盆底超声评估浮针疗法联合揿针穴位埋针治疗压力性尿失禁患者的效果分析

王世帅; 徐秋栋; 陈凤娜

doi:10.16766/j.cnki.issn.1674-4152.003563

盆底超声评估浮针疗法联合揿针穴位埋针治疗压力性尿失禁患者的效果分析

doi: 10.16766/j.cnki.issn.1674-4152.003563

1.
浙江中医药大学附属宁波市中医院(宁波市中医院)妇科，浙江宁波 315010
2.
浙江中医药大学附属宁波市中医院(宁波市中医院)超声科
3.
浙江中医药大学附属宁波市中医院(宁波市中医院)泌尿外科

基金项目:

浙江省中医药科技计划项目 2021ZA126

宁波市科技计划项目 2022S087

详细信息

通讯作者:
徐秋栋，E-mail：Lqldongdong1027@163.com

中图分类号: R694.54 R245.3
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出版历程
- 收稿日期: 2024-03-29
- 网络出版日期: 2024-07-22

Pelvic floor ultrasound evaluation of the clinical efficacy of floating needle therapy combined with pressing needle and embedding needle at acupoints in the treatment of patients with stress urinary incontinence

1.
Department of Gynecology, Ningbo Municipal Hospital of Traditional Chinese Medicine (TCM), Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang 315010, China

摘要

摘要: 目的分析浮针疗法联合揿针穴位埋针治疗压力性尿失禁患者的临床疗效，探讨经会阴盆底超声评估其疗效的临床价值。方法选取2022年9月—2023年11月宁波市中医院治疗的110例压力性尿失禁患者作为研究对象，采用随机数字表法将其分为对照组(55例)和实验组(55例)。对照组患者应用生物反馈电刺激联合盆底肌训练治疗，实验组应用浮针疗法联合揿针穴位埋针治疗。观察2组患者静息状态下及最大Valsalva动作时超声参数，包括：静息状态下膀胱颈位置、逼尿肌厚度(DWT)、膀胱尿道后角(RVA)及尿道倾斜角(UTA)，最大Valsalva动作时膀胱颈移动度(BND)、RVA、尿道旋转角(URA)，统计尿道内口漏斗发生率。结果治疗后，2组患者静息状态下膀胱颈位置及DWT、RVA比较差异均无统计学意义(P>0.05)；实验组UTA高于对照组(P < 0.05)。治疗后，2组患者最大Valsalva动作时，其BND均明显降低(P < 0.05)，且实验组低于对照组(P＜0.05)；2组RVA和URA比较差异均无统计学意义(P>0.05)。实验组患者尿道内口漏斗发生率为87.27%(48/55)，显著低于对照组的100.00%(55/55)，差异有统计学意义(χ²=5.492，P=0.019)。结论压力性尿失禁患者采用浮针疗法联合揿针穴位埋针治疗疗效更佳，更有利于降低尿道内口漏斗发生率，且经会阴盆底超声对其康复效果的评估具有一定临床参考价值。
- 压力性尿失禁 /
- 盆底超声 /
- 浮针疗法 /
- 揿针穴位埋针 /
- 生物反馈电刺激
Abstract: Objective To analyze the clinical efficacy of floating needle therapy combined with pressing needle point embedding therapy in the treatment of patients with stress urinary incontinence, and to explore the clinical value of evaluating its efficacy through perineal pelvic floor ultrasound. Methods A total of 110 patients with stress urinary incontinence admitted to Ningbo Traditional Chinese Medicine Hospital from September 2022 to November 2023 were selected as the study subjects. They were randomly divided into a control group and an experimental group, with 55 cases in each group. The control group was treated with biofeedback electrical stimulation combined with pelvic floor muscle training, and the experimental group was treated with floating needle therapy combined with pressing and embedding acupuncture points. The ultrasound parameters of two groups of patients during resting state and maximum Valsalva maneuver were observed, including bladder neck position, detrusor muscle thickness (DWT), urethral inclination angle (UTA), bladder neck movement (BND), posterior angle of bladder urethra (RVA), and urethral rotation angle (URA). The incidence of urethral infundibulum during the maximum Valsalva maneuver was calculated. Results After the treatment, there was no statistically significant difference in the resting bladder neck position, DWT, and RVA between the two groups (P>0.05), and the UTA in the experimental group was higher than that in the control group (P < 0.05). The BND of both groups of patients significantly decreased during the maximum Valsalva maneuver (P < 0.05), and the BND in the experimental group was lower than that in the control group (P < 0.05) after the treatment. There was no statistically significant difference between the two groups of RVA and URA (P>0.05). The incidence of urethral infundibulum in the experimental group was 87.27% (48/55), significantly lower than 100.00% (55/55) in the control group (P < 0.05). Conclusion The combination of floating needle therapy and pressing needle embedding therapy at acupoints is more effective for patients with stress urinary incontinence, which is more conducive to reducing the incidence of urethral infundibulum. The evaluation of the rehabilitation effect by perineal pelvic floor ultrasound has a certain clinical reference value.
- Stress urinary incontinence /
- Pelvic floor ultrasound /
- Floating needle therapy /
- Press the needle and bury the needle at the acupoint /
- Biofeedback electrical stimulation

