关键词: 压力性尿失禁, Kegel运动训练, 补中益气汤加减

Abstract:

AIM: To explore the effect of electroacupuncture and traditional Chinese medicine combined with pelvic floor muscle training on stress urinary incontinence（SUI）in perimenopausal women. METHODS: 178 patients with mild to moderate SUI were diagnosed in the perimenopausal clinic of the Second Affiliated Hospital of Zhejiang Chinese Medical University from October 2016 to September 2017. Finally, 162 patients completed the treatment and follow-up (Control group n=54, therapy group 1 n=52, therapy group 2 n=56). Kegel exercise training was given to the control group, electrical stimulation biofeedback therapy was given to the therapy group 1 on the basis of the control group. In the therapy group 2, after TCM syndrome differentiation, the treatment of Buzhong Yiqi Decoction and electroacupuncture was given on the basis of the control group. All three groups were treated for 2 courses and regularly followed for 6 months. At the end of treatment, 3 and 6 months after treatment, 1 h urine pad test were performed, and the International Urinary Incontinence Advisory Committee Urinary Incontinence Questionnaire (ICI-Q-SF) were completed. At the end of treatment and 6 months after treatment, urodynamics test were taken, and the efficacy were evaluated. RESULTS:At the end of treatment, 3 and 6 months after treatment, 1 h urine pad test urine leakage and ICI-Q-SF score were significantly lower than those before treatment (P＜0.05); at the end of treatment and 6 months after treatment, abdominal pressure leak point pressure (ALPP), maximum urethral closure pressure (MUCP), bladder compliance (BC) significantly increased as compared with before treatment (P＜0.05). The improvement of the above indicators in the therapy group 1 and 2 was significantly better than those in the control group (P＜0.05), while the therapy group 2 was better than the therapy group 1 in the 1h urine pad test (P＜0.05). In the ICI-Q-SF score, various urodynamic indicators, there was no significant difference between therapy group 1 and 2 (P>0.05).CONCLUSION:The combination of electroacupuncture and traditional Chinese medicine combined with pelvic floor muscle training for the treatment of mild to moderate perimenopausal women with SUI can reduce urine leakage, increase abdominal pressure leakage point pressure (ALPP), maximum urethral closure pressure (MUCP), and improve bladder compliance (BC), significantly improve the quality of life of patients.

Key words: stress urinary incontinence, Kegel exercise training, Buzhong Yiqi Decoction