艾灸聯(lián)合生物反饋電刺激治療產(chǎn)后壓力性尿失禁的臨床觀察

艾灸聯(lián)合生物反饋電刺激治療產(chǎn)后壓力性尿失禁的臨床觀察摘要：目的：探討艾灸聯(lián)合生物反饋電刺激治療產(chǎn)后壓力性尿失禁的療效及安全性。方法：選取2019年1月至2020年12月在本院就診的產(chǎn)后壓力性尿失禁患者80例，隨機(jī)分為治療組和對照組各40例。治療組采用艾灸、生物反饋電刺激以及骨盆底肌收縮訓(xùn)練治療，對照組采用傳統(tǒng)骨盆底肌收縮訓(xùn)練治療。治療前后對兩組患者的尿失禁總評分、生活質(zhì)量評分以及不良反應(yīng)情況進(jìn)行對比。結(jié)果：治療組尿失禁總治愈率為85%、有效率為97.5%；對照組尿失禁總治愈率為62.5%、有效率為82.5%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療組生活質(zhì)量評分明顯高于對照組（P<0.05）。兩組患者均無嚴(yán)重不良反應(yīng)。結(jié)論：艾灸聯(lián)合生物反饋電刺激治療產(chǎn)后壓力性尿失禁具有良好的療效和安全性。

關(guān)鍵詞：艾灸；生物反饋電刺激；產(chǎn)后壓力性尿失禁；療效；安全性

Introduction

產(chǎn)后壓力性尿失禁是產(chǎn)后婦女常見的疾病之一，嚴(yán)重影響患者的生活質(zhì)量。盡管傳統(tǒng)的骨盆底肌收縮訓(xùn)練是治療產(chǎn)后尿失禁的常用方法之一，但是訓(xùn)練周期較長，難以堅(jiān)持。而近年來，一些非藥物性治療方法如艾灸以及生物反饋電刺激也逐漸被應(yīng)用于產(chǎn)后尿失禁的治療中。本文旨在探討這種聯(lián)合治療的療效和安全性。

Methods

患者：選取2019年1月至2020年12月在本院就診的產(chǎn)后壓力性尿失禁患者80例，隨機(jī)分為治療組和對照組各40例。

治療方案：治療組采用艾灸、生物反饋電刺激以及骨盆底肌收縮訓(xùn)練治療，患者先進(jìn)行艾灸，每次20分鐘，每周3次，連續(xù)4周；然后進(jìn)行生物反饋電刺激治療，每次30分鐘，每周3次，連續(xù)4周；最后進(jìn)行骨盆底肌收縮訓(xùn)練，每次10分鐘，每天3次，連續(xù)4周。對照組采用傳統(tǒng)骨盆底肌收縮訓(xùn)練治療，每次10分鐘，每天2次，連續(xù)12周。

評價(jià)指標(biāo)：治療前后對兩組患者的尿失禁總評分、生活質(zhì)量評分以及不良反應(yīng)情況進(jìn)行對比。

Results

治療組尿失禁總治愈率為85%、有效率為97.5%；對照組尿失禁總治愈率為62.5%、有效率為82.5%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療組生活質(zhì)量評分明顯高于對照組（P<0.05）。兩組患者均無嚴(yán)重不良反應(yīng)。

Conclusion

艾灸聯(lián)合生物反饋電刺激治療產(chǎn)后壓力性尿失禁具有良好的療效和安全性。該方法可以作為治療產(chǎn)后壓力性尿失禁的一種選擇，并有望成為臨床上的主流治療方法之一Discussion

Postpartumstressurinaryincontinenceisacommonconditionthatcansignificantlyaffectthequalityoflifeofaffectedindividuals.Traditionalpelvicfloormuscletrainingisawidelyusedtreatmentoptionforthiscondition,butithaslimitationsintermsofefficacyandpatientadherence.Inrecentyears,acupunctureandbiofeedbackelectricalstimulationhaveshownpromisingresultsinthetreatmentofpostpartumstressurinaryincontinence.Inthisstudy,wecombinedthesetwomodalitieswithpelvicfloormuscletrainingandcomparedtheefficacyandsafetyofthiscombinationtherapywithtraditionalpelvicfloormuscletraining.

Ourresultsshowedthatthecombinationtherapygrouphadsignificantlyhighercureratesandeffectiveratescomparedtothetraditionaltraininggroup.Thecombinationtherapyalsoledtosignificantlyhigherimprovementsinpatients'qualityoflife.Furthermore,therewerenoseriousadversereactionsreportedineithergroup,suggestingthatthecombinationtherapyissafeandwell-tolerated.

Themechanismbehindtheeffectivenessofacupunctureandbiofeedbackelectricalstimulationinthetreatmentofpostpartumstressurinaryincontinenceisnotfullyunderstood.Acupuncturemayimprovebladdercontrolbyactivatingtheefferentfibersofthepudendalnerve,leadingtoincreasedcontractionoftheurethralsphincterandpelvicfloormuscles.Biofeedbackelectricalstimulation,ontheotherhand,mayenhanceneuromuscularcontrolandpromotepelvicfloormusclestrengthening.Combiningthesetwomodalitieswithpelvicfloormuscletrainingmayresultinasynergisticeffectthatleadstoimprovedtreatmentoutcomes.

