督灸联合康复训练治疗产后压力性尿失禁的疗效观察  

Observation on the efficacy of Governor Vessel moxibustion plus rehabilitation training for postpartum stress urinary incontinence

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

机构地区：[1]河北省唐山市妇幼保健院,唐山063000

出　　处：《上海针灸杂志》2024年第10期1076-1080,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河北省中医药类科学研究课题计划(2023210)。

摘　　要：目的观察隔姜蒜督灸联合Kegel盆底康复训练治疗产后压力性尿失禁(stress urinary incontinence,SUI)的临床疗效。方法纳入102例产后SUI患者,采用随机数字表法分成训练组(51例)和联合组(51例)。训练组开展Kegel盆底康复训练,联合组在训练组基础上行隔姜蒜督灸。比较两组临床疗效,观察两组治疗前后中医证候积分、1 h尿垫试验漏尿量、盆底功能指标(静息压和收缩压)以及尿道动力学指标[最大尿道关闭压(maximum urethral closure pressure,MUCP)和腹压漏尿点压(abdominal pressure leakage point pressure,ALPP)]的变化。结果联合组总有效率为94.1%,高于训练组的78.4%,差异具有统计学意义(P<0.05)。治疗后,两组中医证候积分和1 h尿垫试验漏尿量均低于同组治疗前(P<0.05),且联合组上述指标均低于训练组(P<0.05)。治疗后,两组盆底静息压、收缩压、MUCP及ALPP均高于同组治疗前(P<0.05),且联合组上述指标均高于训练组(P<0.05)。结论隔姜蒜督灸联合Kegel盆底康复训练治疗产后SUI的临床疗效优于单纯康复训练,可更好地提高盆底功能及尿道动力学指标,进一步改善症状及漏尿情况。Objective To observe the clinical efficacy of ginger and garlic moxibustion on Governor Vessel plus Kegel exercises for postpartum stress urinary incontinence(SUI).Method One hundred and two patients with postpartum SUI were enrolled and allocated,using the random number table,to a training group(51 cases)and a combination group(51 cases).The training group did Kegel exercises and the combination group received ginger and garlic moxibustion on Governor Vessel in addition.The clinical therapeutic effects were compared between the two groups.The TCM syndrome score,urine leakage volume by 1-hour pad test,pelvic floor function indicators(static and contractive pressures)and urethral dynamic indicators[the maximum urethral closure pressure(MUCP)and abdominal leak point pressure(ALPP)]were observed in the two groups before and after treatment.Result The total efficacy rate was 94.1%in the combination group,which was higher than 78.4%in the training group,with a statistically significant difference(P<0.05).After treatment,the TCM syndrome score and urine leakage volume by 1-hour pad test decreased in the two groups compared with before(P<0.05)and were lower in the combination group than those in the training group(P<0.05).After treatment,pelvic floor static and contractive pressures,MUCP and ALPP increased in the two groups compared with before treatment(P<0.05)and were higher in the combination group than in the training group(P<0.05).Conclusion Ginger and garlic moxibustion on Governor Vessel plus Kegel exercises is more effective than Kegel exercises alone in treating postpartum SUI.It can more markedly improve pelvic floor function and urodynamics and relieve the symptoms and urine leakage.

关 键 词：针灸疗法 隔姜灸 隔蒜灸 穴位 督脉 产后 尿失禁 压力性 女性 肾阳虚 

分 类 号：R246.3[医药卫生—针灸推拿学]