陈氏盆乐汤对产后盆底功能障碍性疾病盆底肌力及尿流动力学状态的影响  

Influence of CHENs'Penle Decoction on pelvic floor muscle strength and urodynamics in patients with postpartum pelvic floor dysfunction

作　　者：胡凤英 周先韦 金丽华 陈学奇[2] HU Fengying;ZHOU Xianwei;JIN Lihua;CHEN Xueqi(The Second Affliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,China;The Third Affliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310009,China)

机构地区：[1]浙江中医药大学附属第二医院,杭州310005 [2]浙江中医药大学附属第三医院,杭州310009

出　　处：《中华中医药杂志》2024年第8期4474-4478,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：浙江省中医药科技计划(No.2018ZQ025,No.2020ZA061);第七批全国老中医药专家学术经验继承工作(No.国中医药办人教函[2022]76号)。

摘　　要：目的:分析陈氏盆乐汤对产后盆底功能障碍性疾病(PFD)患者盆底肌力及尿流动力学状态的影响。方法:选取2018年1月至2019年10月收治的PFD患者116例,采用随机数表法分为观察组、对照组,各58例,对照组予以电刺激联合生物反馈盆底肌肉锻炼,观察组予以陈氏盆乐汤联合盆底肌肉锻炼,均治疗8周,对比两组治疗前后、产后6个月与12个月时盆底功能影响问卷(PFDI-20)、盆腔脏器脱垂/尿失禁性功能问卷(PISQ-12)、盆腔器官脱垂量表(POP-Q),盆底三维超声检测膀胱颈至耻骨联合下缘的垂直间距(BSD)、膀胱尿道后角(PUVA)、膀胱颈移动度(UVJ-M),生物刺激反馈仪测定盆底肌肉肌力、肌肉疲劳度,记录不良反应。结果:治疗8周后及产后6、12个月两组PFDI-20评分、POP-Q评分均较治疗前下降(P<0.05),而PISQ-12评分(除对照组治疗8周后)增加(P<0.05),且观察组PFDI-20评分、POP-Q评分低于对照组(P<0.05),而PISQ-12评分高于对照组(P<0.05);产后两组BSD、PUVA、UVJ-M(除对照组治疗8周后)均发生明显变化,且观察组治疗8周后及产后6、12个月BSD高于对照组(P<0.05),而PUVA、UVJ-M低于对照组(P<0.05);观察组产后6、12个月Ⅰ~Ⅲ级的Ⅰ类肌纤维、Ⅱ类肌纤维盆底肌电活动值大于对照组(P<0.05),而盆底肌疲劳值低于对照组(P<0.05);两组均未见明显不良反应。结论:陈氏盆乐汤可明显改善产后PFD患者盆底肌力、尿流动力学,减少盆底肌疲劳,提高其生活质量,安全可靠,值得在临床推广实践。Objective:To analyze the influence of CHENs'Penle Decoction on pelvic floor muscle strength and urodynamics in patients with postpartum pelvic floor dysfunction(PFD).Methods:Between January 2018 and October 2019,116 patients with PFD were selected and randomly divided into observation group and control group,58 cases in each group.The control group received electrical stimulation combined with biofeedback pelvic floor muscle exercise.The observation group received CHENs'Penle Decoction combined with biofeedback pelvic floor muscle exercise.Both groups were treated for 8 weeks.The Pelvic Floor Distress Inventory-Short Form 20(PFDI-20)scores,the Pelvic Organ Prolapse Quantification(POP-Q)scores,and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12(PISQ-12)scores of the 2 groups were compared.Pelvic floor muscle strength[bladder neck-symphyseal distance(BSD),posterior urethrovesical angle(PUVA),and the mobility of the ureterovesical junction(UVJ-M)]was measured by pelvic fioor three-dimensional ultrasound,pelvic floor muscle strength and muscle fatigue were determined with a biostimulation feedback instrument,and adverse reactions were recorded.

关 键 词：陈氏盆乐汤 产后盆底功能障碍性疾病 盆底肌力 尿流动力学 

分 类 号：R271.43[医药卫生—中医妇科学]