雷火灸联合盆底肌训练治疗前列腺术后尿失禁的临床观察

蔡群; 郭勤; 何克林; 钮雪康; 郭芳芳; 袁康妮

doi:10.16766/j.cnki.issn.1674-4152.003307

雷火灸联合盆底肌训练治疗前列腺术后尿失禁的临床观察

doi: 10.16766/j.cnki.issn.1674-4152.003307

1.
浙江中医药大学附属第三医院护理部，浙江杭州 310005
2.
浙江中医药大学附属第三医院针灸科
3.
浙江中医药大学附属第三医院康复科
4.
浙江中医药大学附属第三医院中医护理门诊

基金项目:

浙江省中医药科技计划项目 2021ZA081

详细信息

通讯作者:
蔡群，E-mail：caohuaifang90@yeah.net

中图分类号: R697.3 R245.8
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出版历程
- 收稿日期: 2023-05-04

linical study on the treatment of urinary incontinence after prostatectomy with thunder fire moxibustion

1.
Nursing Department of the Third Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, Hangzhou, Zhejiang 310005, China

摘要

摘要: 目的比较雷火灸联合盆底肌训练和单纯盆底肌训练治疗前列腺术后尿失禁的临床效果及对患者生活质量的影响。方法选取2021年1月1日—2022年11月30日于浙江中医药大学附属第三医院门诊治疗的前列腺术后尿失禁患者66例，采用随机信封的方法分为观察组和对照组，各33例。观察组使用雷火灸结合盆底肌训练，对照组仅接受盆底肌训练。分别于治疗前后及治疗结束后8周比较2组患者中医疗效、尿失禁程度、尿失禁症状评分(ICI-Q-SF)、尿失禁生活质量评分(I-QOL)以及盆底功能。结果观察组患者的中医疗效有效率为96.97%(32/33)，高于对照组的81.82%(27/33)，差异有统计学意义(P<0.05)。治疗后及治疗结束后8周观察组患者尿失禁程度较对照组明显减轻，差异有统计学意义(均P<0.05);治疗后及治疗结束后8周观察组ICI-Q-SF评分分别为(5.67±3.33)分、(4.15±1.12)分，低于对照组的(7.70±3.57)分、(6.52±2.50)分，差异有统计学意义(均P<0.05)。结论雷火灸结合盆底肌训练与单纯的盆底肌训练均可改善前列腺术后尿失禁程度，提高患者的生活质量，联合治疗在改善患者尿失禁程度和生活质量方面优于单纯的盆底肌训练。
- 雷火灸 /
- 前列腺术后尿失禁 /
- 盆底肌训练
Abstract: Objective To compare the clinical effect of thunder fire moxibustion (TFM) combined with pelvic floor muscle training and pelvic floor muscle training alone in the treatment of urinary incontinence after prostate surgery and its influence on patients' quality of life. Methods A total of 66 patients with urinary incontinence after prostate surgery were recruited from the outpatient department of the Third Affiliated Hospital of Zhejiang Chinese Medicine University from 1 January 1, 2021 to November 30, 2022, and divided into observation and control groups by the random envelope method, with 33 cases in each group. The observation group used TFM combined with pelvic floor muscle training, while the control group only received pelvic floor muscle training. The healing effect of traditional Chinese medicine, the degree of incontinence questionnaire-urinary incontinence short form (ICI-Q-SF), the urinary incontinence quality of life (I-QOL) and the pelvic floor function of the two groups were compared before and after treatment and 8 weeks after treatment. Results The efficacy rate of traditional Chinese medicine (TCM) in observation group was 96.97%(32/33), higher than that in the control group [81.82% (27/33)], and the difference was statistically significant (P<0.05).After treatment and 8 weeks after treatment, the degree of urinary incontinence in the observation group was significantly reduced compared with the control group, and the difference was statistically significant (all P<0.05). After treatment and 8 weeks after treatment, the ICI-Q-SF scores of the observation group were (5.67±3.33) points and (4.15±1.12) points respectively, which were lower than those of the control group [(7.70±3.57) points and (6.52±2.50) points], and the differences were statistically significant (all P<0.05). Conclusion TFM combined with pelvic floor muscle training and simple pelvic floor muscle training can improve the degree of urinary incontinence and the quality of life in patients after prostate surgery. Moreover, combined treatment is better than pelvic floor muscle training alone at improving the level of urinary incontinence and patients' quality of life.
- Thunder fire moxibustion /
- Urinary incontinence after prostatectomy /
- Pelvic floor muscle training
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表 1 2组PPI患者一般资料比较

