升阳举陷法艾灸在肾阳虚型压力性尿失禁老年女性患者中的应用研究

Clinical study of elevating Yang moxibustion therapy in elderly female patients with stress urinary incontinence of kidney-Yang deficiency

目的 评价升阳举陷法艾灸在肾阳虚型压力性尿失禁老年女性患者中的应用效果。方法 采用方便抽样法,选取2019年9月-2021年5月在杭州市某三级甲等医院就诊的肾阳虚型压力性尿失禁老年女性患者80例作为研究对象,采用随机数字表法,分为试验组和对照组,每组各40例,试验组在盆底肌功能训练和膀胱功能训练的基础上实施升阳举陷法艾灸,对照组采取盆底肌功能训练和膀胱功能训练,疗程为12周,随访至第16周结束。比较两组日均尿失禁次数、1 h尿垫试验漏尿量、国际尿失禁咨询委员会问卷简表(International Consultation on Incontinence Questionnaire-short form,ICI-Q-SF)评分、中医证候评分。结果 治疗第12周,两组日均尿失禁次数比较,差异具有统计学意义(t=-3.794,P<0.001);试验组1 h尿垫试验漏尿量较治疗前的减少值大于对照组(Z=5.270,P<0.001),两组ICI-Q-SF评分(t=-3.297,P=0.001)、中医证候评分(t=-2.035,P<0.05)比较,差异均具有统计学意义(P<0.05)。治疗第16周,两组日均尿失禁次数、ICI-Q-SF评分、中医证候评分比较,差异均具有统计学意义(P<0.05)。两组在各时间点日均尿失禁次数(F_(组间)=4.282,F_(时间)=2.357,F_(交互)=5.689)、ICI-Q-SF比较评分(F_(组间)=11.918,F_(时间)=86.718,F_(交互)=36.155)、中医证候评分比较(F_(组间)=5.324,F_(时间)=190.594,F_(交互)=23.778),差异均具有统计学意义(P<0.05)。结论 升阳举陷法艾灸可减少肾阳虚型压力性尿失禁老年女性患者日均尿失禁次数及1 h尿垫试验漏尿量,降低ICI-Q-SF评分及中医证候评分,改善老年女性患者的尿失禁症状,提高老年女性患者的生活质量。

Objective To evaluate the application effect of elevating Yang moxibustion therapy in elderly female patients with stress urinary incontinence of kidney-Yang deficiency. Methods The elderly female patients with stress urinary incontinence in kidney-Yang deficiency were enrolled from a tertiary A hospital in Hangzhou between September 2019 and May 2021. By the random number table,they were divided into an experimental group(n=40)and a control group(n=40). The control group took pelvic floor muscle and bladder function training,the experimental group took the elevating Yang moxibustion on the basis of the control group for a course of 12 weeks,followed up to the 16 th week. The daily urinary incontinence frequencies,1-hour urine leakage from pad test,ICI-QSF score and TCM syndrome score of stress urinary incontinence in kidney-Yang deficiency were compared between the 2 groups. Results At the 12 th week of treatment,the difference in the number of daily incontinence between the 2 groups was statistically significant(t=-3.794,P<0.001);the decrease of urine leakage in 1-hour pad test in the experimental group was greater than that in the control group(Z=5.270,P<0.001);the ICI-Q-SF score(t=-3.297,P=0.001) and TCM syndrome score(t =-2.035,P <0.05) were compared between the 2 groups;the differences were statistically significant. At the 16 th week of treatment,there were statistically significant differences in the number of daily urinary incontinence,ICI-Q-SF score and TCM syndrome score between the 2 groups. There were statistically significant differences in the number of daily urinary incontinence,ICI-Q-SF score and TCM syndrome score between the 2 groups at each time point(P<0.05). Conclusion Moxibustion with elevating Yang method can reduce the daily frequencies of urinary incontinence and the urine leakage amount of 1-hour pad test in elderly female stress urinary incontinence patients with kidney-Yang deficiency,reduce the score of ICI-Q-SF and TCM syndrome score,thus improving the symptoms of urinary incontinence,and the quality of life of elderly female patients.