热敏灸联合补中益气颗粒治疗围绝经期压力性尿失禁临床观察

Clinical observation on treatment of perimenopausal stress urinary incontinence with heat sensitive moxibustion and Buzhong Yiqi granule

目的 评价热敏灸联合补中益气颗粒治疗围绝经期压力性尿失禁的临床疗效。方法 将2019年9月—2021年6月河北省中医院收治的52例围绝经期压力性尿失禁患者采用随机数字表法分为对照组和热敏灸组各26例。对照组口服补中益气颗粒并进行盆底功能锻炼,热敏灸组在对照组治疗基础上联合腰腹部热敏灸治疗(隔日1次),2组疗程均为2个月。观察2组患者治疗前后1 h尿垫试验漏尿量、24 h漏尿次数、尿失禁问卷简表(ICIQ-SF)评分、中医症状积分及盆底三维彩超指标(肛提肌裂孔面积、膀胱颈移动度、尿道旋转角度),比较2组临床总有效率。结果 2组治疗后1 h尿垫试验漏尿量、24 h漏尿次数、ICIQ-SF评分、中医症状积分均明显低于治疗前(P均<0.05),且热敏灸组均明显低于对照组(P均<0.05)。2组患者治疗后肛提肌裂孔面积、膀胱颈移动度、尿道旋转角度均较治疗前明显减小(P均<0.05),且热敏灸组均明显小于对照组(P均<0.05)。热敏灸组临床疗效总有效率为95.83%(23/24),对照组为80.00%(20/25),热敏灸组明显高于对照组(P<0.05)。结论 热敏灸联合补中益气颗粒治疗围绝经期压力性尿失禁,可明显减轻患者的漏尿症状,改善患者的盆底结构及功能。

Objective It is to evaluate the clinical efficacy of heat sensitive moxibustion combined with Buzhong Yiqi granules in the treatment of perimenopausal stress urinary incontinence.Methods Fifty-two patients with perimenopausal stress urinary incontinence admitted to Hebei Provincial Hospital of Traditional Chinese Medicine from September 2019 to June 2021 were randomly divided into heat sensitive moxibustion group and control group,with 26 cases in each group.The control group was treated with Buzhong Yiqi granule orally and pelvic floor functional exercise,the heat sensitive moxibustion group was treated with lumbar and abdominal heat sensitive moxibustion on the basis of treatment in the control group(once every other day).The course of treatment in both groups was 2 months.Before and after treatment,the leakage volume of urine pad test in one hour,the leakage frequency in 24 hours,the score of the short form of incontinence questionnaire(ICIQ-SF),the score of TCM symptoms and the three-dimensional color ultrasound indicators of the pelvic floor(area of levator ani fissure,bladder neck mobility,urethral rotation angle)were observed and compared between the two groups,the total clinical effective rate of the two groups was compared.Results After treatment,the leakage volume of urine pad test within one hour,the leakage frequency of urine in 24 hours,the score of ICIQ-SF and the score of TCM symptoms in both groups were significantly lower than those before treatment(all P<0.05),and the indexes in the heat sensitive moxibustion group were significantly lower than those in the control group(all P<0.05).After treatment,the area of levator ani fissure,bladder neck mobility,urethral rotation angle in both groups were significantly reduced compared with those before treatment(all P<0.05),and those in the heat sensitive moxibustion group were significantly smaller than those in the control group(all P<0.05).The total effective rate was 95.83%(23/24)in the heat sensitive moxibustion group and 80.00%(20/25)in the control group,the rate in the heat sensitive moxibustion group was significantly higher than that in the control group(P<0.05).Conclusion Heat sensitive moxibustion combined with Buzhong Yiqi granule can significantly relieve the symptoms of urine leakage and improve the pelvic floor structure and function of patients with perimenopausal stress urinary incontinence.