补中益气汤加味联合盆底肌肉锻炼-生物反馈-电刺激治疗产后早期盆底功能障碍性疾病的疗效研究

Effect of modified Buzhong Yiqi decoction combined with pelvic floor muscle exercise-biofeedback-electrical stimulation on early stage postpartum pelvic floor dysfunction

为探讨补中益气汤加味联合盆底肌肉锻炼-生物反馈-电刺激治疗初产妇产后早期盆底功能障碍性疾病（PFD）的疗效及其对TGF-β1,MMP-2,TIMP-2的影响。选取本院2014年3月—2016年12月期间收治的186例PFD患者,按照随机数字表法随机分为试验组与对照组,每组93例。对照组给予盆底肌肉锻炼-生物反馈-电刺激治疗,试验组在对照组基础上加用补中益气汤加味进行治疗,比较2组的临床疗效。结果表明,试验组治疗后1,3,6个月阴道收缩肌电值、阴道收缩持续时间、阴道动态压力及盆底肌电活动评分均显著高于对照组（P〈0.05）。试验组尿失禁改善有效率为97.14%,明显高于对照组的75.68%（P〈0.05）。试验组性生活质量改善有效率为96.43%,明显高于对照组的74.07%（P〈0.05）。试验组治疗后1,3,6个月子宫脱垂、后壁脱垂发生率及前壁脱垂等级略低于对照组,但差异不具有统计学意义。治疗后,试验组TGF-β1,TIMP-2水平高于对照组,而MMP-2水平低于对照组,差异具有统计学意义（P〈0.05）。由结果可知,对PFD患者采用补中益气汤加味联合盆底肌肉锻炼-生物反馈-电刺激治疗,可有效缓解患者临床症状,促进身体恢复,改善性生活质量,优势显著,值得推广。

To investigate the curative effect of modified Buzhong Yiqi decoction combined with pelvic floor muscle exercise-biofeedback-electrostimulation on early postpartum pelvic floor dysfunction disease（ PFD） and its effect on the expression of transforming growth factor（ TGF-β1）,matrix metalloprotein（ MMP-2）,and tissue inhibitor of metalloproteinase（ TIMP-2）. A total of 186 PFD patients admitted to our hospital from March 2014 to December 2016 were selected in the study and were randomly divided into test group（ n = 93） and control group（ n = 93）. The control group received pelvic floor muscle exercises-biofeedback-electrostimulation,while the test group was additionally treated with modified Buzhong Yiqi decoction based on the treatment in control group. Then the clinical efficacy was compared between two groups. The results showed that vaginal contractile electromyography（ EMG）,duration of vaginal constriction,dynamic vaginal pressure and pelvic floor myoelectric activity in the test group at 1,3 and 6 months after treatment were significantly higher than those before treatment and the control group（ P 0. 05）. The effective rate for urinary incontinence was 97.14% in test group,significantly higher than 75. 68% in the control group（ P 0. 05）. The effective rate for improvement of sexual life quality was 96. 43% in test group,significantly higher than 74. 07% in control group（ P 0. 05）. 1,3 and 6 months after treatment,the uterine prolapse,posterior wall prolapse and anterior wall prolapse grade in test group was slightly lower than that in the control group,but the difference was not statistically significant. After treatment,the levels of TGF-β1 and TIMP-2 in the test group were higher than those in the control group,while the levels of MMP-2 were lower than those in the control group（ P 0. 05）. The results showed that modified Buzhong Yiqi decoction combined with pelvic floor muscle exercise-biofeedback-electrostimulation can effectively relieve the clinical symptoms,promote the body recovery and improve the quality of sexual life in PFD patients,with remarkable advantages,so it is worthy of popularizing.