电温针背俞穴联合盆底肌锻炼治疗脾肾阳虚型女性压力性尿失禁的临床观察

Clinical Observation on Electrothermic-Needling Moxibustion on Back-shu Points Combined with Pelvic Floor Muscle Exercise in Treating Female Stress Urinary Incontinence with Spleen-kidney Yang Deficiency Type

【目的】观察电温针背俞穴联合盆底肌锻炼治疗脾肾阳虚型女性压力性尿失禁的临床疗效。【方法】将60例脾肾阳虚型女性压力性尿失禁患者随机分为治疗组和对照组,每组各30例。对照组患者给予盆底肌锻炼治疗,治疗组患者在对照组治疗基础上给予电温针背俞穴(双侧脾俞、胃俞、肾俞、三焦俞)治疗,4周为1个疗程,连续治疗3个疗程。观察2组患者治疗前后1 h尿垫试验漏尿量和尿失禁影响问卷(IIQ-7)评分的变化情况,并评价2组患者的临床疗效。【结果】(1)治疗12周后,治疗组尿失禁症状的改善总有效率为90.0%(27/30),对照组为63.3%(19/30),组间比较,治疗组的总有效率和总体疗效均优于对照组,差异均有统计学意义(P<0.05)。(2)治疗后,2组患者1 h尿垫试验漏尿量均较治疗前明显减少,IIQ-7评分均较治疗前明显降低(P<0.05),且治疗组的1h尿垫试验漏尿量明显少于对照组,IIQ-7评分明显低于对照组,差异均有统计学意义(P<0.05)。【结论】电温针背俞穴联合盆底肌锻炼能有效治疗女性压力性尿失禁。

Objective To observe and evaluate the therapeutic effect of electrothermic-needling moxibustion on back-shu points combined with pelvic floor muscle exercise in treating female stress urinary incontinence with spleen-kidney yang deficiency type. Methods Sixty patients with spleen-kidney yang deficiency type of female stress urinary incontinence were randomly divided into treatment group(30 cases)and control group(30 cases).The control group was given pelvic floor muscle exercise 3 times per day,and the treatment group was given pelvic floor muscle exercise combined with electrothermic-needling moxibustion on back-shu points of bilateral Pishu(BL20),Weishu(BL21),Shenshu(BL23),and Sanjiaoshu(BL22). Four weeks constituted one course of treatment,and the treatment for the two groups covered 3 courses. Before and after treatment, the urine leakage volume evaluated with one-hour urinary pad test and the scores of incontinence impact questionnaire(IIQ-7)in the two groups were observed, and then the clinical efficacy was compared between the two groups. Results(1)After treatment for 12 weeks, the total effective rate for the relief of urinary incontinence symptoms in the treatment group was 90.0%(27/30),and that in the control group was 63.3%(19/30). The intergroup comparison showed that the total effective rate and the overall efficacy of the treatment group were superior to those of the control group,the differences being statistically significant(P<0.05).(2)After treatment, the amount of urine leakage evaluated with one-hour urinary pad test in both groups was significantly reduced and the IIQ-7 scores were decreased as compared with those before treatment(P<0.05),and the urine leakage volume and IIQ-7 scores in the treatment group were significantly less than those in the control group, the difference being statistically significant(P < 0.05). Conclusion Electrothermic-needling moxibustion on back-shu points combined with pelvic floor muscle exercise exert certain effect for the treatment of female stress urinary incontinence.