世界中医药

目的：观察电针联合盆底肌肉功能锻炼对产后盆腔器官脱垂的临床疗效，并分析其部分作用机制。方法：选取2016年1月至2017年1月海南医学院附属第二医院收治的产后盆腔器官脱垂患者60例，随机分为对照组和观察组，每组30例。2组均接受盆底肌肉功能训练，观察组在此治疗方案基础上加用电针，30 min/次，5次/周，以20次为1个疗程，2组均接受为期2个疗程的治疗，疗程之间间隔2 d，比较2组中医证候积分、生命质量评分（PFIQ-7）、尿失禁症状评分（ICIQ-SF）、盆底肌力评估以及转化生长因子（TGF）-β1水平的变化。结果：治疗后2组中医证候积分均有所下降，其中观察组优于对照组（P<0.05）；2组PFIQ-7及ICIQ-SF总分均较治疗前明显降低，差异有统计学意义(P<0.05)，其中观察组下降的趋势更明显，差异有统计学意义(P<0.05)。2组治疗后盆底最大收缩力与收缩持续时间均有明显改善，与治疗前比较，差异有统计学意义（P<0.05），其中观察组优于对照组，差异有统计学意义(P<0.05)。与对照组比较，电针联合盆底肌肉训练更可明显上调产后盆腔器官脱垂机体TGF-β1的水平，差异有统计学意义（P<0.05）。结论：电针联合盆底肌肉训练可有效提高盆底肌力，减少尿失禁的发生，改善患者的生命质量，上调TGF-β1水平。

English Summary:

To observe the clinical curative effect of electro-acupuncture combined with pelvic floor muscle training on postpartum pelvic organ prolapse, and to analyze part of the action mechanism. Methods:A total of 60 cases of patients with postpartum pelvic organ prolapse in our hospital from January 2016 to January 2017 were included in the study and randomly divided into the control group and the observation group, with 30 cases in each group. Both of the two groups of patients had pelvic floor muscle training. The observation group had electro-acupuncture on the basis of the treatment, 30 min/times, five times per week, 20 times for a course of treatment. Both of the two groups accepted 2 courses of treatment, and the treatment had 2 d interval. TCM syndrome integrals, quality of life scores (PFIQ-7), urinary incontinence symptom scores (ICIQ-SF), pelvic floor muscle assessment and TGF-β1 concentration changes of two groups before and after treatment were compared. Results:1)TCM syndrome integrals in the two groups of patients declined after treatment, and the observation group was better than that of the control group (P<0.05); 2)Total scores of PFIQ-7 and ICIQ-SF in the two groups were significantly lower than before treatment (P<0.05), and the downward trend in the observation group was more obvious. 3)The maximal contractile force and contraction duration of the pelvic floor were significantly improved after treatment, and there was significant difference between the two groups (P<0.05). The observation group was better than the control group. 4)Compared with the control group, electro-acupuncture combined with pelvic floor muscle training obviously increased TGF-β1 level in the postpartum pelvic organ prolapse, and the differences were statistically significant (P<0.05). Conclusion:Electro-acupuncture combined with pelvic floor muscle training can effectively improve the pelvic floor muscle strength, reduce the occurrence of urinary incontinence, and improve the life quality of patients. The mechanism may be related with the up-regulation of TGF-β1 concentration.

查看全文查看/发表评论下载PDF阅读器