艾灸配合中药治疗妇女压力性尿失禁的临床研究
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摘要
目的：压力性尿失禁(SUI)虽不直接危及生命，但它严重影响患者的生活质量。许多患者对本病认识不足或由于害羞而难于启齿，大约只有1.5％-6％的女性尿失禁患者寻求正确的治疗。相当多的SUI患者常因难以启齿而延误治疗，患者情绪消沉自卑，社会交际活动减少，并且性欲往往低下，导致严重的身心疾患，其严重地影响了女性的身心健康、生活及工作，研究SUI的治疗具有非常重要的意义。因此，本课题的目的就是观察艾灸配合中药治疗妇女SUI的临床疗效。
方法：将60例门诊诊断为SUI的女性患者，随机分为治疗组和对照组两组。治疗组用艾条行温和灸法交替灸气海、关元、足三里、三阴交和脾俞、肾俞、次髎两组穴位，在灸法应用同时配合服用补脾益肾方中药；对照组只服用补脾益肾方中药。各组均连续治疗30天，观察了患者治疗前后尿失禁程度、伴随症状、漏尿量、尿失禁发作频率等指标，并按照疗效标准评价治疗效果。同时观察了两组治疗对不同中医证型的疗效。
结果：两组患者治疗前后比较，均能够显著减轻尿失禁程度、减少漏尿量(P<0.01)；减轻尿失禁伴随症状(P<0.01)；降低尿失禁发作频率(P<0.01)；且治疗组临床疗效优于对照组(P<0.05)。两组治疗对不同中医证型的疗效之间无显著性差异(P>0.05)。
结论：艾灸配合补脾益肾方中药和单用补脾益肾方中药均对女性SUI患者有治疗效果，但艾灸配合补脾益肾方中药能够提高治疗女性SUI的效果。
Objective: To investigate moxibustion and Chinese medicine for treatment of stress urinary incontinence(SUI) in women in the clinical efficacy. Even though the SUI is not a dangerous illness, it makes a big influence in the daily life of women. Usually most of women they hesitate to being a treatment because they feel ashamed. It is only 1.5%-6% of SUI women to find a right treatment, that means most of the SUI women are shy to take any therapy. It at last makes them nervous and embarrassed to meet people or attend any social meeting, it is also even affecting their sex life or severe affect their health. Consideration of the therapy of the women' SUI is very important and meaningful, I start to study and try to find a best and safe treatment for it.
Methods: 60 cases of women's stress urinary incontinence clinic patients were randomly divided into two groups. The trial group moxibustion alternately the two sets of Points by moxibustion: Qihai(RN6),Guanyuan(RN4), Zusanli(ST36), Sanyinjiao(SP6) and Pishu(BL20), Shenshu(BL23), Ciliao(BL32), and given a decoction at the same time. The control group was only given this medicine. The leak volume, associated symptoms, and incontinence episode frequency were observed.
Results: The two groups were able to significantly reduce the amount of leakage of urine(P<0.01), the associated symptoms(P<0.01), and episodes of incontinence reduced P<0.01), the trial group were better than the control group(P<0.05).
Conclusion: The synergistic combination of the moxibustion and drug could significantly improve the treatment results for female stress urinary incontinence.
方法：将60例门诊诊断为SUI的女性患者，随机分为治疗组和对照组两组。治疗组用艾条行温和灸法交替灸气海、关元、足三里、三阴交和脾俞、肾俞、次髎两组穴位，在灸法应用同时配合服用补脾益肾方中药；对照组只服用补脾益肾方中药。各组均连续治疗30天，观察了患者治疗前后尿失禁程度、伴随症状、漏尿量、尿失禁发作频率等指标，并按照疗效标准评价治疗效果。同时观察了两组治疗对不同中医证型的疗效。
结果：两组患者治疗前后比较，均能够显著减轻尿失禁程度、减少漏尿量(P<0.01)；减轻尿失禁伴随症状(P<0.01)；降低尿失禁发作频率(P<0.01)；且治疗组临床疗效优于对照组(P<0.05)。两组治疗对不同中医证型的疗效之间无显著性差异(P>0.05)。
结论：艾灸配合补脾益肾方中药和单用补脾益肾方中药均对女性SUI患者有治疗效果，但艾灸配合补脾益肾方中药能够提高治疗女性SUI的效果。
Objective: To investigate moxibustion and Chinese medicine for treatment of stress urinary incontinence(SUI) in women in the clinical efficacy. Even though the SUI is not a dangerous illness, it makes a big influence in the daily life of women. Usually most of women they hesitate to being a treatment because they feel ashamed. It is only 1.5%-6% of SUI women to find a right treatment, that means most of the SUI women are shy to take any therapy. It at last makes them nervous and embarrassed to meet people or attend any social meeting, it is also even affecting their sex life or severe affect their health. Consideration of the therapy of the women' SUI is very important and meaningful, I start to study and try to find a best and safe treatment for it.
