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电针骶四穴联合腹三灸治疗脑卒中后尿失禁的临床疗效:尿动力学、生活质量和安全性观察。

Clinical Efficacy of Electroacupuncture at Sacral Four Points Combined with Moxibustion at Abdominal Three Points for Treating Post-Stroke Urinary Incontinence: Observations on Urodynamics, Quality of Life, and Safety.

机构信息

Department of Acupuncture and Massage, Shengli Oilfield Central Hospital, 257034 Dongying, Shandong, China.

出版信息

Arch Esp Urol. 2024 Aug;77(7):732-738. doi: 10.56434/j.arch.esp.urol.20247707.102.

Abstract

BACKGROUND

Urinary incontinence is a common complication following a stroke. No specific drugs are available in Western medicine, and surgical treatment is highly traumatic, limiting its clinical application. This study aimed to observe the clinical efficacy of electroacupuncture at the "Sacral Four Points" combined with moxibustion at the "Abdominal Three Points" on post-stroke urinary incontinence, exploring its impact on urodynamics and quality of life.

METHODS

Patients with post-stroke urinary incontinence treated at our Hospital from January 2021 to December 2023 were recruited. The study included 117 patients: 57 in the electroacupuncture group and 60 in the combined group. Urodynamic parameters were measured, and scores from the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and the Incontinence Quality of Life Questionnaire (I-QOL) were recorded before, and after the first and third courses of treatment. Clinical efficacy and adverse reactions were evaluated post-treatment.

RESULTS

The study found no significant differences in clinical characteristics between the groups ( > 0.05), providing a baseline for comparison. Both groups showed substantial decreases in leakage volume after one course of treatment ( < 0.05), with a reduction in the ICIQ-UI SF score ( < 0.05) and an increase in the I-QOL score ( < 0.05). After three courses of treatment, the leakage volume of patients in both groups significantly decreased ( < 0.05), the ICIQ-UI SF score decreased ( < 0.05), and the I-QOL score increased ( < 0.05). The combined group showed a lower leakage volume compared to the electroacupuncture group ( < 0.05), with lower ICIQ-UI SF scores ( = 0.027) and higher I-QOL scores ( = 0.048). Importantly, the total effective rate was significantly higher in the combined group (88.33% vs 64.91%, = 0.037), demonstrating the safety and efficacy of the treatment.

CONCLUSIONS

Electroacupuncture at the "Sacral Four Points" combined with moxibustion at the "Abdominal Three Points" improves the clinical symptoms and enhances the quality of life for patients with post-stroke urinary incontinence, showing superior results compared to electroacupuncture alone.

摘要

背景

尿失禁是中风后的常见并发症。西医尚无特定药物,手术治疗创伤大,限制了其临床应用。本研究旨在观察电针“骶四穴”结合艾灸“腹三穴”治疗中风后尿失禁的临床疗效,探讨其对尿动力学和生活质量的影响。

方法

选取 2021 年 1 月至 2023 年 12 月我院收治的中风后尿失禁患者 117 例,电针组 57 例,联合组 60 例。测量尿动力学参数,记录国际尿失禁咨询问卷-尿失禁简短表(ICIQ-UI SF)和尿失禁生活质量问卷(I-QOL)评分治疗前、治疗 1 个疗程后和治疗 3 个疗程后的评分。治疗后评估临床疗效及不良反应。

结果

两组患者临床特征比较差异无统计学意义( > 0.05),具有可比性。两组患者治疗 1 个疗程后漏尿量均显著减少( < 0.05),ICIQ-UI SF 评分降低( < 0.05),I-QOL 评分升高( < 0.05)。治疗 3 个疗程后,两组患者漏尿量均明显减少( < 0.05),ICIQ-UI SF 评分降低( < 0.05),I-QOL 评分升高( < 0.05)。联合组漏尿量少于电针组( < 0.05),ICIQ-UI SF 评分低于电针组( = 0.027),I-QOL 评分高于电针组( = 0.048)。联合组总有效率明显高于电针组(88.33% vs 64.91%, = 0.037),表明治疗安全有效。

结论

电针“骶四穴”结合艾灸“腹三穴”可改善中风后尿失禁患者的临床症状,提高生活质量,疗效优于单纯电针。

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