| 姜童,秦丽娜,吕桃桃,田野,冯荣荣,薛宝山.“骶四针”联合盆底磁刺激对产后压力性尿失禁患者控尿能力和盆底肌力的临床观察[J].中国医药导报,2024,21(5):105-109 |
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| “骶四针”联合盆底磁刺激对产后压力性尿失禁患者控尿能力和盆底肌力的临床观察 |
| Clinical observation of “four sacral points” combined with pelvic floor magnetic stimulation on urinary control ability and pelvic floor muscle strength in patients with postpartum stress urinary incontinence |
| 收稿日期： 修订日期：2023-05-16 |
| DOI：10.20047/j.issn1673-7210.2024.05.25 |
| 关键词: 产后 压力性尿失禁 “骶四针” 盆底表面肌电 盆底磁刺激 |
| Key Words: |
| 基金项目:北京市中医管理局中医药服务覆盖专项中医特色康复体系建设项目（209-117）；北京中医药大学新教师启动基金项目（2022-BUCMXJKY013） |
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| 摘要:目的 观察“骶四针”联合盆底磁刺激治疗产后压力性尿失禁（PSUI）患者的临床效果。 方法 选择2022年8月至2023年4月就诊于北京中医药大学第三附属医院康复科的68例PSUI患者，采用随机数字表法将其分为对照组和治疗组，各34例。对照组给予盆底磁刺激治疗，治疗组给予“骶四针”联合盆底磁刺激治疗。比较两组治疗前后1 h尿垫试验漏尿量、平均24 h漏尿次数、盆底肌肉肌力分级测试（GRRUG）、盆底表面肌电、国际尿失禁咨询委员会尿失禁问卷简表（ICI-Q-SF）评分；比较两组临床疗效。 结果 治疗后，两组1 h尿垫试验漏尿量、平均24 h漏尿次数和ICI-Q-SF评分均较治疗前降低，且治疗组低于对照组，差异有统计学意义（P＜0.05）。治疗后，两组GRRUG均较治疗前改善，且治疗组优于对照组，差异有统计学意义（P＜0.05）。治疗后，两组肌电Ⅱ及得分、肌电Ⅰ及得分均较治疗前升高；治疗组肌电Ⅱ低于对照组，差异有统计学意义（P＜0.05）。治疗后，两组肌电Ⅱ得分、肌电Ⅰ及得分比较，差异无统计学意义（P＞0.05）。治疗组临床疗效优于对照组，差异有统计学意义（P＜0.05）。结论 “骶四针”联合盆底磁刺激可减少PSUI患者漏尿量和漏尿次数，提升患者的控尿能力，其作用机制可能与提升Ⅱ类肌电信号最大值，增强快肌收缩力有关。 |
| Abstract:Objective To observe the clinical effect of “four sacral points” combined with pelvic floor magnetic stimulation in patients with postpartum stress urinary incontinence (PSUI). Methods Sixty-eight patients with PSUI who attended the Department of Rehabilitation, Beijing University of Chinese Medicine Third Affiliated Hospital from August 2022 to April 2023 were collected. They were divided into control group and treatment group by random number table method, with 34 cases in each group. The control group was treated with pelvic floor magnetic stimulation, while the treatment group was treated with “four sacral points” combined with pelvic floor magnetic stimulation. One hour urinary pad test leakage, average twenty-four hours leakage, general report revised urinary grade (GRRUG), surface electromyography of pelvic floor, and International Consulation on Incontinence questionnaire short form (ICI-Q-SF) score were compared between two groups before and after treatment; the clinical efficacy of two groups was compared. Results After treatment, one hour urinary pad test leakage, average twenty-four hours leakage, and ICI-Q-SF score in both groups were lower than those before treatment, and treatment group was lower than control group, and the differences were statistically significant (P＜0.05). After treatment, GRRUG in both groups were improved compared with that before treatment, and treatment group was better than control group, and the differences were statistically significant (P＜0.05). After treatment, electro- myography Ⅱ and scores, electromyographyⅠ and scores in both groups were higher than those before treatment, electromyography Ⅱ in treatment group was lower than that in control group, and the differences were statistically significant (P＜0.05). After treatment, there were no significant differences in electromyography Ⅱ scores, electromyography Ⅰ and scores between two groups (P＞0.05). The clinical effect of treatment group was better than that of control group, and the difference was statistically significant (P＜0.05). Conclusion “Four sacral points” combined with pelvic floor magnetic stimulation can reduce the amount of urine leakage and frequency of urine leakage in patients with PSUI, and improve the patients’ ability to control urine, and its mechanism of action may be related to the increase of the maximum value of class Ⅱ electromyographic signals and the enhancement of the contraction force of the fast muscle. |
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