温针灸联合盆底功能训练对改善产后轻度压力性尿失禁患者生活质量的临床疗效评价

Clinical Efficacy Evaluation of Warm Acupuncture Combined with Pelvic Floor Functional Training on Improving Quality of Life in Patients with Mild Postpartum Stress Urinary Incontinence

摘要: 目的：在“升阳举陷、固摄膀胱”理论指导下，构建温针灸联合盆底功能训练治疗产后轻度压力性尿失禁的临床干预方案，着重关注对患者生活质量的影响。方法：选取符合纳入标准的产后轻度压力性尿失禁患者并随机分为对照组与治疗组。对照组进行常规盆底功能训练，治疗组在对照组基础上联合温针灸治疗，两组均隔日1次，每周3次，休息1天，连续4周。采用尿失禁生活质量问卷量表，从行为的限制、心理的影响和社会障碍三个维度量化评估患者生活质量变化，比较两组干预前后及组间差异。结果：两组患者在治疗结束时，尿失禁生活质量问卷总分及行为限制、心理影响、社会障碍三个维度的评分均较干预前明显改善(P < 0.01)，且治疗组三个维度生活质量改善幅度方面均优于对照组(P < 0.05)。结论：温针灸联合盆底功能训练，可以有效改善产后轻度压力性尿失禁患者的漏尿情况，并从行为、心理和社会交往等多个层面显著提升其生活质量，具有较好的临床应用价值和推广前景。

Abstract: Objective: To construct a clinical intervention protocol of warm acupuncture combined with pelvic floor functional training for mild postpartum stress urinary incontinence under the guidance of the theory of “elevating yang to lift sinking and consolidating the bladder”, with a focus on its effect on patients’ quality of life. Methods: Eligible patients diagnosed with mild postpartum stress urinary incontinence were recruited and randomly divided into control group and treatment group. The control group received routine pelvic floor functional training. On the basis of the intervention for the control group, the treatment group was additionally treated with warm acupuncture. Interventions in both groups were performed once every other day, three times per week with one rest day, for a consecutive 4 weeks. The Incontinence Quality of Life Questionnaire (I-QOL) was adopted to quantitatively assess changes in patients’ quality of life from three dimensions: behavioral limitation, psychological impact and social barriers. The intra-group differences before and after intervention as well as inter-group differences were compared. Results: At the end of treatment, the total score of the Incontinence Quality of Life Questionnaire and the scores of its three dimensions (behavioral limitation, psychological impact and social barriers) in both groups were significantly improved compared with those before intervention (P < 0.01). Moreover, the treatment group achieved greater improvement in all three dimensions of quality of life than the control group (P < 0.05). Conclusion: Warm acupuncture combined with pelvic floor functional training can effectively relieve urine leakage in patients with mild postpartum stress urinary incontinence, and significantly improve their quality of life in multiple aspects including behavior, psychology and social interaction. It possesses favorable clinical application value and promotion prospect.