| 引用本文:孙天恒1，陈欢2，刘志顺2.五苓散类方治疗压力性尿失禁的临床应用[J].世界中医药,2022,(10):. |
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| 五苓散类方治疗压力性尿失禁的临床应用 |
| Clinical Application of Wuling Powder Analogues in the Treatment of Stress Urinary Incontinence |
| 投稿时间：2021-05-14 |
| DOI：10.3969/j.issn.1673-7202.2022.10.020 |
| 中文关键词: 五苓散 春泽汤 五苓散类方 压力性尿失禁 膀胱咳 沿革 理论探讨 临床应用 |
| English Keywords:Wuling Powder Chunze Decoction Wuling Powder analogues Stress urinary incontinence Bladder cough Evolution Theoretical discussion Clinical application |
| 基金项目:十三五国家重点研发计划中医药现代化课题项目（2017YFC1703602） |
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| 中文摘要: |
| 目的：梳理五苓散类方及其治疗“膀胱咳”的沿革，结合现代临床文献，总结古今医家使用五苓散类方治疗压力性尿失禁的疗效、安全性，并探究其可能的机制。方法：阅读古代、近代中医学论著，归纳五苓散及春泽汤的变化及其在“咳而遗尿”患者中的应用。通过搜索国家知识基础设施数据库（CNKI）、中国学术期刊数据库（CSPD）、中文科技期刊数据库（CCD）、中国生物医学文献数据库（CBMdisc）、PubMed等中英文数据库，查找有关五苓散类方治疗压力性尿失禁的文章，对文献进行归纳总结。结果：共搜索到11篇文章，发表时间1988—2020年。其中8篇为病例报道，3篇为理论探讨，涉及9例个案，无临床随机对照试验。1篇以五苓散原方药物治疗1例咳嗽后漏尿的患者，取得较好疗效。8例个案均在五苓散类方基础上进行加减、合方治疗，其中6例效果较好，2例疗效不明显，采取温阳益肾方剂后效果满意，未见不良反应报告。结论：五苓散类方在辨证使用时，对压力性尿失禁有较明显的效果。该方作用在于调治膀胱气化不利，培脾土以制水，在此基础上根据病情兼顾肺、肾的治疗，临床疗效更加显著。五苓散类方对下焦的气化作用可能与针刺骶部穴位的作用存在共同机制，未来可结合医学试验进一步研究。 |
| English Summary: |
| To summarize Wuling Powder analogues and their evolution in the treatment of “bladder cough”，investigate the efficacy and safety of Wuling Powder analogues in the treatment of stress urinary incontinence(SUI) based on the modern clinical literature，and explore the underlying mechanism.Methods:The ancient and modern traditional Chinese medicine(TCM) books were read to summarize the changes in Wuling Powder and Chunze Decoction and their application in patients with cough-induced urinary incontinence.The research articles on Wuling Powder analogues in the treatment of SUI were retrieved from CNKI，CSPD，CCD，CBMdisc，and PubMed，and summarized.Results:Eleven articles published from 1988 to 2020 were searched.Eight of them were case reports involving nine cases，and three were theoretical studies.There was no clinical randomized controlled trial(RCT).In one case report，Wuling Powder under the original formula was provided for one patient with cough-induced urinary incontinence and achieved a good curative effect.The other eight cases were treated by modified Wuling Powder，and the results showed that the effect was satisfied in six cases and insignificant in two cases.After the treatment with yang-warming and kidney-tonifying formula，the effect was improved and satisfied.No adverse reaction was reported.Conclusion:When used in syndrome differentiation，Wuling Powder analogues show a significant effect on SUI.Wuling Powder analogues are effective in regulating the unfavorable qi transformation of the bladder and cultivating the spleen to control water，and in addition to the treatment of the lung and kidney according to the conditions，the clinical effect is significant.The effect of Wuling Powder analogues on qi transformation in the lower energizer may share the mechanism with acupuncture at the sacral region，which can be further studied in combination with medical experiments in the future. |
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