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表 1 2组压力性尿失禁患者一般资料比较

Table 1. Comparison of general data of two groups of patients with stress urinary incontinence

组别	例数	年龄 (x±s，岁)	病程时间 (x±s，年)	BMI (x±s)	产次(例)		分娩方式(例)		尿失禁程度(例)
组别	例数	年龄 (x±s，岁)	病程时间 (x±s，年)	BMI (x±s)	1次	≥2次	阴道分娩	剖宫产	轻度	中度
对照组	55	46.58±11.31	2.46±0.43	23.06±1.17	46	9	48	7	26	29
实验组	55	43.29±11.26	2.60±0.52	22.81±1.56	45	10	50	5	22	33
统计量		1.529^a	1.539^a	0.951^a	0.064^b		0.374^b		0.591^b
P值		0.129	0.127	0.344	0.801		0.541		0.442
注：^a为t值，^b为χ²值。

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表 2 2组压力性尿失禁患者静息状态下盆底超声参数比较(x±s)

Table 2. Comparison of pelvic floor ultrasound parameters in two groups of patients with stress urinary incontinence at rest(x±s)

组别	例数	膀胱颈位置(mm)		DWT(mm)		RVA(°)		UTA(°)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	55	21.80±7.06	22.31±6.80	3.57±0.65	3.56±0.55	124.35±22.75	118.18±13.98	19.10±13.10	22.35±7.01^c
实验组	55	19.49±8.07	21.20±6.58	3.67±0.59	3.66±0.49	132.00±26.81	123.98±18.45	19.20±9.03	25.09±6.65^c
统计量		1.598^a	0.792^b	0.845^a	1.035^b	1.614^a	1.736^b	0.047^a	2.155^b
P值		0.113	0.396	0.400	0.324	0.110	0.075	0.963	0.040
注：^a为t值，^b为F值；与同组治疗前比较，^cP < 0.05。

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表 3 2组压力性尿失禁患者最大Valsalva动作时盆底超声参数比较(°)

Table 3. Comparison of pelvic floor ultrasound parameters during maximum Valsalva movement in two groups of patients with stress urinary incontinence(°)

组别	例数	BND(x±s)		RVA(x±s)		URA[M(P₂₅, P₇₅)]
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	55	27.95±7.48	25.07±5.51^b	140.96±30.35	133.25±18.04^b	43(25，58)	38(29, 42)^b
实验组	55	26.22±8.52	22.16±5.95^b	147.89±21.44	138.20±14.26^b	45(19，59)	38(29, 43)^b
统计量		1.132^a	2.584^c	1.383^a	1.215^c	0.348^d	0.627^d
P值		0.260	0.017	0.169	0.108	0.766	0.493
注：^a为t值，^c为F值，^d为Z值；与同组治疗前比较，^bP < 0.05。

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