补中益气汤、盆底肌训练联合心理指导对子宫切除术术后患者盆底肌张力的影响

Effect of Buzhong Yiqi Decoction and pelvic floor muscle training combined with psychological guidance on pelvic floor muscle tension in patients undergoing hysterectomy

目的观察补中益气汤、盆底肌训练联合心理指导对子宫切除术术后患者盆底肌张力的影响。方法将190例宫腔镜子宫切除术术后患者随机分为2组。对照组98例术后予补中益气汤治疗,治疗组92例在对照组基础上加盆底肌训练结合心理指导。2组均4周为1个疗程,连续3个疗程后比较2组临床疗效。比较2组治疗前后盆底功能盆底肌最大收缩压、收缩持续时间及阴道肌电压、女性性功能指数(FSFI)评分,观察2组治疗1个月内尿潴留发生率。结果治疗组总有效率97.83%(90/92),对照组总有效率88.78%(87/98),治疗组总有效率高于对照组(P<0.05)。治疗后,2组盆底肌最大收缩压、收缩持续时间、阴道肌电压、FSFI评分均高于本组治疗前(P<0.05),且治疗组均高于对照组(P<0.05)。治疗组尿潴留发生率5.43%(5/92),对照组尿潴留发生率24.49%(24/98),治疗组尿潴留发生率低于对照组(P<0.05)。结论补中益气汤、盆底肌训练联合心理指导能有效改善子宫切除术术后患者盆底肌张力,提高患者性生活质量,减少尿潴留的发生。

Objective To observe the effect of Buzhong Yiqi Decoction,pelvic floor muscle training(PFMT)combined with psychological guidance on pelvic floor muscle tension in patients undergoing hysterectomy.Methods Totally 190 patients undergoing hysterectomy were randomly assigned to receive either Buzhong Yiqi Decoction(the control group,n=98)or Buzhong Yiqi Decoction+PFMT+psychological guidance(the treatment group,n=92).The treatment continued for 3 courses(1 course for 4 weeks).The maximum systolic pressure and duration of pelvic floor muscle,vaginal muscle voltage,female sexual function index(FSFI)were included as comparators.The incidence of urinary retention on month 1 and the curative effect were assessed.Results The overall effective rate in the treatment group was better than that in the control group(97.83%[90/92]vs 88.78%[87/98],[P<0.05],respectively).After treatment,maximum systolic pressure and duration of pelvic floor muscle,vaginal muscle voltage,FSFI score in the two groups were significantly increased(P<0.05),which in the treatment group were significantly higher than those in the control group(P<0.05).The incidence of urinary retention was lower in the treatment group(5.43%[5/92])compared with the control group(24.49%[24/98]),(P<0.05).Conclusion For patients undergoing hysterectomy,Buzhong Yiqi Decoction,PFMT combined with psychological guidance can effectively improve pelvic floor muscle tension and quality of sexual life,and reduce urinary retention.