芒针透刺结合电针及盆底肌训练对产后压力性尿失禁患者盆腔功能的影响

Influence of Thorny Needle Penetrating Acupuncture Combined with EA and Pelvic Floor Muscle Training on Pelvic Function in Patients with PSUI

目的:分析芒针透刺结合电针及盆底肌训练对产后压力性尿失禁(PSUI)患者盆腔功能的影响。方法:采用随机数字表完全随机分为对照组和观察组各73例。在盆底肌训练基础上,对照组实施电针治疗,观察组实施芒针透刺结合电针治疗,两组患者均治疗8周。比较两组患者疗效、两组患者治疗前后中医症候积分(腰膝酸软、夜尿多与小便失禁)、排尿漏尿情况(1 h漏尿量、日均排尿次数)、尿流动力学指标[最大尿道闭合压(MUCP)、腹压漏尿点压力(ALPP)与膀胱顺应性(BC)]和盆腔功能情况(盆底肌肌力)。结果:观察组患者治疗总有效率显著高于对照组,差异具有统计学意义(P<0.05)。治疗8周后,两组患者腰膝酸软、夜尿多、小便失禁中医症候积分和1 h漏尿量、日均排尿次数较治疗前显著降低,且相较于对照组,观察组更低,差异具有统计学意义(P<0.05);两组患者MUCP、ALPP、BC和盆底肌肌力较治疗前显著升高,且相较于对照组,观察组更高,差异具有统计学意义(P<0.05)。结论:芒针透刺结合电针及盆底肌训练治疗PSUI患者可改善尿失禁、漏尿症状和尿流动力学指标,提高盆腔功能。

Objective:To analyze the influence of thorny needle penetrating acupuncture combined with electro-acupuncture(EA)and pelvic floor muscle training on pelvic function in patients with postpartum stress urinary incontinence(PSUI).Methods:146 patients with PSUI were randomly divided into the control group and the observation group,with 73 patients in each group.On the basis of pelvic floor muscle training,the control group was treated with EA,whereas the observation group was treated with thorny needle penetrating acupuncture combined with EA.Both groups were treated for 8 weeks.Therapeutic efficacy was compared between the two groups.TCM symptoms scores(soreness and weakness of waist and knees,nocturia,urinary incontinence),urination and urine leakage(1h urine leakage volume,average daily urination frequency),urodynamic indicators[maximum urethral closure pressure(MUCP),abdominal leak point pressure(ALPP),bladder compliance(BC)]and pelvic function(pelvic floor muscle strength)were compared between before and after the treatment in the two groups.Results:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).After 8 weeks of treatment,the scores of TCM symptoms,including soreness and weakness of waist and knees,nocturia and urinary incontinence,1h urine leakage and daily average urination frequency,were significantly decreased compared with those before the treatment in the two groups,and the above indicators were lower in the observation group than those in the control group(P<0.05);MUCP,ALPP,BC and pelvic floor muscle strength were significantly improved in the two groups compared with those before the treatment,and the improvements were more significant in the observation group than those in the control group(P<0.05).Conclusion:Thorny needle penetrating acupuncture combined with EA and pelvic floor muscle training can improve urinary incontinence,urine leakage and urodynamic indicators,and enhance pelvic function in treatment of PSUI.