Methods: 60 cases of women's stress urinary incontinence clinic patients were randomly divided into two groups. The trial group moxibustion alternately the two sets of Points by moxibustion: Qihai(RN6),Guanyuan(RN4), Zusanli(ST36), Sanyinjiao(SP6) and Pishu(BL20), Shenshu(BL23), Ciliao(BL32), and given a decoction at the same time. The control group was only given this medicine. The leak volume, associated symptoms, and incontinence episode frequency were observed.
Results: The two groups were able to significantly reduce the amount of leakage of urine(P<0.01), the associated symptoms(P<0.01), and episodes of incontinence reduced P<0.01), the trial group were better than the control group(P<0.05).
Conclusion: The synergistic combination of the moxibustion and drug could significantly improve the treatment results for female stress urinary incontinence.
引文
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[2] 陈涛．女性压力性尿失禁电刺激治疗综述．中国疗养医学，2005，14(6)：469
[3] Locher JL, Burgio KL. Epidemiology of incontinence. In: Ostergard DR, Dent AE. Urogynecology and Urodynamics: theory and practice. 4thed. Baltimore: Willians&Wilins, 1996, 67-75.
[4] Chmel R, Novackova M, Vlk R, et al Epidemiological aspects of the female urinary incontinence. Cas Lek Cesk, 2005, 144(2):95-97.
[5] CAOZY, editor in chief. Chinese obstetrics and Gynecology [M].Beijing: The People Sanitation Publishing Company, 1999:1370
[6] 张群英．固肾培元益气汤治疗女性尿失禁46例观察．实用中医药杂志，2005(6)：342-343
[7] 李杏田，张玉兰，郭玉霞．中药治疗尿失禁30例疗效观察．现代中西医结合杂志，2003，(11)：1177
[8] 曹东波，陈新．固脬汤治疗产后顽固性尿失禁60例临床观察．湖南中医药导报，2004，(09)：15
[9] 马胜，马后志．针灸治疗压力性尿失禁[J]．四川中医，1998，16(3)：51
[10] 李传明，张艳华．针刺治疗尿失禁的临床体会[J]．中国针灸，19933(1)：15-16
[11] 李苹．头体针配合治疗压力性尿失禁15例[J]．中国针灸，2001，21(3)：168
[12] 吴笛．眼针配头针加电治疗脑血管意外后尿失禁40例[J]．针灸临床杂志，1999，1999，15(9)：33-34
[13] 江瑜，李琳．中药盒灸治疗老年尿失禁37例[J]．贵阳中医学院学报，1999，21(2)：32
[14] 萧惠．温灸治疗中风后尿失禁疗效观察[J]．实用医学杂志，1999，15(11)：933
[15] 宓轶群，陈一．针灸治疗女性压力性尿失禁36例[J]．中国针灸，2003，23(11)：640
[16] 杨廷辉，周清毅，赵开祝．电针治疗女性压力性尿失禁临床研究[J]．电针治疗女性SUI临床研究，2006，22(6)：90-91
[17] 何金明，李俊，陈寅，黄亚胜．中药穴位注射治疗压力性尿失禁[J]．湖北中医学院学报，2004，6(3)：39-40
[18] 张采真，吕艳青穴位埋线配合功能锻炼治疗压力性尿失禁临床观察[J]．中国针灸，2004，24(7)：457-458
[19] 覃彬森，李雅男，石坚．针灸加中药治疗压力性尿失禁[J]．中国医学研究与临床，2004，2(1)：72-72
[20] 宋志君，李巍．中药穴位外敷治疗老年女性压力性尿失禁[J]．中国民间疗法，2002，10(2)：29-30
[21] 宋岩峰著．女性尿失禁诊断与治疗[M]．第一版．北京，人民军医出版社，2003
[22] Cammu H, Van NM, Amy JJ. A 10-year follow-up after Kegel pelvic floor muscle exercises for CSI [J]. BJU International, 2000, 85:655-658
[23] Elser DM, Wyman JF, McClish DK, et al. The effect of bladder training pelvic floor muscle training, oration training on aerodynamic is parameters in women with urinary incontinence. Continence Program of Women Research Group[J]. Neurourol-Urodyy.1999,18:427-436
[24] Galloway NT, EI-Galley RE,Sand PK, et al Extracorporeal m agnatic innervations the ropy for stress urinary incontinence[J].Urology,1999, 53:1108—1111
[25] Sung MS, Choi YH, Back SH, et al. The effect of pelvic floor muscle exercises on genuine stress incontinence among Korean women focusing on its effects on the quality of life[J].Yonsei-Med-J,2000,41:237-251
[26] Chaliha Chet al.Perrurethral injection therapy for the treatment of stress incontinence.Br J Urol, 1995,76, 151-155
[27] Sullivan J, Abrams PK, ET Pharmacological management off incontinence. Eor-Urol,1999, 36(Suppl):189-195.
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