加减补中益气汤联合凯格尔训练对更年期压力性尿失禁患者盆底肌改善及生活质量的影响

Effects of Modified Buzhong Yiqi Decoction Combined with Kegel Training on the Improvement of Pelvic Floor Muscles and Quality of Life in Patients with Menopausal Stress Urinary Incontinence

目的探讨加减补中益气汤联合凯格尔训练对更年期压力性尿失禁(SUI)(肾气亏虚型)患者盆底肌改善及生活质量的影响。方法选取2020年1月—2021年12月临沂市中医医院收治的更年期SUI(肾气亏虚型)患者92例,按随机数字表法分为观察组(46例)和对照组(46例)。两组患者均给予常规干预加凯格尔训练,观察组在此基础上联合加减补中益气汤治疗。两组患者均连续治疗6周。比较两组患者治疗前后的24 h尿失禁次数、阴道收缩肌电值、阴道动态压力、阴道收缩持续时间、盆底功能障碍问卷简表(PFDI-20)评分、盆底功能影响问卷简表(PFIQ-7)评分、性功能评分及治疗期间的不良反应。结果与治疗前比较,治疗后两组患者的24 h尿失禁次数均减少(P<0.05),且观察组低于对照组(P<0.01);治疗后两组患者的阴道收缩肌电值、阴道动态压力,以及女性性功能指数(FSFI)量表各维度(性欲、性交疼痛、性交满意度、阴道润滑度、性高潮、性唤起功能)评分均升高(P<0.05),且观察组均高于对照组(P<0.01);治疗后两组患者的阴道收缩持续时间均延长(P<0.05),且观察组长于对照组(P<0.01);治疗后两组患者的PFDI-20评分、PFIQ-7评分均降低(P<0.05),且观察组均低于对照组(P<0.01)。结论应用加减补中益气汤联合凯格尔训练治疗更年期SUI(肾气亏虚型)患者,可有效改善盆底肌情况,促进盆底功能恢复,提高其性功能和生活质量,且安全性较高。

Objective To investigate the effect of modified Buzhong Yiqi Decoction combined with Kegel training on the improvement of pelvic floor muscles and quality of life in menopausal patients with stress urinary incontinence(SUI)(kidney qi deficiency type).Methods Ninety-two menopausal patients with SUI(kidney qi deficiency type)who were admitted to Linyi Traditional Chinese Medical Hospital from January 2020 to December 2021 were selected and divided into an observation group(46 cases)and a control group(46 cases)according to the random number table method.Both groups were given routine interventions.At the same time,the control group was additionally given Kegel training,and the observation group was given modified Buzhong Yiqi Decoction based on the control group.Both groups were treated for 6 consecutive weeks.The 24-hour urinary incontinence frequency,vaginal contraction electromyography,vaginal dynamic pressure,vaginal contraction duration,pelvic floor distress inventory short form-20(PFDI-20),and pelvic floor impact questionnaire short form-7(PFIQ-7)scores before and after treatment were compared between the two groups,and sexual life quality score and adverse reactions during treatment were compared between the two groups.Results Compared with that before treatment,the frequency of 24-h urinary incontinence in both groups decreased after treatment(P<0.05),and the frequency of the observation group was lower than that of the control group(P<0.01).After treatment,the vaginal contraction electromyography,vaginal dynamic pressure,and the scores of each dimension of the FSFI scale(sexual desire,sexual pain,sexual satisfaction,vaginal lubrication,orgasm,and sexual arousal function)of patients in the two groups increased(P<0.05),and the observation group was higher than the control group(P<0.01).After treatment,the duration of vaginal contraction in both groups was prolonged(P<0.05),and the duration in the observation group was longer than that in the control group(P<0.01).After treatment,the scores of PFIQ-20 and PFIQ-7 in the two groups decreased(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.01).Conclusion Modified Buzhong Yiqi Decoction combined with Kegel training in the treatment of menopausal patients with SUI(kidney qi deficiency type)can effectively improve the condition of pelvic floor muscles,promote the recovery of pelvic floor function,and improve sexual life and quality of life,with high safety.