压灸足运感区联合盆底肌肉训练对中风后尿失禁患者临床症状、膀胱残余尿量及生活质量的影响

Effects of foot massage and pelvic floor muscle training on clinical symptoms,residual urine volume of bladder and quality of life of patients with urinary incontinence after stroke

目的:观察压灸足运感区联合盆底肌肉训练对中风后尿失禁患者临床症状、膀胱残余尿量及生活质量的影响。方法:将90例中风后尿失禁患者采用奇偶数分组法分为对照组(n=42)和观察组(n=48)。对照组给予盆底肌肉训练,观察组在盆底肌肉训练基础上给予压灸足运感区。比较两组排尿情况、临床症状评分、尿流动力学指标、尿失禁生活质量量表(I-QOL)评分、日常生活活动能力量表(ADL)评分的差异,并记录两组疗效。结果:两组治疗前排尿情况、尿流动力学比较,差异无统计学意义(P>0.05)。与治疗前比较,两组白天和夜间排尿次数、膀胱残余尿量治疗后降低,且观察组更低(P<0.05);两组最大尿流量(MFR)、尿量(TV)、平均单次尿量、相对排尿阻力(RVR)治疗后升高,且观察组更高(P<0.05)。两组治疗前I-QOL评分、临床症状评分、ADL评分比较,差异无统计学意义(P>0.05)。与治疗前比较,两组ADL评分、I-QOL总分及其3个维度评分治疗后升高,且观察组更高(P<0.05)。两组临床症状评分治疗后降低,且观察组更低(P<0.05)。观察组总有效率为91.67%(44/48),高于对照组的76.19%(32/42),差异有统计学意义(P<0.05)。结论:压灸足运感区联合盆底肌肉训练可减轻中风后尿失禁临床症状,改善尿流动力学,促进膀胱功能恢复,提高患者生活质量。

Objective:To observe the effect of foot massage combined with pelvic floor muscle training on the clinical symptoms,bladder residual urine volume and quality of life of patients with urinary incontinence after stroke.Methods:90 cases of post stroke urinary incontinence were divided into the control group(n=42)and the observation group(n=48)by odd even number grouping method.The control group was given pelvic floor muscle training,and the observation group was given foot movement sensation area by pressing moxibustion on the basis of pelvic floor muscle training.The differences of urination diary,clinical symptom score,urodynamic index,urinary incontinence quality of life scale(I-QOL)score and activity of daily living scale(ADL)score between the two groups were compared,and the curative effects of the two groups were recorded.Results:There was no significant difference in urination diary and urodynamics between the two groups before treatment(P>0.05).Compared with that before treatment,the diurnal and nocturnal micturition frequency and bladder residual urine volume in the two groups decreased after treatment,and lower in the observation group(P<0.05).The maximum urine flow(MFR),urine volume(TV),average single urine volume,and relative urinary resistance(RVR)in the two groups increased after treatment,and were higher in the observation group(P<0.05).There was no significant difference in I-QOL score,clinical symptom score and ADL score between the two groups before treatment(P>0.05).Compared with that before treatment,ADL score,total I-QOL score and its three dimension scores in the two groups increased after treatment,and higher in the observation group(P<0.05).The clinical symptom score of the two groups decreased after treatment,and that of the observation group was lower(P<0.05).The total effective rate in the observation group was 91.67%(44/48),higher than 76.19%(32/42)in the control group,with a statistical difference(P<0.05).Conclusion:Moxibustion foot movement sensation area combined with pelvic floor muscle training can reduce the clinical symptoms of urinary incontinence after stroke,improve urodynamics,promote the recovery of bladder function,and improve the quality of life of patients.