经皮穴位电刺激联合盆底康复治疗女性轻、中度压力性尿失禁的临床研究

Clinical Study of Transcutaneous Acupoint Electrical Stimulation Combined with Pelvic Floor Muscle Training in the Treatment of Female Mild or Moderate Stress Urinary Incontinence

目的:探讨经皮穴位电刺激联合盆底康复治疗女性轻、中度压力性尿失禁(SUI)的临床疗效。方法:选取南宁市妇幼保健院2015年7月—2016年12月确诊的轻度和中度SUI女性患者90例。随机分为经皮穴位电刺激联合盆底康复治疗组(联合组),盆底康复治疗组,Kegel训练组,每组30例。经皮穴位选取中极穴,曲骨穴,会阴穴,双侧会阳穴,双侧中髎穴,双侧足三里穴,双侧三阴交穴进行电刺激。治疗6周后评估3组患者尿失禁改善情况(ICI-Q-SF问卷)、盆底肌肌力。结果:经ICI-Q-SF量表评估,3组患者的疗效比较差异有统计学意义(Z=6.872,P=0.032)。3组患者的总有效率比较差异有统计学意义(93.3%,73.3%,66.7%,χ~2=6.686,P=0.035)。3组患者在治疗前盆底肌力比较差异无统计学意义(Z=1.876,P=0.391);而治疗后3组患者的盆底肌力比较差异有统计学意义(Z=19.300,P=0.000)。联合组患者在治疗后正常尿意膀胱压测定容量(NDCC)、最大膀胱压测定容量(MCC)、漏尿点压(PVLP)和最大尿道闭合压(MCP)均高于盆底康复治疗组和Kegel训练组,差异有统计学意义(均P<0.05)。结论:经皮穴位电刺激联合盆底康复治疗女性轻、中度SUI疗效满意,较单一方案效果好,值得临床推广。

Objective:To investigate the clinical efficacy of percutaneous acupoint electrical stimulation combined with pelvic floor muscle training in the treatment of mild and moderate stress urinary incontinence in women. Methods:90 patients with mild and moderate stress urinary incontinence were enrolled in our department from July 2015 to December 2016. The patients were randomly divided into three groups. The patients were treated with transcutaneous acupoint electrical stimulation combined with pelvic floor muscle training group(combined group), rehabilitation group and pelvic floor muscle Kegel training group(training group). Using the middle hole, song bone hole, perineum hole, huiyang, zhongliao, zusanli and sanyinjiao holesfor electrical stimulation. After 6 weeks of treatment, three groups of patients improved urinary incontinence(ICI-Q-SF questionnaire), pelvic floor muscle strength. MVV, total urinary frequency(TOV) and total leakage events times(LT) were compared before and after treatment in groups. NDCC, MCC, PVLP and MCP were measured. Results:The ICI-Q-SF was used to evaluate the curative effect of three groups of patients( Z = 6. 872, P = 0. 032). The total effective rates in 3 groups were statistically significant(93.3%, 73.3%, 66.7%, χ~2=6.686, P=0.035). There was no significant difference in pelvic floor muscle strength between the three groups before treatment( Z=1.876, P=0.391), while there was significant difference in pelvic floor muscle strength between the three groups after treatment( Z=19.300, P=0.000). In the combined group, the normal urinary bladder pressure test(NDCC), maximum bladder pressure test(MCC), urinary bladder leak pressure(PVLP) and maximal urethral closure pressure(MCP) were significantly higher than those of the pelvic floor rehabilitation group and Kegel training group(all P<0.05). Conclusions:Transcutaneous acupoint electrical stimulation combined with pelvic floor muscle training is effective in the treatment of mild and moderate stress urinary incontinence in women, which is better than that of single program.