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经皮胫神经刺激治疗帕金森病患者下尿路症状及其对健康相关生活质量的影响:一项随机对照试验

Transcutaneous tibial nerve stimulation in the treatment of lower urinary tract symptoms and its impact on health-related quality of life in patients with Parkinson disease: a randomized controlled trial.

作者信息

Perissinotto Maria Carolina, DʼAncona Carlos Arturo Levi, Lucio Adélia, Campos Renata Martins, Abreu Anelyssa

机构信息

Maria Carolina Perissinotto, PhD, Universidade Estadual de Campinas-Unicamp, Department of Urology, Campinas, São Paulo, Brazil. Carlos Arturo Levi D'Ancona, PhD, Universidade Estadual de Campinas-Unicamp, Department of Urology, Campinas, São Paulo, Brazil. Adélia Lúcio, PhD, Universidade Estadual de Campinas-Unicamp, Department of Urology, Campinas, São Paulo, Brazil. Renata Martins Campos, MSN, Universidade Estadual de Campinas-Unicamp, Department of Urology, Campinas, São Paulo, Brazil. Anelyssa Abreu, PhD, Universidade Estadual de Campinas-Unicamp, Department of Neurology, Campinas, São Paulo, Brazil.

出版信息

J Wound Ostomy Continence Nurs. 2015 Jan-Feb;42(1):94-9. doi: 10.1097/WON.0000000000000078.

Abstract

PURPOSE

A randomized controlled trial study was performed to evaluate the efficacy of transcutaneous tibial nerve stimulation (TTNS) and sham TTNS, in patients with Parkinson disease (PD) with lower urinary tract symptoms (LUTS).

DESIGN

Randomized controlled trial.

SUBJECTS AND SETTINGS

Thirteen patients with a diagnosis of PD and bothersome LUTS were randomly allocated to one of the following groups: Group I: TTNS group (n = 8) and group II: Sham group (n = 5). Both groups attended twice a week during 5 weeks; each session lasted 30 minutes.

METHODS

Eight patients received TTNS treatment and 5 subjects allocated to group II were managed with sham surface electrodes that delivered no electrical stimulation. Assessments were performed before and after the treatment; they included a 3-day bladder diary, Overactive Bladder Questionnaire (OAB-V8), and the International Consultation on Incontinence Quality of Life Questionnaire Short Form (ICIQ-SF), and urodynamic evaluation.

RESULTS

Following 5 weeks of treatment, patients allocated to TTNS demonstrated statistically significant reductions in the number of urgency episodes (P = .004) and reductions in nocturia episodes (P < .01). Participants allocated to active treatment also showed better results after treatment in the OAB-V8 and ICIQ-SF scores (P < .01, respectively). Urodynamic testing revealed that patients in the active treatment group showed improvements in intravesical volume at strong desire to void (P < .05) and volume at urgency (P < .01) when compared to subjects in the sham treatment group.

CONCLUSION

These findings suggest that TTNS is effective in the treatment of LUTS in patients with PD, reducing urgency and nocturia episodes and improving urodynamic parameters as well as symptom scores measured by the OAB-V8 and health-related quality-of-life scores measured by the ICIQ-SF.

摘要

目的

进行一项随机对照试验研究,以评估经皮胫神经刺激(TTNS)和假TTNS对患有下尿路症状(LUTS)的帕金森病(PD)患者的疗效。

设计

随机对照试验。

研究对象与设置

13名诊断为PD且有困扰性LUTS的患者被随机分配到以下组之一:第一组:TTNS组(n = 8)和第二组:假刺激组(n = 5)。两组在5周内每周参加两次治疗;每次治疗持续30分钟。

方法

8名患者接受TTNS治疗,分配到第二组的5名受试者使用不进行电刺激的假表面电极进行处理。在治疗前后进行评估;评估包括3天膀胱日记、膀胱过度活动症问卷(OAB-V8)、国际尿失禁咨询委员会生活质量问卷简表(ICIQ-SF)以及尿动力学评估。

结果

经过5周的治疗,接受TTNS治疗的患者在尿急发作次数上有统计学意义的显著减少(P = .004),夜尿发作次数也减少(P < .01)。接受积极治疗的参与者在治疗后的OAB-V8和ICIQ-SF评分中也显示出更好的结果(分别为P < .01)。尿动力学测试显示,与假治疗组的受试者相比,积极治疗组的患者在强烈排尿欲望时的膀胱内体积(P < .05)和尿急时的体积(P < .01)有所改善。

结论

这些发现表明,TTNS对PD患者的LUTS治疗有效,可减少尿急和夜尿发作次数,改善尿动力学参数以及由OAB-V8测量的症状评分和由ICIQ-SF测量的健康相关生活质量评分。

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