中医穴位疗法联合盆底电刺激治疗女性压力性尿失禁的随机对照试验

A Randomized Controlled Trial of Traditional Chinese Medicine Acupoint Therapy Combined with Pelvic Floor Electrical Stimulation for Female Stress Urinary Incontinence

摘要: 目的：评价中医穴位疗法和盆底电刺激联合治疗压力性尿失禁女性患者的临床效果。方法：将压力性尿失禁女性患者(104例)随机分为实验组和对照组2组，每组各52例。实验组采用中医穴位(气海、关元、石门、肾俞、足三里等，随证加减)针刺留针15~20 min后，联合盆底电刺激30 min；对照组仅行盆底电刺激。两组均每2天1次，10次为1疗程，治疗2个疗程。观察治疗前后1 h尿垫漏尿量、ICI-Q-SF评分及不良反应。结果：治疗后，实验组1 h漏尿量由6.25 g降至2.20 g，对照组由6.90 g降至3.35 g，组间差异有统计学意义(F = 28.820, P < 0.001)；实验组ICI-Q-SF评分由4.00分降至1.00分，对照组由4.50分降至2.00分，两组均较治疗前改善(P < 0.05)，实验组优于对照组(P < 0.05)。两组均无严重不良事件。结论：中医穴位疗法联合盆底电刺激可显著减少女性压力性尿失禁患者的漏尿量、改善症状，疗效优于单纯电刺激，安全性好。

Abstract: Objective: To assess the effectiveness of acupoint therapy from traditional Chinese medicine, combined with electrical stimulation of the pelvic floor in women suffering from stress urinary incontinence (SUI). Methods: One hundred and four female patients with stress urinary incontinence were randomly assigned to two groups: an experimental group and a control group, with 52 patients in each group. The experimental group received acupuncture at acupoints including Qihai (CV6), Guanyuan (CV4), Shimen (CV5), Shenshu (BL23), Zusanli (ST36), and other syndrome-differentiated modifications as appropriate. After needle retention for 15~20 minutes, pelvic floor electrical stimulation was administered for 30 minutes. The control group received pelvic floor electrical stimulation alone. Both groups were treated once every 2 days, with 10 sessions constituting one course of treatment and a total of 2 courses. Outcomes included 1-hour pad test leakage volume, the International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF) score, and adverse events before and after treatment. Results: After treatment, the 1-hour pad test leakage volume in the experimental group decreased from 6.25 g to 2.20 g, while that in the control group decreased from 6.90 g to 3.35 g; the between-group difference was statistically significant (F = 28.820, P < 0.001). The ICI-Q-SF score in the experimental group decreased from 4.00 to 1.00, and that in the control group decreased from 4.50 to 2.00. Both groups showed significant improvement compared with baseline (P < 0.05), and the experimental group demonstrated superior improvement compared with the control group (P < 0.05). No serious adverse events occurred in either group. Conclusion: Traditional Chinese medicine acupoint therapy combined with pelvic floor electrical stimulation can significantly reduce urine leakage and improve symptoms in women with stress urinary incontinence. This combined therapy appears more effective than pelvic floor electrical stimulation alone and is associated with good safety.