中药督脉熏蒸联合生物反馈训练对产后盆底功能障碍患者盆底肌肌力及尿动力学的影响

Effects of traditional Chinese medicine fumigation on Du meridian combined with biofeedback training on pelvic floor muscle strength and urodynamics in patients with postpartum pelvic floor dysfunction

目的:观察中药督脉熏蒸联合生物反馈训练治疗产后盆底功能障碍(PPFD)的效果。方法:选取PPFD患者180例,依照随机数字表法分为中药熏蒸组(A组)、生物反馈训练组(B组)、联合治疗组(C组)3组,每组60例。3组均给予常规治疗,即凯格尔运动法及阴道哑铃盆底肌肉锻炼。在常规治疗基础上A组再给予中药督脉熏蒸治疗;B组再给予生物反馈训练;C组再给予中药督脉熏蒸联合生物反馈训练,均治疗8周。治疗前后比较3组患者的盆底肌肌力、尿动力学、盆底神经肌电生理指标、盆底功能障碍影响问卷简版(PFIQ-7)、盆底症状影响量表简版(PFDI-20)、盆腔器官脱垂与尿失禁性功能问卷简版(PISQ-12)评分。结果:治疗后,3组患者的盆底肌肌力正常率、尿道最大闭合压力(MUCP)、功能尿道长度(FUL)、膀胱顺应性(BC)、应力性漏尿点压力(SLPP)、快肌收缩最大值、10s慢肌收缩平均值、PISQ-12评分均高于治疗前(P<0.05),且C组高于A组、B组(P<0.05);3组患者PFIQ-7、PFDI-20均低于治疗前(P<0.05),且C组低于A组、B组(P<0.05)。结论:中药督脉熏蒸联合生物反馈训练可减轻PPFD相关症状,改善PPFD患者盆底功能、性功能。

Objective:To observe the effect of traditional Chinese medicine fumigation on Du meridian combined with biofeedback training on postpartum pelvic floor dysfunction(PPFD).Methods:A total of 180 patients with PPFD were collected and divided into three groups using a random number table method:A,B and C.All three groups were given routine treatment for 8 weeks,including Kegel exercise 3 times a day and vaginal dumbbell pelvic floor muscle exercise once a day.In group A,Chinese medicine fumigation on Du meridian was given on the basis of conventional treatment.In group B,the biofeedback training was given on the basis of routine treatment.In group C,the combined treatment was given.Pelvic floor muscle strength,urodynamics,pelvic floor neuromuscular electrophysiological indicators,pelvic floor dysfunction impact questionnaire(PFIQ-7),pelvic floor symptom impact questionnaire(PFDI-20),and pelvic organ prolapse and urinary incontinence function questionnaire(PISQ-12)were compared.Results:After treatment,the normal rate of pelvic floor muscle strength,maximum urethral closure pressure(MUCP),functional urethral length(FUL),bladder compliance(BC),stress leakage point pressure(SLPP),maximum fast muscle contraction,average 10-s slow muscle contraction,and PISQ-12 in all three groups were significantly higher than before treatment(P<0.05),and those in group C were significantly higher than those in group A and group B(P<0.05).After treatment,the PFIQ-7 and PFDI-20 of the three groups were lower than before treatment(P<0.05),and those in group C were lower than in group A and group B(P<0.05).Conclusion:Traditional Chinese medicine fumigation on Du meridian combined with biofeedback training can improve pelvic floor muscle strength,urodynamics,pelvic floor neuromuscular electrophysiological indicators,pelvic floor function,sexual function of patients with PPFD,and alleviate PPFD related symptoms.