仿生物电刺激联合认知行为疗法对女性压力性尿失禁患者的效果评价

Effect evaluation of biomimetic electrical stimulation combined with cognitive-behavioral therapy on female patients with stress urinary incontinence

目的观察仿生物电刺激联合认知行为疗法对女性压力性尿失禁(SUI)患者的效果。方法本研究为前瞻性随机对照研究。选取2019年3月至2023年6月北京大学第三医院收治的160例女性SUI患者为研究对象,采用随机数字表法分为观察组和对照组,各80例。对照组给予单纯认知行为疗法干预,观察组在对照组基础上增加盆底仿生物电刺激治疗,均干预8周。比较2组干预前后的盆底功能超声指标、盆底肌电值、尿失禁问卷简表(ICI-Q-SF)评分、焦虑自评量表(SAS)评分和抑郁自评量表(SDS)评分,并比较干预后2组总有效率。结果研究过程中,对照组脱落1例,观察组脱落3例,最终对照组79例、观察组77例完成本研究。干预后,2组膀胱尿道后角、膀胱颈移动度、ICI-Q-SF、SAS和SDS评分均小于/低于干预前且观察组均小于/低于对照组,盆底快速收缩阶段、持续收缩阶段和耐力收缩阶段肌电值均高于干预前且观察组均高于对照组(均P<0.05)。干预后,观察组总有效率明显高于对照组[97.4%(75/77)比88.6%(70/79)](P<0.05)。结论仿生物电刺激联合认知行为疗法可有效改善女性SUI患者的盆底功能,减少尿失禁症状和负面情绪。

Objective To observe the effect of biomimetic electrical stimulation combined with cognitive-behavioral therapy on female patients with stress urinary incontinence(SUI).Methods This study was a prospective randomized controlled study.A total of 160 patients with female SUI admitted to Peking University Third Hospital from March 2019 to June 2023 were selected as the research objects,and they were divided into observation group and control group by random number table method,with 80 cases in each group.The control group was treated with cognitive-behavioral therapy(CBT),and the observation group was given bionic electrical stimulation of pelvic floor on the basis of the control group.The intervention lasted for 8 weeks.The pelvic floor functional ultrasound indicators,pelvic floor electromyography values,scores of urinary incontinence questionnaire brief form(ICI-Q-SF),self-rating anxiety scale(SAS),and self-rating depression scale(SDS)were compared between the two groups before and after the intervention.The total effective rate was compared between the two groups after the intervention.Results During the research process,one case in the control group and three cases in the study group were lost.Finally,79 cases in the control group completed the study,and 77 cases in the observation group completed this research.After intervention,bladder urethral posterior angle and bladder neck mobility,scores of ICI-Q-SF,SAS and SDS in both groups were less/lower than before intervention,and those in the observation group were less/lower than those in the control group,the electromyographic values during the rapid contraction stage,sustained contraction stage,and endurance contraction stage of the pelvic floor were all higher than before intervention,and those in the observation group were higher than those in the control group(all P<0.05).After intervention,the total effective rate of the observation group was significantly higher than that of the control group[97.4%(75/77)vs 88.6%(70/79)](P<0.05).Conclusion The combination of biomimetic electrical stimulation and cognitive-behavioral therapy can effectively improve pelvic floor function,reduce urinary incontinence symptoms and negative emotions in female patients with SUI.