1.上海中医药大学,上海市浦东新区蔡伦路1200号,200120
2.上海市黄浦区香山中医医院
3.上海市奉贤区中心医院
4.上海中医药大学附属龙华医院
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收稿:2021-05-12,
修回:2021-09-30,
纸质出版:2022-01-02
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白富裕,张梦媛,李泽宇等.“烧山火”针刺手法为主治疗女性混合性尿失禁的真实世界研究[J].中医杂志,2022,63(01):50-55.
BAI Fuyu,ZHANG Mengyuan,LI Zeyu,et al.Acupuncture Mainly with Mountain-burning Warming Method for Treatment of Female with Mixed Urinary Incontinence: a Real-world Study[J].Journal of Traditional Chinese Medicine,2022,63(01):50-55.
白富裕,张梦媛,李泽宇等.“烧山火”针刺手法为主治疗女性混合性尿失禁的真实世界研究[J].中医杂志,2022,63(01):50-55. DOI: 10.13288/j.11-2166/r.2022.01.010.
BAI Fuyu,ZHANG Mengyuan,LI Zeyu,et al.Acupuncture Mainly with Mountain-burning Warming Method for Treatment of Female with Mixed Urinary Incontinence: a Real-world Study[J].Journal of Traditional Chinese Medicine,2022,63(01):50-55. DOI: 10.13288/j.11-2166/r.2022.01.010.
目的
2
基于真实世界研究观察“烧山火”针刺手法为主治疗女性混合性尿失禁患者的临床疗效和安全性。
方法
2
121例女性混合性尿失禁患者在尊重患者意愿的前提下按照4
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1的比例分配至治疗组(96例)和对照组(25例)。两组均进行生活方式指导等基础干预,治疗组同时采用针刺治疗,取穴为肾俞(双侧)、“骶四穴”、百会、三阴交(双侧),其中肾俞穴行“烧山火”针刺手法,“骶四穴”行电针治疗,每周治疗3次,每次30 min;对照组进行盆底肌训练,每日3次。两组均治疗6周,并于治疗结束后6个月进行随访。分别于治疗前后及随访时记录两组患者国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)评分、尿失禁严重程度评分、生活质量评分、汉密尔顿抑郁量表(HAMD)评分,同时观察治疗期间两组不良事件发生情况。
结果
2
治疗组脱落2例,对照组脱落3例。治疗组患者治疗后及随访时ICI-Q-SF评分、尿失禁严重程度评分、生活质量评分、HAMD评分均较本组治疗前降低(
P
<0.01),对照组患者仅治疗后各项评分较治疗前降低(
P
<0.01)。治疗组治疗后、随访时各项评分均低于同时间对照组(
P
<0.01),且治疗组各项评分治疗前后差值、随访时与治疗前差值与对照组比较差异具有统计学意义(
P
<0.05或
P
<0.01)。两组不良事件发生率比较差异均无统计学意义(
P
>0.05)。
结论
2
以“烧山火”手法为主的针刺治疗可有效改善女性混合性尿失禁患者的临床症状,并能提高患者生活质量、减轻心理压力,且临床应用安全性良好。
Objective
2
To assess the effectiveness and safety of acupuncture with mountain-burning warming method for female with mixed urinary incontinence (MUI) based on real-world study.
Methods
2
A total of 121 eligible female with MUI were assigned to the treatment group (96 cases) and the control group (25 cases) with a ratio of 4
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1 on respection of the patients' wishes. Patients in both group received basic treatments such as guidance on life style, and additionally acupuncture was administered in the treatment group; the acupoints included bilateral Shenshu (BL 23), ‘sacral four points’, Baihui (DU 20) and bilateral Sanyinjiao (SP 6), among which mountain-burning warming manipulation was applied on ‘Shenshu’ (BL 23), and electro-acupuncture was conducted on the ‘sacral four points’, three times per week, and thirty minutes each time; pelvic floor muscle exercises were additionally given to the control group with three times daily; the treatment in both groups lasted for six weeks, and patients were followed up six weeks after treatment finish. The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICI-Q-SF) score, the severity of urinary incontinence score, the quality of life score, and the Hamilton Depression Scale (HAMD) score were assessed before and after treatment and during follow-up. The adverse events during treatment in both groups were recorded.
Results
2
There were two dropouts in the treatment group and three dropouts in the control group. The ICI-Q-SF score, urinary incontinence severity score, quality of life score, and HAMD score in the treatment group after treatment and during follow-up were all significantly lower than those before treatment (
P
<0.01), while the control group only had lower scores after treatment than before treatment (
P
<0.01). After treatment and during follow-up, all above scores of the treatment group group were lower than those of the control group (
P
<0.01), and there were more decreases of the treatment group in terms of the differences of the scores between pre- and post-treatment and between pre-treatment and follow-up (
P
<0.05 or
P
<0.01). There were no significant differences in the incidence of adverse events between the two groups (
P
>0.05).
Conclusion
2
Acupuncture with mountain-burning warming method can effectively improve the clinical symptoms, inprove quality of life and reduce psychological pressure in female with MUI, and is considered to be safe.
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