补中益气汤联合盆底肌锻炼治疗经尿道前列腺切除术后尿失禁的效果

Effect of Buzhong Yiqi Decoction combined with pelvic floor exercise on urinary incontinence after transurethral resection of the prostate

目的观察补中益气汤联合盆底肌锻炼治疗经尿道前列腺切除术(TURP)后发生尿失禁的临床效果.方法以本院2016年2月至2018年6月收治的60例TURP后发生暂时性尿失禁患者为研究对象.采取抽纸条方式将其随机分为A、B、C组(每组20例),A组患者术后给予常规抗感染治疗不做特殊处理,B组患者采取盆底肌锻炼法,C组患者给予补中益气汤结合盆底肌锻炼法治疗.对比三组患者的尿失禁问卷表简表(ICI-Q-SF)评分、不同节点尿动力学指标(最大尿流率、残余尿量、最大尿道闭合压与最小漏尿点腹压)、临床治疗效果及纽芬兰纪念大学幸福度量表(MUNSH)评分.结果三组治疗前的ICI-Q-SF、MUNSH评分比较,差异均无统计学意义(均P>0.05);治疗后,三组的ICI-Q-SF评分均下降,MUNSH评分均升高(均P<0.001);C组的ICI-Q-SF评分低于A组与B组,B组低于A组(均P<0.001);C组的MUN-SH评分高于A组与B组,B组高于A组(均P<0.001).治疗后,C组的最大尿流率低于A与B组,残余尿量、最大尿道闭合压与最小漏尿点腹压均高于A与B组(均P<0.05);B组的最大尿流率低于A组,残余尿量、最大尿道闭合压与最小漏尿点腹压均高于A组(均P<0.05).C组的临床治疗有效率高于A组与B组,B组高于A组(均P<0.05).结论补中益气汤联合盆底肌锻炼治疗TURP术后尿失禁的效果更好,能够提高患者幸福感,改善患者尿动力学指标.

Objective To observe the clinical effect of Buzhong Yiqi Decoction combined with pelvic floor muscle exercise in the treatment of patients with urinary incontinence after transurethral resection of the prostate(TURP).Methods Sixty patients with transient urinary incontinence after TURP who were admitted to our hospital from February 2016 to June 2018 were selected as the research objects.The patients were randomly divided into three groups(20 cases in each group)by drawing paper strips.Patients in group A received conventional anti-infection therapy without special treatment,patients in group B received pelvic floor muscle exercise,and patients in group C received Buzhong Yiqi Decoction combined with pelvic floor muscle exercise.The urinary incontinence questionnaire(ICI-Q-SF)scores,urodynamic indicators of different nodes(maximum urine flow rate,residual urine volume,maximum urethral closure pressure and minimum leakage point abdominal pressure),clinical effect and the score of the memorial university of Newfoundland happiness scale(MUNSH)of the three groups of patients were compared.Results ICI-Q-SF and MUNSH scores of the three groups before treatment had no statistical significance(all P>0.05).After treatment,ICI-Q-SF score was decreased and MUNSH score was increased in all three groups(all P<0.001).ICI-Q-SF score of group C was lower than that of group A and group B,and that of group B was lower than that of group A(all P<0.001).MUNSH score of group C was higher than that of group A and group B,and group B was higher than that of group A(all P<0.001).After treatment,the maximum urine flow rate in group C was lower than that in groups A and B,and the residual urine volume,the maximum urethral closure pressure and the abdominal pressure at the miiumum urine leakage point were higher than those in groups A and B(all P<0.05).The maximum urine flow rate in group B was lower than that in group A,and the residual urine volume,the maximum urethral closure pressure and the abdominal pressure at the minimum urine leakage point were higher than those in group A(all P<0.05).The clinical effective rate of group C was higher than that of group A and group B,and group B was higher than that of group A(all T9<0.05).Conclusions Buzhong Yiqi Decoction combined with pelvic floor muscle exercise has a better effect on the treatment of urinary incontinence after TURP,which can improve the well-being of patients and improve the urodynamic indicators of patients.