仿生物电刺激治疗不同中医证型女性压力性尿失禁的疗效分析

Analysis on the curative effect of biomimetic electrical stimulation in treatment of different syndromes of TCM of female stress urinary incontinence

目的：探讨盆底康复治疗对不同中医证型（如肾气亏虚型、气血亏虚型及湿热下注型）压力性尿失禁的临床疗效。方法：选取长沙市院2013年1月-2013年10月收治的轻、中度女性压力性尿失禁患者89例,按中医不同证型分为肾气亏虚型组、气血亏虚型组及湿热下注型组,给予1个疗程盆底康复治疗（电刺激＋生物反馈治疗）;采用尿失禁问卷调查、盆底肌力检测和修改的会阴肌肉测试法,对研究对象按标准进行调查和评估,治疗结束后再次评价盆底肌力提升情况、症状改善率及治疗后6个月内的复发率,对比各组的治疗效果。结果：89例患者无失访,总满意率为88.7%,3组压力性尿失禁患者治疗前后比较,差异有统计学意义（P〈0.05）,其中气血亏虚型组尿失禁的症状改善率明显高于其他两组（P〈0.05）;但3组患者治疗后6个月内的复发率比较,差异无统计学意义（P〉0.05）。结论：盆底康复治疗对不同中医证型女性压力性尿失禁的治疗疗效显著,具有无创、安全、简便等优点,值得临床推广。

Objective： To explore the clinical effect of pelvic floor rehabilitation for different syndromes of TCM（ such as kidneyQi deficiency type,Qi-blood deficiency type,and downward flow of dampness and heat type） of female stress urinary incontinence（ SUI）.Methods： Eighty-nine female patients with mild and moderate SUI treated in the hospital from January 2013 to October 2013 were selected and divided into kidney-Qi deficiency type group,Qi-blood deficiency type group,and downward flow of dampness and heat type group according to different syndromes of TCM,pelvic floor rehabilitation（ electrical stimulation and biological feedback therapy） was conducted for one course of treatment; SUI questionnaire,pelvic floor muscle strength test,and modified perineal muscle test were used to survey and assess the study respondents; after treatment,the improvement of pelvic floor muscle strength,improvement rate of symptoms,and recurrence rate within six months after treatment were reevaluated,the curative effects in different groups were compared. Results： None of the 89 patients was lost to follow-up,the total satisfaction rate was 88. 7%,there were statistically significant differences in the satisfaction rates between before and after treatment in the three groups（ P 〈0. 05）,the improvement rate of symptoms in Qi-blood deficiency type group was statistically significantly higher than those in the other two groups（ P〈0. 05）; but there was no statistically significant difference in the recurrence rate within six months after treatment among the three groups（ P〉0. 05）. Conclusion： The curative effect of pelvic floor rehabilitation in treatment of different syndromes of TCM of female SUI is significant,which has the advantages of noninvasion,safety,and convenience,the method is worthy of clinical promotion.