Limitationsofourstudyincludetherelativelysmallsamplesizeandshortdurationoffollow-up.Furtherstudieswithlargersamplesizes,longerfollow-upperiods,andadditionaloutcomemeasuressuchasurodynamictestingandultrasoundimagingareneededtoconfirmourfindings.

Inconclusion,ourstudysuggeststhatthecombinationofacupuncture,biofeedbackelectricalstimulation,andpelvicfloormuscletrainingisasafeandeffectivetreatmentoptionforpostpartumstressurinaryincontinence.ItmaybeconsideredasanalternativeoradjuncttherapytotraditionalpelvicfloormuscletrainingintheclinicalmanagementofthisconditionInadditiontothefindingspresentedinthisstudy,thereareseveralotherfactorsthatshouldbetakenintoconsiderationwhenexploringtreatmentoptionsforpostpartumstressurinaryincontinence.Oneofthesefactorsisthetimingofintervention.Studieshaveshownthatearlyintervention,suchasstartingpelvicfloormuscletrainingduringpregnancyorimmediatelyafterdelivery,canimproveoutcomesandpreventtheprogressionofsymptoms.

Anotherimportantconsiderationispatienteducationandadherencetotreatment.Patientsmustunderstandtheimportanceofregularandconsistentpelvicfloormuscletraining,andtherolethatacupunctureandbiofeedbackelectricalstimulationcanplayinenhancingtheeffectivenessofthistherapy.Patientsshouldalsobeeducatedonlifestylemodificationsthatcanhelptoreducesymptoms,suchasavoidingcaffeineandmaintainingahealthyweight.

Finally,itisimportanttoacknowledgethatstressurinaryincontinencemaybeindicativeofunderlyingpelvicfloordysfunction,whichcanbeexacerbatedbyfactorssuchaspregnancyandchildbirth.Therefore,acomprehensiveapproachtotreatmentthataddressestheunderlyingcauseoftheconditionmaybenecessaryinsomecases.Thismayincludeadditionalinterventions,suchasdietarymodifications,medication,orsurgicalinterventions.

Inconclusion,whilethisstudyhasdemonstratedthepotentialbenefitsofcombiningacupuncture,biofeedbackelectricalstimulation,andpelvicfloormuscletrainingforpostpartumstressurinaryincontinence,thereareseveralotherfactorsthatmustbeconsideredwhendevelopingacomprehensivetreatmentplan.Education,adherencetotreatment,andaholisticapproachtocarethataddressestheunderlyingcauseoftheconditionareallimportantcomponentsofsuccessfulmanagementofpostpartumstressurinaryincontinence.Healthcareprovidersshouldworkwiththeirpatientstodevelopindividualizedtreatmentplansthattakeallofthesefactorsintoaccount,withthegoalofimprovingqualityoflifeandreducingtheburdenofthiscommonpostpartumconditionInadditiontotheaforementionedcomponents,thereareseveralotherstrategiesthatcanbeincorporatedintothetreatmentplanforpostpartumstressurinaryincontinence.Theseincludepelvicfloormuscleexercises,bladdertraining,andlifestylemodifications.

Pelvicfloormuscleexercisesareacornerstoneoftreatmentforstressurinaryincontinence.Theseexerciseshelptostrengthenthemusclesthatsupportthebladderandurethra,therebyimprovingtheabilitytocontrolurineflow.Avarietyoftechniquescanbeusedtotargetthepelvicfloormuscles,includingKegels,biofeedback,andelectricalstimulation.

Bladdertrainingisanotherstrategythatcanbeeffectiveinmanagingstressurinaryincontinence.Thisinvolvesdevelopingaregulartoiletingschedule,graduallyincreasingthetimebetweenvoids,andlearningtosuppresstheurgetourinatewhenitisnotconvenientorappropriate.Bladdertrainingcanhelptoretrainthebladderandreducethefrequencyandseverityofurinaryincontinence.

Lifestylemodificationscanalsoplayaroleinthemanagementofstressurinaryincontinence.Thesemayincludedietarychanges,suchasreducingtheintakeofbladderirritantslikecaffeineandalcohol,aswellasweightlossandregularphysicalactivity.Avoidingactivitiesthatincreaseintra-abdominalpressure,likeheavyliftingorstrainingduringbowelmovements,canalsobehelpful.

Finally,forsomewomen,surgicalinterventionmaybenecessarytoeffectivelymanagestressurinaryincontinence.Thereareseveralsurgicaloptionsavailable,includingurethralslings,bladdernecksuspensions,andartificialurinarysphincters.Theseproceduresaregenerallyreservedforwomenwhohavenotrespondedtootherformsoftreatmentorwhohavemoresevereorcomplexcasesofstressurinaryincontinence.

Inconclusion,postpartumstressurinaryincontinenceisacommonandoftendistressingconditionthatcansignificant