Oyama Ian A, Rejba Amy, Lukban James C, Fletcher Erica, Kellogg-Spadt Susan, Holzberg Adam S, Whitmore Kristene E
University of Medicine and Dentistry New Jersey Robert Wood Johnson School of Medicine, Cooper Hospital, Camden, New Jersey 08043, USA.
Urology. 2004 Nov;64(5):862-5. doi: 10.1016/j.urology.2004.06.065.
To evaluate the effectiveness of transvaginal manual therapy of the pelvic floor musculature (Thiele massage) in symptomatic female patients with interstitial cystitis and high-tone dysfunction of the pelvic floor.
A total of 21 women with documented interstitial cystitis and high-tone pelvic floor dysfunction underwent transvaginal massage using the Thiele technique twice a week for 5 weeks. Symptoms were evaluated before massage, at protocol conclusion, and at a mean of 4.5 months after therapy completion (long-term follow-up). The response to treatment was evaluated through the O'Leary-Sant Interstitial Cystitis Symptom and Problem Indexes, Likert Visual Analogue Scales for urgency and pain, and Short-Form 12-item (SF-12) Quality-of-Life Scale, and through changes in the physical examination findings using a 5-point modified Oxford Scale to document pelvic floor tenderness.
A statistically significant improvement was seen in the Symptom and Problem Indexes of the O'Leary-Sant Questionnaire (P = 0.015 and P = 0.039, respectively), Likert Visual Analogue Scales for urgency and pain (P = 0.001 and P = 0.005, respectively), the Physical and Mental Component Summary from the SF-12 Quality-of-Life Scale (P = 0.049 and P = 0.044, respectively), and the modified Oxford Scale (P <0.05) after protocol completion. At long-term follow-up, the O'Leary-Sant Interstitial Cystitis Symptom and Problem Indexes (P = 0.049 and P = 0.02, respectively), Likert Visual Analogue Scales for urgency and pain (P = 0.004 and P = 0.005, respectively), and modified Oxford Scale for three of four muscles in the pelvic floor (P <0.05) remained significantly improved.
Thiele massage appears to be very helpful in improving irritative bladder symptoms in patients with interstitial cystitis and high-tone pelvic floor dysfunction in addition to decreasing pelvic floor muscle tone.
评估经阴道盆底肌肉手法治疗（蒂勒按摩）对有症状的间质性膀胱炎和盆底高张性功能障碍女性患者的疗效。
共有21名确诊为间质性膀胱炎和盆底高张性功能障碍的女性患者，采用蒂勒技术每周进行两次经阴道按摩，共持续5周。在按摩前、方案结束时以及治疗完成后平均4.5个月（长期随访）时对症状进行评估。通过奥利里-桑特间质性膀胱炎症状和问题指数、尿急和疼痛的李克特视觉模拟量表、简短健康调查12项（SF-12）生活质量量表，以及使用5分改良牛津量表记录盆底压痛情况的体格检查结果变化来评估治疗反应。
在方案完成后，奥利里-桑特问卷的症状和问题指数（分别为P = 0.015和P = 0.039）、尿急和疼痛的李克特视觉模拟量表（分别为P = 0.001和P = 0.005）、SF-12生活质量量表的身体和精神成分总结（分别为P = 0.049和P = 0.044）以及改良牛津量表（P <0.05）有统计学意义的改善。在长期随访中，奥利里-桑特间质性膀胱炎症状和问题指数（分别为P = 0.049和P = 0.02）、尿急和疼痛的李克特视觉模拟量表（分别为P = 0.004和P = 0.005）以及盆底四块肌肉中三块肌肉的改良牛津量表（P <0.05）仍有显著改善。
除了降低盆底肌肉张力外，蒂勒按摩似乎对改善间质性膀胱炎和盆底高张性功能障碍患者的膀胱刺激症状非常有帮助。
