而膀胱颈活动度、尿道旋转角度、漏尿量、ICI-Q-SF评分、盆底肌表面电信号水平(峰值)显著降低(P<0.05),且研究组优于对照组(P<0.05)。治疗4周、6周、8周后,研究组盆底肌力情况及盆底Ⅰ类、Ⅱ类肌纤维疲劳度均优于对照组,差异均有统计学意义(P<0.05)。采用GEE模型结果显示,治疗时间、治疗方案及两者的交互作用比较差异有统计学意义(P<0.05)。结论针灸联合生物反馈电刺激在治疗产后压力性尿失禁方面具有很好的应用前景,可显著改善患者的ICI-Q-SF评分和盆底肌表面电信号,应用价值较高。Objective To investigate the effects of acupuncture and moxibustion combined with biofeedback electrical stimulation on postpartum stress urinary incontinence(PSUI)on the scores of the Incontinence Questionnaire of the International Urinary Incontinence Advisory Committee(ICI-Q-SF)and the surface electrical signals of pelvic floor muscles.Methods 264 patients with PSUI admitted to our hospital from June 2022 to June 2023 were randomly divided into control group(n=132)to receive biofeedback electrical stimulation and study group(n=132)to receive acupuncture combined with biofeedback electrical stimulation for 8 weeks,and the therapeutic effects of the two groups were observed.Urine leakage,pelvic floor function,muscle strength,muscle fiber fatigue,ICI-Q-SF score,pelvic floor muscle surface electrical signal and urodynamic level[(maximum urethral closure pressure(MUCP),maximum urine flow rate(MFR)and peak time(Tmax)the data of cough point internal bladder pressure(CLPP)]were compared before and after treatment.GEE model was used to evaluate the effects of two treatments on ICI-Q-SF score and surface electrical signal of pelvic floor muscle.Results The total effective rate of the control group was 74.24%,the study group was 91.67%,the difference was statistically significant(P<0.05).Compared with before treatment,at 4,6 and 8 weeks after treatment,the measured levels of vaginal systolic pressure,resting pressure,electrical signal(activity)and urodynamic level were significantly increased,while the data of bladder neck motion,urethra rotation angle,urine leakage,ICIQ-SF score and electrical signal level(peak)of pelvic floor muscle were significantly decreased(P<0.05),and the study group was better than the control group(P<0.05).At 4,6 and 8 weeks after treatment,the pelvic floor muscle strength of the study group and the classⅠand classⅡmuscle fiber fatigue of the two groups were better than those of the control group,and the differences were statistically significant(P<0.05).GEE model results showed that the tre

关 键 词：针灸 生物反馈 电刺激 产后压力性尿失禁 国际尿失禁咨询委员会尿失禁问卷表 盆底肌表面电信号 

分 类 号：R245[医药卫生—针灸推拿学]