Table 1. Comparison of data between two groups of PPI patients

组别	例数	年龄(x±s，岁)	病程(x±s，d)	尿失禁程度(例)
组别	例数	年龄(x±s，岁)	病程(x±s，d)	轻度	中度	重度
对照组	33	59.36±2.53	164.48±54.73	8	15	10
观察组	33	59.39±2.16	164.45±49.86	10	11	12
统计量		0.052^a	0.002^a	-0.027^b
P值		0.959	0.998	0.978
注：^a为t值，^b为Z值。

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表 2 2组PPI患者中医疗效比较

Table 2. Comparison of TCM efficacy between two group in patients with PPI

组别	例数	痊愈(例)	显效(例)	有效(例)	无效(例)	总有效率(%)
对照组	33	4	9	14	6	81.82
观察组	33	8	17	7	1	96.97
注：2组疗效比较，Z=-2.898，P=0.004。

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表 3 2组PPI患者尿失禁程度比较(例)

Table 3. Comparison of urinary incontinence between two groups in patients with PPI (cases)

组别	例数	治疗前			治疗后			治疗8周后
组别	例数	轻度	中度	重度	轻度	中度	重度	轻度	中度	重度
对照组	33	8	15	10	10	20	3	13	20	0
观察组	33	10	11	12	20	13	0	28	5	0

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表 4 2组PPI患者尿失禁程度比较的广义估计方程结果

Table 4. Results of generalized estimation equation comparing urinary incontinence between two groups of patients with PPI

变量	β	SE	Wald χ²	P值	OR值	95% CI
观察组^a	-1.949	0.572	11.621	0.001	0.142	0.046~0.437
治疗8周后^b	-3.214	0.530	36.814	<0.001	0.040	0.014~0.113
治疗后^b	-1.982	0.283	49.226	<0.001	0.138	0.079~0.240
注：^a以对照组为参照，^b以治疗前为参照。

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表 5 2组PPI患者ICI-Q-SF评分比较(x±s，分)

Table 5. Comparison of ICI-Q-SF scores between two groups in PPI patients (x±s, points)

组别	例数	治疗前	治疗后	治疗8周后	F值	P值
对照组	33	16.91±3.56	7.70±3.57^a	6.52±2.50^ab	87.595	<0.001
观察组	33	16.79±3.19	5.67±3.33^a	4.15±1.12^ab	164.532	<0.001
t值		0.146	2.390	4.953
P值		0.885	0.020	<0.001
注：与治疗前比较，^aP<0.05；与治疗后比较，^bP<0.05。

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表 6 2组PPI患者I-QOL评分比较(x±s，分)

Table 6. Comparison of I-QOL scores between two groups in PPI patients (x±s, points)

组别	例数	治疗前	治疗后	治疗8周后	F值	P值
对照组	33	51.76±7.67	69.76±8.85^a	75.61±8.31^ab	78.019	<0.001
观察组	33	51.85±7.75	76.33±8.76^a	87.33±7.55^ab	161.252	<0.001
t值		0.048	3.034	5.999
P值		0.962	0.003	<0.001
注：与治疗前比较，^aP<0.05；与治疗后比较，^bP<0.05。

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表 7 2组PPI患者盆底功能比较(x±s)

Table 7. Comparison of pelvic floor function between two groups in PPI patients (x±s)

组别	例数	静息肌电值(ms)			最大收缩力(N)			持续收缩力(N)
组别	例数	治疗前	治疗后	治疗8周后	治疗前	治疗后	治疗8周后	治疗前	治疗后	治疗8周后
对照组	33	29.42±3.55	12.76±2.24^a	10.61±2.63^ab	39.88±5.59	76.73±6.48^a	82.52±8.26^ab	29.64±3.25	64.73±6.35^a	70.33±7.22^ab
观察组	33	29.48±3.02	8.52±1.56^a	6.52±1.18^ab	40.00±5.63	81.73±6.83^a	90.52±7.16^ab	29.70±3.79	69.64±6.70^a	79.52±8.70^ab
t值		0.075	8.931	8.149	0.088	3.052	4.204	0.070	3.056	4.667
P值		0.941	<0.001	<0.001	0.930	0.003	<0.001	0.945	0.003	<0.001
注：与治疗前比较，^aP<0.05;与治疗后比较，^bP<0.05。

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