电针对产后轻中度压力性尿失禁合并盆腔器官脱垂疗效观察

目的观察电针治疗产后轻中度压力性尿失禁合并盆腔器官脱垂的临床疗效。方法采用随机数字表法将68例产后轻中度压力性尿失禁合并盆腔器官脱垂的患者分为观察组和对照组,每组34例。观察组取百会、中脘、气海、中极、水道、子宫、足三里、三阴交,子宫、水道连接电针仪;肾俞、次髎、会阳,次髎、会阳连接电针仪;两组穴位隔日交替使用。对照组采用生物反馈电刺激治疗。每周3次,连续治疗6周,并于治疗前、治疗后采用盆底肌力检测、1 h尿垫试验、盆腔器官脱垂定量(pelvic organ prolapse quantitation,POP-Q)分度法进行疗效评价。结果观察组治疗后盆底肌持续收缩力、快速收缩力均高于对照组(P<0.05),且观察组治疗后与治疗前肌力差值大于对照组(P<0.01);观察组治疗后1 h尿垫试验漏尿量小于对照组(P<0.05),且观察组治疗前后漏尿量差值大于对照组(P<0.01);两组治疗后POP-Q分度均较治疗前降低(P<0.01),且两组间比较差异有统计学意义(P<0.05)。结论电针治疗产后轻中度压力性尿失禁合并盆腔器官脱垂,有助于提高盆底肌收缩力,在改善漏尿量及盆腔器官脱垂程度方面存在优势。

Observations on the Effect of Electroacupuncture on Mild-to-moderate Postpartum Stress Urinary Incontinence with Pelvic Organ Prolapse

Objective To investigate the clinical efficacy of electroacupuncture for mild-to-moderate postpartum stress urinary incontinence with pelvic organ prolapse.Method Sixty-eight patients having mild-to-moderate stress urinary incontinence with pelvic organ prolapse were assigned,using a random number table,to observation and control groups,34 cases each.In the observation group,Baihui(GV20),Zhongwan(CV12),Qihai(CV6),Zhongji(CV3),Shuidao(ST28),Zigong(Extra),Zusanli(ST36)and Sanyinjiao(SP6)as one group of points and Shenshu(BL23),Ciliao(BL33)and Huiyang(BL35)as another group of points were selected and connected to an electroacupuncture device;the two groups of points were used alternately.The control group received biofeedback and electrostimulation.Treatment was given three times a week for six consecutive weeks.Pelvic floor muscle strength was tested,1-hour pad test was performed and the Pelvic Organ Prolapse Quantitation(POP-Q)system was used before and after treatment for the evaluation of therapeutic effect.Result After treatment,pelvic floor muscle strength and endurance were greater(P<0.05)and the pre-/post-treatment muscle strength difference value was larger(P<0.01)in the observation group than in the control group.After treatment,1-hour pad test leakage amount was smaller(P<0.05)and the pre-/post-treatment leakage amount difference value was larger(P<0.01)in the observation group than in the control group.After treatment,the POP-Q grade decreased in the two groups compared with before(P<0.01)and had a statistically significant difference between the two groups(P<0.05).Conclusion Electroacupuncture helps to increase pelvic floor muscle contractility in treating mild-to-moderate postpartum stress urinary incontinence with pelvic organ prolapse and may have an advantage in reducing leakage amount and pelvic organ prolapse.