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单纯膀胱训练与膀胱训练联合盆底肌训练治疗女性膀胱过度活动症的随机临床试验

Bladder training compared to bladder training associated with pelvic floor muscle training for overactive bladder symptoms in women: A randomized clinical trial.

机构信息

Postgraduate Program in Surgical Science, School of Medical Sciences of the State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.

Physiotherapy Department Pontifical Catholic University of Minas Gerais (PUC-MINAS), Belo Horizonte, Minas Gerais, Brazil.

出版信息

Neurourol Urodyn. 2023 Nov;42(8):1802-1811. doi: 10.1002/nau.25285. Epub 2023 Sep 18.

Abstract

AIMS

To compare the effects of bladder training (BT) versus BT with pelvic floor muscle training (PFMT) in women with overactive bladder (OAB) symptoms.

METHODS

Randomized controlled clinical trial including women with OAB symptoms, randomized into two groups: BT versus BT + PFMT. For 12 consecutive weeks, the women received home BT. The BT + PFMT performed supervised PFMT, once/week, associated at home PFMT protocol. Primary outcomes were urinary urgency, daytime voiding frequency, nocturia and urgency urinary incontinence assisted by both 3-day bladder diary and International Consultation on Incontinence OAB (ICIQ-OAB) questionnaire. Secondary outcomes were 24-h pad test and Patient Global Impression of Improvement. T-test, analysis of variance, Mann-Whitney (SPSS 20.0) and power/effect size (G-power) were applied in data analyses.

RESULTS

Sixty-three women were included (B = 31; BT + PFMT = 32). There was no significant statistical difference between groups in terms of urinary symptoms: daytime frequency (BT: pre: 11.59 [±5.80], post: 9.10 [±4.05]; BT + PFMT: pre: 10.67 [±3.73], post: 8.08 [±3.38]) p = 0.75; nocturia: (BT: pre: 1.46 [±0.91], post: 0.82 [±0.82]; BT + PFMT: pre: 1.80 [±2.26], post: 0.82 [±1.15]) p = 0.70; urinary urgency (BT: pre: 3.22 [±4.70], post: 4.49 [±4.32]; BT + PFMT: pre: 6.87 [±5.60], post: 6.15 [±4.52]) p = 0.10; ICIQ-OAB total score: (BT: pre: 9.16 [±2.55], post: 6.32 [±3.77]; (BT + PFMT: pre: 9.75 [±2.06], post: 5.06 [±3.44] p = 0.30.

CONCLUSIONS

Supervised PFMT added to BT did not provide further improvements than isolated BT in women with OAB symptoms.

摘要

目的

比较膀胱训练(BT)与 BT 联合盆底肌训练(PFMT)对膀胱过度活动症(OAB)女性的疗效。

方法

本随机对照临床试验纳入 OAB 症状女性,随机分为两组:BT 组和 BT+PFMT 组。12 周内,女性均接受家庭 BT。BT+PFMT 组接受每周一次的监督 PFMT,并在家中执行 PFMT 方案。主要结局指标为 3 天膀胱日记和国际尿失禁咨询委员会膀胱过度活动症问卷(ICIQ-OAB)评估的尿急、日间排尿次数、夜尿和急迫性尿失禁。次要结局指标为 24 小时尿垫试验和患者总体改善印象。数据采用 t 检验、方差分析、Mann-Whitney(SPSS 20.0)和功效/效应大小(G- power)进行分析。

结果

共纳入 63 名女性(B 组=31 名;BT+PFMT 组=32 名)。两组在日间频率(BT 组:治疗前:11.59±5.80,治疗后:9.10±4.05;BT+PFMT 组:治疗前:10.67±3.73,治疗后:8.08±3.38)、夜尿(BT 组:治疗前:1.46±0.91,治疗后:0.82±0.82;BT+PFMT 组:治疗前:1.80±2.26,治疗后:0.82±1.15)、尿急(BT 组:治疗前:3.22±4.70,治疗后:4.49±4.32;BT+PFMT 组:治疗前:6.87±5.60,治疗后:6.15±4.52)和 ICIQ-OAB 总评分(BT 组:治疗前:9.16±2.55,治疗后:6.32±3.77;BT+PFMT 组:治疗前:9.75±2.06,治疗后:5.06±3.44)方面均无显著统计学差异(p=0.75、0.70、0.10、0.30)。

结论

与单纯 BT 相比,OAB 女性接受监督 PFMT 联合 BT 治疗并未获得进一步改善。

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