经皮胫神经电刺激治疗对国人女性药物难治性膀胱过度活动症的临床疗效

Posterior Tibial Nerve Stimulation in the Management of Drug-resistant Overactive Bladder for Chinese Women :A Prospective and Controlled Study

[目的]观察经皮胫神经电刺激(percutaneous tibial nerve stimulation,PTNS)治疗国人女性药物难治性膀胱过度活动症(overactive bladder,OAB)的疗效。[方法]将128例国人女性OAB患者随机分成两组,分别采用PTNS(每周1次)、口服M受体阻滞剂(酒石酸托特罗定2mg,2次/d),共持续3个月,观察治疗前后OAB症状评分、日排尿次数、日尿失禁次数等指标并对M受体药物治疗组疗效不满意的25例患者行PTNS治疗。[结果]M受体组、PTNS组治疗前后组内患者在OAB症状评分、日排尿次数和日尿失禁次数上均有显著性改善(P<0.05),但在M受体组和PTNS组间OAB症状评分、日排尿次数和日尿失禁次数在治疗改善上均无显著性差异(P>0.05)。25例药物难治性OAB患者OAB症状评分由PTNS治疗前的(25.4±4.9)下降到治疗结束后的(17.2±3.1),前后差异有统计学意义(P<0.05)。[结论]PTNS治疗可显著改善国人女性OAB患者的排尿功能障碍,对于药物治疗无效或者疗效不满意的患者再行PTNS治疗也是可行有效的。

[Objective] To analyze the clinical efficacy of posterior tibial nerve stimulation（PTNS） for Chinese female patients with overactive bladder . [Methods] 128 overactive bladder（OAB） Chinese female patients were randomly divided into two groups. The PTNS group ：patients were received posterior tibial nerve stimulation therapy once a week for 12 weeks（n=63）.The M receptor blockers group：patients were received M receptor blockers（Tolterodine Tartrate Tablets 2mg, 2 times per day ） for 12weeks（n=65）.And 25 patients who failed in M receptor blockers group received posterior tibial nerve stimulation therapy once a week for 12 weeks. Al the patients underwent a physiotherapeutic evaluation that included the overactive bladder questionnaire（OAB-q）, micturition number per day and urinary incontinence number per day before and after treatment. [Result] The overactive bladder questionnaire（OAB-q） score, micturition number per day and urinary incontinence number per day declined significantly before and after treatment in each group. There were no significant differences in OAB-q score between PTNS group and M receptor blockers group. After the subsequent posterior tibial nerve stimulation, the overactive bladder questionnaire（OAB-q） score, micturition number per day and urinary incontinence number per day declined significantly in the 25 patients group who failed in M receptor blockers group. [Conclusion] Posterior tibial nerve stimulation（PTNS） provides good therapeutic effect for female primary overactive bladder and improves quality of life of patients. And the posterior tibial nerve stimulation therapy wil be a viable option in the drug-resistant overactive bladder（OAB） Chinese female patients.