女性压力性尿失禁的中西医治疗研究进展

Research Progress on the Treatment of Female Stress Urinary Incontinence with Traditional Chinese and Western Medicine

摘要: 压力性尿失禁在我国成年女性中发病率较高，对患者的生活质量造成显著影响。本文通过梳理近年来的相关研究，从西医角度总结了该病在盆底解剖结构、激素水平变化等方面的病理机制，同时从中医理论出发，阐述了其属于“遗溺”等范畴，并以肾气亏虚为根本、涉及多个脏腑功能失调的病机认识。在治疗上，西医主要采用生活方式调整、盆底肌锻炼、生物反馈、激光疗法、药物及手术等多种方法；中医则包括中药内服(如金匮肾气丸、补中益气汤)、多种针刺疗法(毫针、电针、浮针、芒针)、艾灸及其他外治疗法。目前该病的临床治疗倾向于个体化的综合方案，中西医结合模式表现出较好的应用前景。未来尚需开展更多高质量研究，以建立规范的诊疗共识，从而更好地指导临床实践。

Abstract: Stress urinary incontinence (SUI) exhibits a high prevalence among adult women in China and significantly impairs patients’ quality of life. By reviewing recent relevant studies, this article summarizes the pathological mechanisms of SUI from a Western medical perspective, including alterations in pelvic floor anatomy and hormonal levels. From the standpoint of traditional Chinese medicine (TCM), it elaborates that SUI falls under categories such as “involuntary urination”, with its pathogenesis rooted in kidney qi deficiency and involving dysfunction of multiple organ systems. In terms of treatment, Western medicine primarily employs lifestyle modifications, pelvic floor muscle training, biofeedback, laser therapy, medications, and surgery. TCM approaches encompass oral herbal formulations (e.g., Jinkui Shenqi Wan, Buzhong Yiqi Tang), various acupuncture techniques (filiform needle, electroacupuncture, floating needle, elongated needle), moxibustion, and other external therapies. Current clinical management tends toward individualized and integrated regimens, with the combined application of Western and TCM modalities demonstrating promising prospects. Further high-quality research is warranted to establish standardized diagnostic and therapeutic guidelines, thereby better informing clinical practice.