益气缩泉汤治疗中老年妇女急迫性尿失禁疗效分析

发布时间：2018-03-31 22:34

本文选题：益气缩泉汤　切入点：急迫性尿失禁　出处：《浙江大学》2016年硕士论文

【摘要】：研究目的根据国际尿控协会(International Continence Society, ICS)的定义,伴随突然而强烈的尿意而出现的不自主尿液自尿道外口溢出,称为急迫性尿失禁(urge urinary incontinence, UUI)是中老年妇女的常见病。尽管这一疾病为非致死性疾病,但会给患者带来焦虑、尴尬和沮丧等不良情绪,导致患者社交障碍,严重影响患者的工作和生活。UUI发病率并不确定,据国内外较大样本调查,其发病率在5.8-18.4%。男女均可发生,女性高于男性,且随着年龄的增加发病率也明显增高。UUI是由于逼尿肌强烈收缩而出现的尿失禁,病因复杂,确切的发病机理并不十分明确。尽管现在有多种治疗方法,如生活方式干预,盆底肌肉训练,生物反馈治疗,电刺激治疗以及药物治疗,甚至手术治疗等,但疗效不够理想也存在一定风险,不适合在中老年妇女中广泛应用。我们通过临床观察和分析益气缩泉汤在治疗中老年妇女急迫性尿失禁中的疗效,希望为该病的提供一个新的治疗方法。研究方法根据ICS标准,选取中老年妇女急迫性尿失禁患者36例,给予益气缩泉汤口服,疗程42天。所有患者分别于治疗前、治疗2周和治疗6周记录主观症状,填写生活质量评分表、排尿日记和国际尿失禁咨询委员会尿失禁问卷表(ICIQ-FLUTS)进行评价,以及行血压,血、尿常规,肝功能、肾功能以及心电图等检查,了解该组方对患者机体其它方面的影响。完整的临床资料运用SPSS 15.0统计软件进行统计分析。结果经治疗2-6周后患者的尿频尿急症状明显改善,表现在每次平均尿量增加、24h平均排尿次数减少、平均尿失禁次数减少、夜尿次数减少、24小时饮水量增加,治疗前后比较统计学差异显著(P0.05)。治疗前平均总ICIQ-FLUS评分为(72.21±14.23),治疗后平均总ICIQ-FLUS评分为(44.90±12.25),平均总ICIQ-FLUS评分在治疗后明显降低,有显著性差异(p0.05)。益气缩泉汤治疗前患者的I-PSS评分为(13.50±2.65),治疗2周后为(10.I0±1.72),治疗6周后为(6.47±2.35),治疗后I-PSS评分分值下降,有显著性差异(p0.05)。生活质量评分治疗前为(4.88±0.58),治疗2周后为(3.36±1.08),治疗6周后为(1.88±1.36),治疗后生活质量评分下降,有显著性差异(p0.05)。结论1.益气缩泉汤对中老年妇女急迫性尿失禁治疗疗效明显,未发现明显副作用。2.采用ICIQ-FLUS问卷表填写,经评定急迫性尿失禁患者服用益气缩泉汤后其生活质量明显提高,具有较好的临床治疗价值和可行性。
[Abstract]:Objective according to the definition of International Continence Society (ICSs), the involuntary urine overflow from the external urethral orifice was accompanied by sudden and intense urinary intent. Called urge urinary incontinence, UUI is a common disease in middle-aged and elderly women. Although it is a non-fatal disease, it can cause anxiety, embarrassment and depression in patients and lead to social disorders. The incidence of severe impact on the work and life of patients. UUI incidence is uncertain. According to a large sample survey at home and abroad, the incidence rate is between 5.8-18.40.The incidence of UUI is higher in women than in men. The incidence of UUI also increased with age. UUI was caused by detrusor contraction. The etiology was complicated and the exact pathogenesis was not very clear. Although there are many treatments, such as lifestyle intervention, Pelvic floor muscle training, biofeedback therapy, electrical stimulation, drug therapy, and even surgical treatment, but there are risks to the lack of satisfactory results. It is not suitable to be widely used in middle-aged and elderly women. We hope to provide a new treatment method for this disease by clinical observation and analysis of the curative effect of Yiqi Jiaquan decoction in the treatment of urgent urinary incontinence in middle-aged and elderly women. Thirty-six elderly women with urgent urinary incontinence were treated with Yiqi Jiaquan decoction for 42 days. Subjective symptoms were recorded before treatment for 2 weeks and 6 weeks after treatment, and quality of life score was filled out. Urinary diaries and ICIQ-FLUTS were used to evaluate urinary incontinence, and blood pressure, blood, urine routine, liver function, renal function and electrocardiogram were examined. To understand the effect of this group on other aspects of the patient's body. The complete clinical data were analyzed by SPSS 15.0 statistical software. Results after 2 to 6 weeks of treatment, the patients' urination frequency urinal symptoms were obviously improved. The results were as follows: the average urine volume increased and the average urination times decreased, the average urinary incontinence times decreased, the night urine times decreased and the drinking water increased in 24 hours. Before and after treatment, the average total ICIQ-FLUS score was 72.21 卤14.23g, the average total ICIQ-FLUS score was 44.90 卤12.25g, and the average total ICIQ-FLUS score decreased significantly after treatment. The I-PSS score of patients with Yiqi Jiaquan decoction before treatment was 13.50 卤2.65g, after 2 weeks it was 10.I0 卤1.72G, and after 6 weeks it was 6.47 卤2.350.After treatment, the I-PSS score decreased. The quality of life score was 4.88 卤0.58 before treatment, 3.36 卤1.08 after 2 weeks, 1.88 卤1.36 after 6 weeks, and decreased after treatment. Conclusion 1. Yiqi Jiquan decoction is effective in the treatment of urgent urinary incontinence in middle-aged and old women. 2. Use ICIQ-FLUS questionnaire form to fill out. 2. The quality of life of patients with urgent urinary incontinence was improved after taking Yiqi Jiaquan decoction, which has good clinical value and feasibility.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.5

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