生物反馈电刺激联合米拉贝隆治疗女性膀胱过度活动症的疗效观察

Observation on the curative effect of biofeedback electrical stimulation combined with mirabegron in the treatment of female overactive bladder

目的探讨生物反馈电刺激联合米拉贝隆治疗女性膀胱过度活动症(OAB)患者的疗效。方法选取2019年10月至2021年7月在本院收治的120例女性OAB患者,根据数字表法将患者分为联合组和单药组,每组各60例。联合组应用生物反馈电刺激联合β3受体激动剂米拉贝隆(25 mg,1次/d)治疗,单药组应用米拉贝隆(50 mg,1次/d)治疗。观察并比较两组患者的膀胱过度活动症状评分(OABSS)(包括白天排尿、夜尿、尿急、急迫性尿失禁次数)、女性性功能指数评分(FSFI)(包括性欲、性唤起、阴道润滑、性高潮、性交疼痛、性满意评分)、最大尿流率(Q_(max))、膀胱残余尿量(PVR)。结果治疗4周后,两组患者的白天排尿次数、夜尿次数、尿急次数、尿失禁次数、OABSS评分较治疗前明显减少,而Qmax较治疗前增加,性欲、性唤起、阴道润滑度、性满意度较治疗前明显改善,差异均有统计学意义(均P<0.05);联合组患者的白天排尿次数、夜尿次数、尿急次数、尿失禁次数、OABSS评分、Q_(max)、性欲、性唤起、阴道润滑度、性满意度较单药组改善显著,差异均有统计学意义(均P<0.05)。两组的PVR、性交疼痛、性高潮评分较治疗前相比,差异均无统计学意义(均P>0.05)。治疗2周后,联合组患者的白天排尿次数、夜尿次数、尿急次数、尿失禁次数、OABSS评分、Q_(max)较治疗前改善明显,差异均有统计学意义(均P<0.05),而单药组仅尿急次数较治疗前减少(P<0.05)。联合组的总有效率(91.7%)明显高于单药组(71.7%),差异有统计学意义(P<0.01)。结论生物反馈电刺激联合米拉贝隆不仅可以促进女性OAB患者膀胱功能的恢复,明显改善排尿症状,还能有效提高性生活质量,较米拉贝隆单药治疗效果更好,适合临床推广。

Objective To explore the efficacy of biofeedback electrical stimulation combined with Mirabelone in the treatment of female patients with overactive bladder(OAB).Methods A total of 120 female patients with OAB admitted to our hospital from October 2019 to July 2021 were selected and divided into combination group and monotherapy group according to numerical table method,with 60 cases in each group.The combination group was treated with biofeedback electrical stimulation combined withβ3 agonist Mirabelone(25 mg once a day),while the monotherapy group was treated with Mirabelone(50 mg once a day).The overactive bladder symptom score(OABSS)(daytime urination,nocturnal urination,urgency of urination,and frequency of urge incontinence),female sexual function index(FSFI)(sexual desire,arousal,vaginal lubrication,orgasm,pain during intercourse,and sexual satisfaction score),maximum urinary flow rate(Q_(max)),and residual urinary volume(PVR)of the two groups were observed.Results After 4 weeks of treatment,the number of daytime urination,night urination,urgent urination,urinary incontinence and OABSS score in 2 groups were significantly reduced compared with before treatment,while Q_(max)was increased,sexual desire,sexual arousal,vaginal lubrication and sexual satisfaction were significantly improved compared with before treatment,with statistical significance(all P<0.05).Compared with the single drug group,the number of daytime urination,night urination,urgent urination,urinary incontinence,OABSS score,Qmax,sexual desire,sexual arousal,vaginal lubrication and sexual satisfaction in the combination group were significantly improved(all P<0.05).There were no significant differences in PVR,pain during intercourse and orgasm scores between the two groups compared with those before treatment(all P>0.05).After 2 weeks of treatment,the number of daytime urination,night urination,urgent urination,urinary incontinence,OABSS score and Q_(max)of patients in the combined treatment group were significantly improved compared with before treatment,with statistical significance(all P<0.05),while the number of urgent urination in the single treatment group was reduced compared with before treatment(P<0.05).The total effective rate of combination group(91.7%)was significantly higher than that of monotherapy group(71.7%),and the difference was statistically significant(P<0.01).Conclusions Biofeedback electrical stimulation combined with Mirabelone can not only promote the recovery of bladder function in female patients with OAB,significantly improve the symptoms of urinate,but also effectively improve the quality of sex life,which is better than Mirabelone single drug treatment,suitable for clinical promotion.