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电针联合盆底肌训练改善前列腺癌根治术后尿失禁的回顾性研究

Improvement of Urinary Incontinence after Radical Prostatectomy with Electroacupuncture Combined with Supervised Pelvic Floor Muscle Exercises: A Retrospective Study.

作者信息

Wu Yingjia, Yang Yuping, Guo Yingli, Kang Yingdan

机构信息

Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medicine University, 310061 Hangzhou, Zhejiang, China.

Department of Urology, Shanghai Ruijin Hospital Zhoushan Branch, 316000 Zhoushan, Zhejiang, China.

出版信息

Arch Esp Urol. 2025 Jul;78(6):751-757. doi: 10.56434/j.arch.esp.urol.20257806.100.

Abstract

OBJECTIVE

This study aimed to investigate the efficacy of electroacupuncture (EA) combined with supervised pelvic floor muscle training (PFMT) in improving post-radical prostatectomy urinary incontinence (PRPUI).

METHODS

The clinical data and treatment methods of patients with PRPUI admitted to the Third Affiliated Hospital of Zhejiang Chinese Medicine University from January 2023 to December 2023 were retrospectively collected, and they were divided into the PFMT group and PFMT + EA group according to the postoperative treatment methods. The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) and Incontinence Quality of Life Questionnaire (I-QOL) of patients before treatment (T0), 6 weeks of treatment (T1) and 12 weeks of treatment (T2) were collected and compared. Pelvic floor electromyography assessment values (maximum systolic electromyography (EMG) value, mean EMG value during isometric contraction and mean EMG value during endurance contraction) in patients at T0 and T2 were collected and compared.

RESULTS

A total of 226 patients with PRPUI were included in the study: PFMT group (n = 112) and PFMT + EA group (n = 114). The results from repeated measures Analysis of Variance (ANOVA) indicated a significant interaction between time and group for ICIQ-UI-SF and I-QOL ( < 0.001), as well as a significant main effect for time and group ( < 0.001). The ICIQ-UI-SF in the PFMT + EA group was lower than that in the PFMT group at T1 and T2, but the I-QOL was higher in the PFMT + EA group than in the PFMT group, and there was a significant difference between the two groups ( < 0.001). At the T2 time point, the maximum systolic EMG value, mean isometric contraction EMG value and mean endurance contraction EMG value in the PFMT + EA group were significantly higher than those in the PFMT group ( < 0.05).

CONCLUSIONS

EA combined with supervised PFMT can be used as an effective non-surgical treatment for the treatment of PRPUI.

摘要

目的

本研究旨在探讨电针(EA)联合监督下的盆底肌肉训练(PFMT)对改善根治性前列腺切除术后尿失禁(PRPUI)的疗效。

方法

回顾性收集2023年1月至2023年12月在浙江中医药大学附属第三医院收治的PRPUI患者的临床资料和治疗方法,根据术后治疗方法将其分为PFMT组和PFMT + EA组。收集并比较患者治疗前(T0)、治疗6周(T1)和治疗12周(T2)时的国际尿失禁咨询问卷-尿失禁简表(ICIQ-UI-SF)和尿失禁生活质量问卷(I-QOL)。收集并比较患者在T0和T2时的盆底肌电图评估值(最大收缩肌电图(EMG)值、等长收缩期间的平均EMG值和耐力收缩期间的平均EMG值)。

结果

本研究共纳入226例PRPUI患者:PFMT组(n = 112)和PFMT + EA组(n = 114)。重复测量方差分析(ANOVA)结果表明,ICIQ-UI-SF和I-QOL在时间和组间存在显著交互作用(< 0.001),时间和组间也存在显著主效应(< 0.001)。在T1和T2时,PFMT + EA组的ICIQ-UI-SF低于PFMT组,但PFMT + EA组的I-QOL高于PFMT组,两组间差异有统计学意义(< 0.001)。在T2时间点,PFMT + EA组的最大收缩EMG值、平均等长收缩EMG值和平均耐力收缩EMG值均显著高于PFMT组(< 0.05)。

结论

EA联合监督下的PFMT可作为治疗PRPUI的一种有效的非手术治疗方法。

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