补中益气汤合二仙汤联合盆底肌生物反馈电刺激对女性压力性尿失禁患者盆底功能、尿流动力学及性激素的影响

The Effect of Center-Supplementing and Qi-Boosting Decoction Combined with Two-elixir Decoction and Pelvic Floor Muscle Biofeedback Electrical Stimulation on Pelvic Floor Function,Urodynamics and Sex Hormones in Female Patients with Stress Urinary Incontinence

目的:观察补中益气汤合二仙汤联合盆底肌生物反馈电刺激对女性压力性尿失禁患者盆底功能、尿流动力学及性激素的影响。方法:选取萍乡矿业集团有限责任公司总医院2020年10月至2023年10月治疗的女性压力性尿失禁患者100例,随机分为对照组和观察组,每组各50例。对照组给予盆底肌生物反馈电刺激治疗,观察组在对照组治疗的基础上给予补中益气汤合二仙汤治疗。观察两组患者临床疗效、复发率及治疗前后尿失禁问卷简表(international consultationon on incontinence questionnaire-short form,ICIQ-SF)评分、盆底功能[阴道收缩压(vaginal systolic pressure,VSP)和阴道静息压(vaginal resting pressure,VRP)和盆底肌力]、尿流动力学参数[膀胱顺应性(bladder compliance,BC)、残余尿量(residual urine volume,RUV)、最大尿流率(maximum urinary flow rate,Qmax)和最大尿道闭合压(maximum urethral closure pressure,MUCP)]和性激素[雌二醇(estradiol,E_(2))、卵泡刺激素(follicle-stimulating hormone,FSH)]变化情况。结果:观察组有效率为90.00%,复发率为8.00%,对照组有效率为72.00%,复发率为26.00%,观察组有效率高于对照组、复发率低于对照组,差异有统计学意义(P<0.05)。观察组治疗后ICIQ-SF各维度评分及总分低于对照组,差异有统计学意义(P<0.05)。观察组治疗后VSP和VRP高于对照组,差异有统计学意义(P<0.05),观察组治疗后盆底肌力0—2级的患者少于对照组,5级的患者多于对照组,差异有统计学意义(P<0.05)。观察组治疗后BC、Qmax、MUCP水平高于对照组,RUV水平低于对照组,差异有统计学意义(P<0.05)。观察组治疗后E_(2)水平高于对照组,FSH水平低于对照组,差异有统计学意义(P<0.05)。结论:补中益气汤合二仙汤与盆底肌生物反馈电刺激相结合治疗女性压力性尿失禁,疗效确切,能显著提高盆底肌肉的功能和盆底肌力,改善尿流动力学参数,调节性激素水平以缓解尿失禁症状。

Objective:To observe the effect of Center-Supplementing and Qi-Boosting Decoction combined with Two-elixir Decoction and pelvic floor muscle biofeedback electrical stimulation on pelvic floor function,urodynamics and sex hormones in female patients with stress urinary incontinence(SUI).Methods:A total of 100 female patients with stress urinary incontinence treated at General Hospital of Pingxiang Mining Group Co.,Ltd.from October 2020 to October 2023 were randomly divided into the control group and the observation group,with 50 cases in each group.The control group received biofeedback electrical stimulation treatment,while the observation group received Center-Supplementing and Qi-Boosting Decoction combined with Two-elixir Decoction on the basis of the control group′s treatment.Clinical efficacy,recurrence rate,and changes in international consultation on incontinence questionnaire-short form(ICIQ-SF)scores,pelvic floor function[including vaginal systolic pressure(VSP)and vaginal resting pressure(VRP),pelvic floor muscle strength],urodynamic parameters[including bladder compliance(BC),residual urine volume(RUV),maximum urinary flow rate(Qmax),and maximum urethral closure pressure(MUCP)],and sex hormones[including estradiol(E_(2))and follicle-stimulating hormone(FSH)]before and after treatment were observed in both groups.Results:The effective rate was 90.00%in the observation group and 72.00%in the control group,with a recurrence rate of 8.00%in the observation group and 26.00%in the control group.The observation group had a significantly higher effective rate and a lower recurrence rate than the control group,and the differences were statistically significant(P<0.05).After treatment,the ICIQ-SF scores in all dimensions and the total score in the observation group were significantly lower than in the control group,and the differences were statistically significant(P<0.05).VSP and VRP in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05),and fewer patients in the observation group had pelvic floor muscle strength graded 0-2,while more had grade 5,compared to the control group,and the differences were statistically significant(P<0.05).The levels of BC,Qmax,and MUCP were higher and RUV was lower in the observation group than in the control group,and the differences were statistically significant(P<0.05).Additionally,E_(2) levels were higher and FSH levels were lower in the observation group compared to the control group,and the differences were statistically significant(P<0.05).Conclusion:Center-Supplementing and Qi-Boosting Decoction combined with Two-elixir Decoction and pelvic floor muscle biofeedback electrical stimulation has a significant therapeutic effect on female stress urinary incontinence.It effectively improves pelvic floor muscle function and strength,enhances urodynamic parameters,and regulates sex hormone levels,alleviating incontinence symptoms.