仿生物理治疗联合补中益气丸对子宫全切术患者盆底功能康复效果的影响

摘要

目的：探讨仿生物理治疗联合补中益气丸对腹式非脱垂子宫全切术后患者盆底功能康复效果的影响。方法将108例行腹式非脱垂子宫全切除术患者随机分为治疗组与对照组。治疗组给予低频电刺激＋生物反馈＋补中益气丸治疗，对照组给予低频电刺激＋生物反馈治疗。统计2组手术前、术后3个月、疗程结束即时、术后6个月、术后12个月压力性尿失禁发生情况，观察2组盆底肌肉肌力及肌电位、肛提肌裂孔和阴道顶端脱垂情况。结果治疗后2组压力性尿失禁发生率明显降低，漏尿量明显减少，肌力及肌电位明显提高，且治疗组改善情况均优于对照组（P ＜0.05或 P ＜0.01）。治疗后2组肛提肌裂孔内结构完整紧凑，肛提肌裂孔面积缩小，与治疗前相比差异均有统计学意义（P 均＜0.05），且治疗组肛提肌面积缩小情况优于对照组（P ＜0.05）；疗程结束即时、术后6个月、术后12个月治疗组 C 点绝对值明显高于对照组（P 均＜0.05）。结论仿生物理治疗联合补中益气丸可以明显降低子宫切除术后患者压力性尿失禁发生率，提高盆底肌肉肌力，延缓阴道顶端下移，维持阴道紧缩度，且改善盆底功能受损效果更持久。%Objective It is to analyze the effect of biofeedback and electrical stimulation combined with Buzhong Yiqi Pill on the female pelvic floor function after abdominal non-prolapsed total abdominal hysterectomy. Methods 108 undergoing ab-dominal non-prolapsed total abdominal hysterectomy were randomly divided into treatment group and control treatment:the treatment group was treated with biofeedback and low frequency electrical stimulation combined with Buzhong Yiqi Pill,while the control group were treated with low frequency electrical stimulation and biofeedback therapy only. The occurrence of stress urinary incontinence before operation,in 3 months after operation,at the end of treatment course,in 6 and 12 months after op-eration in both groups were counted and the pelvic muscle force and myoelectric potential,anal levator hiatus,prolapse of top of vagina were observed. Results After treatment,the occurrence and quantity of stress urinary incontinence were decreased, and pelvic muscle force and myoelectric potential were increased significantly in both groups,and the improvements in treat-ment group were better than those in control group(P < 0. 05 or P < 0. 01). On the other hand,the construction was complete and close in anal levator hiatus while the area decreased in both groups,compared with that before treatment,the differences were significant(P < 0. 05),and the decrease was more significant in treatment group than that in control group(P < 0. 05). The absolute values of C point at the end of treatment course,in 6 and 12 months after operation in treatment group were high-er than those in control group( P < 0. 05). Conclusion Biofeedback and electrical stimulation combined with Buzhong Yiqi Pill could effectively low down the occurrence of stress urinary incontinence,strengthen pelvic muscle force,delay down mov-ing of top of vagina,and the improving effects on pelvic floor dyssynergia were more durable.