益气升提散穴位敷贴联合电刺激对产后压力性尿失禁的疗效分析

Effect analysis of Yiqishengtisan acupoint application combined with electrical stimulation on postpartum stress urinary incontinence

目的探讨益气升提散穴位敷贴联合电刺激疗法对产后压力性尿失禁(stress urinary incontinence,SUI)的治疗效果。方法选取2022年1月至2023年5月期间在唐山市妇幼保健院中医科就诊的188例轻中度SUI产妇,以随机数字表法分为对照组(电刺激疗法)和试验组(益气升提散穴位敷贴联合电刺激疗法),每组94例,疗程为2个月。比较两组临床疗效、盆底肌肌力、尿流动力学指标、漏尿情况及生活质量,并统计不良反应发生情况。结果与治疗前相比,治疗后两组主证、次证及中医证候总积分下降,且试验组低于对照组(P<0.05)。治疗后两组阴道动态压、Ⅰ类和Ⅱ类肌纤维肌力、负压漏尿点压力(ALPP)、最大尿道闭合压(MUCP)、膀胱顺应性(BC)、尿失禁生活质量问卷(I-QOL)评分较治疗前均升高,且试验组高于对照组(P<0.05)。治疗后两组每天总漏尿次数、1 h漏尿量均减少,且试验组少于对照组,临床总有效率高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论产后SUI采用益气升提散穴位敷贴联合电刺激疗法在增强盆底肌肌力、改善尿流动力学状态、减少漏尿方面效果显著,能提高患者生活质量,安全性高。

Objective To explore the therapeutic effect of Yiqishengtisan acupoint application combined with electrical stimulation on postpartum stress urinary incontinence(SUI).Methods 188 women with mild to moderate SUI who were treated in the TCM outpatient clinic of Tangshan Maternal and Child Health Hospital from January 2022 to May 2023 were randomly divided into control group(electrical stimulation therapy)and experimental group(Yiqishengtisan acupoint application combined with electrical stimulation therapy),with 94 cases in each group and a treatment course of 2 months.The clinical efficacy,pelvic floor muscle strength,urodynamic indexes,urinary leakage and quality of life were compared between the two groups,and the occurrence of adverse reactions was counted.Results Compared with before treatment,the scores of main disease,secondary disease and total TCM syndrome of the two groups decreased after treatment,and those in the experimental group were lower than the control group(P<0.05).After treatment,vaginal dynamic pressure,classⅠand classⅡmuscle fiber strength,negative pressure leakage point pressure(ALPP),maximum urethral closure pressure(MUCP),bladder compliance(BC)and urinary incontinence quality of life questionnaire(I-QOL)scores in both groups were higher than those before treatment,and the experimental group was higher than the control group(P<0.05).After treatment,the total number of urine leakage per day and 1 h of urine leakage in the two groups were reduced,and the experimental group was less than the control group,and the total clinical effective rate was higher than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion For postpartum SUI,Yiqishengtisan acupoint application combined with electrical stimulation has significant effects on enhancing pelvic floor muscle strength,improving urinary flow dynamics,reducing urinary leakage,and improving quality of life with high safety.