产后压力性尿失禁的中西治疗进展

Advances in the Treatment of Postpartum Stress Urinary Incontinence: A Review of Chinese and Western Medicine

摘要: 产后压力性尿失禁(Postpartum Stress Urinary Incontinence, PSUI)是女性产后常见的盆底功能障碍性疾病，以咳嗽、喷嚏或运动时尿液不自主漏出为主要表现，严重影响患者的生活质量和身心健康。近年来，随着生育政策调整及盆底健康意识提升，PSUI的发病率呈上升趋势，已成为产科及康复医学领域的重要研究课题。目前，该领域研究虽已取得一定进展，但在发病机制、个体化治疗策略及中西医整合应用等方面仍存在诸多争议与不足。本文系统综述了PSUI的流行病学特征与发病机制，重点梳理了中医治疗(包括中药内服、针灸、推拿及盆底肌康复训练等辨证论治方法)与西医治疗(涵盖盆底肌训练、生物反馈电刺激、药物及手术干预)的最新临床研究与机制探索成果。通过对比分析两种治疗体系的优势与局限，本文旨在为临床工作者提供多维度、个性化的治疗策略参考，以优化患者预后，推动中西医结合在PSUI治疗中的深入应用。

Abstract: Postpartum Stress Urinary Incontinence (PSUI) is a prevalent pelvic floor dysfunction in women following childbirth. It is clinically characterized by involuntary urinary leakage triggered by activities that increase intra-abdominal pressure, such as coughing, sneezing, or exercise. This condition significantly compromises patients’ quality of life and psychological health. In recent years, with the adjustment of fertility policies and heightened awareness of pelvic floor health, the incidence of PSUI has been on the rise, emerging as a key research focus in obstetrics and rehabilitation medicine. Despite notable advancements in this field, controversies and gaps persist concerning its pathogenesis, individualized treatment strategies, and the integrated application of Traditional Chinese Medicine (TCM) and Western medicine. This paper systematically reviews the epidemiological features and pathogenesis of PSUI, with a particular focus on the latest clinical research and mechanistic insights from both TCM and Western medical treatments. TCM interventions discussed include oral administration of herbal medicines, acupuncture, tuina (Chinese massage), and pelvic floor muscle rehabilitation based on syndrome differentiation. Western medical approaches encompass pelvic floor muscle training, biofeedback electrical stimulation, pharmacotherapy, and surgical interventions. By comparatively analyzing the respective advantages and limitations of these two therapeutic systems, this review aims to provide clinicians with a multidimensional and personalized treatment strategy reference, optimize patient outcomes, and further advance the integration of TCM and Western medicine in the management of PSUI.