低强度体外冲击波在治疗膀胱过度活动症中的临床应用

Clinical application of low-intensity extracorporeal shock wave in the treatment of overactive bladder

目的探讨低强度体外冲击波在治疗膀胱过度活动症中的临应作用方法回顾性分析自2020年11月—2021年8月期间在新疆医科大学第一附属医院就诊的105例膀胱过度活动症患者资料。这些患者分别接受了低强度体外冲击波治疗(冲击波组,n=35)、M受体阻滞剂治疗(药物组,n=53)、低强度体外冲击波联合M受体阻滞剂治疗(联合组,n=17),收集患者在治疗结束及随访时填写的问卷资料,分析比较初诊时(W0),治疗4周(W4)、8周(W8)、随访1月(F1)、随访3月(F3)和随访6月(F6)时的问卷评分(膀胱过度活动症评分表、生活困扰问卷)。结果通过比较患者一般资料证实3组一般资料基线一致(P>0.05),具有组间可比性。对3组患者问卷评分进行统计,发现与W0相比,W4、W8、F1、F3、F6问卷评分发生显著变化(P<0.05),证实3组治疗方案均有疗效。在W4及W8时,药物组及冲击波组尿急分数和IIQ-7分数高于联合组(P<0.05)。F1时,冲击波组及联合组的尿急分数、OABSS分数、ICIQ-SF分数显著低于药物组(P<0.05),联合组IIQ-7分数、UDI-6分数显著低于冲击波组与药物组,而尿频分数则仅是冲击波组低于药物组,与联合组并无明显差异;F3时,药物组所有问卷评分均显著低于冲击波组与联合组(P<0.05);F6时,尿频分数、尿急分数、OABSS分数、ICIQ-SF分数、IIQ-7分数、UDI-6分数在冲击波组显著低于药物组,与联合组并无明显差异,而夜尿分数及尿失禁分数在冲击波组低于联合组和药物组。结论低强度体外冲击波作为一种新型的无创治疗方式,在改善OAB症状时具有良好的临床治疗效果。

Objective To explore the clinical role of low-intensity extracorporeal shock wave(LIESW)in the treatment of overactive bladder(OAB).Methods Clinical data of 105 OAB patients treated in our hospital during Nov.2020 and Aug.2021 were retrospectively analyzed.The patients were treated with LIESW(LIESW group,n=35),M-blocker(drug group,n=53),and LIESW combined with M-blocker(combined group,n=17),respectively.Questionnaires completed at the end of treatment were collected to compare information at the initial consultation(W0),4 weeks of treatment(W4),8 weeks of treatment(W8),1 month of follow-up(F1),3 months of follow-up(F3)and 6 months of follow-up(F6).Results The general data in the three groups were consistent at baseline(P>0.05)and comparable.Compared with the score at W0,the scores at W4,W8,F1,F3,and F6 were significantly higher(P<0.05),indicating the treatment in all three groups were effective.At W4 and W8,the urinary urgency scores and Incontinence Impact Questionnaire Short Form(IIQ-7)scores were higher in the drug and LIESW groups than in the combined group(P<0.05).At F1,urinary urgency scores,overactive bladder symptom score(OABSS),and International Consultation on Incontinence Questionnaire Short Form(ICIQ-SF)scores were significantly lower in the LIESW and combined groups than in the drug group(P<0.05);IIQ-7 scores and Urogenital Distress Inventory(UDI-6)scores were significantly lower in the combined group than in the other two groups;urinary frequency scores was significantly lower in the LIESW group than in the drug group,and there was no difference in the combined group.At F3,all above scores were significantly lower in the drug group than in the other two groups(P<0.05).At F6,urinary frequency scores,urinary urgency scores,OABSS scores,ICIQ-SF scores,IIQ-7 scores,and UDI-6 scores were significantly lower in the LIESW group than in the drug group,and were not significantly different in the combined group.The nocturia scores and incontinence scores were lower in the LIESW group than in the other two groups.Conclusion LIESW as a new non-invasive treatment modality has good clinical results in improving OAB symptoms.