摘要
目的比较艾灸配合盆底肌训练与单纯盆底肌训练或单纯西药治疗产后压力性尿失禁的疗效差异。方法将58例符合标准的患者按照随机数字表法分为联合组(19例)、训练组(19例)、西药组(20例)。联合组采用盆底肌训练与艾灸穴位相配合的方法,盆底肌训练每日3次,每次5 min;艾灸足三里、三阴交、关元、中极、气海,每日1次,每次30 min。训练组采用肌力训练方式训练盆底部肌肉,每日3次,每次5 min。西药组服用盐酸度洛西汀,每天80 mg(每次40 mg,每日2次)。上述治疗均6 d为1个疗程,共观察4个疗程,1个月后随访。采用1 h尿垫试验记录漏尿量,于治疗前、治疗后及1个月后随访进行国际尿失禁咨询委员会尿失禁问卷简表(ICIQ-UI-SF)评分,比较各组评分情况,并比较3组近、远期疗效。结果联合组近期疗效及远期疗效优于训练组和西药组(P<0.05)。联合组患者在治疗后和随访时漏尿量、ICIQ-UI-SF评分均较治疗前明显改善(P<0.01);治疗后联合组在1 h尿垫试验记录漏尿量、ICIQ-UI-SF评分方面改善优于训练组和西药组(P<0.01,P<0.05)。结论艾灸配合盆底肌训练疗法能改善产后压力性尿失禁患者近期生活质量。艾灸配合盆底肌训练疗法对产后压力性尿失禁患者远期生活质量改善优于单纯的盆底肌训练方法。
Objective To compare the clinical efficacy among moxibustion plus pelvic floor muscle exercises, pelvic floor muscle exercises, and Western medication in treating postpartum stress urinary incontinence. Method Fifty-eight eligible patients were divided by the random number table into an integration group （19 cases）, an exercise group （19 cases） and a Western medication group （20 cases）. The integration group was intervened by pelvic floor muscle exercises plus moxibustion, 3 times of exercises a day, 5 min each time, and moxibustion at Zusanli （ST36）, Sanyinjiao （SP6）, Guanyuan （CV4）, Zhongji （CV3） and Qihai （CV6）, once a day, 30 min each session. The exercise group was intervened by muscle force exercises to train the pelvic floor muscle, 3 times a day, 5 min each time. The Western medication group was intervened by oral administration of Duloxetine hydrochloride, 80 mg a day （40 mg per dose, twice a day）. For the above methods, 6 d was taken as a course of treatment. Four treatment courses were observed, with a 1-month follow-up study. The 1-hour pad test was used to record the volume of urine leak. Before and after the treatment, as well as in the 1-month follow-up, the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form （ICIQ-UI-SF） score was evaluated and compared among the groups, and the short-term and long-term therapeutic efficacies were also compared. Result The short-term and long-term therapeutic efficacies of the integration group were superior to those of the exercise group and Western medication group （P〈0.05）. The integration group showed significant improvement after the treatment and in the follow-up study compared to the pre-treatment state （P〈0.01）; after the intervention, the integration group was better than the exercise group and Western medication group in comparing the urine leak volume by the 1 h pad test and ICIQ-UI-SF score （P〈0.01,P〈0.05）. Conclusion Moxibustion plus pelvic floor muscle exercises can improve the short-term quality of life of patients with postpartum stress urinary incontinence. This method can produce a better effect in improving the quality of life compared to pelvic floor muscle exercises alone.
出处
《上海针灸杂志》
2018年第2期192-195,共4页
Shanghai Journal of Acupuncture and Moxibustion
基金
湖南省教育厅科技处课题(13C704)
