| Objective: To observe the clinical effect of needle warming moxibustion combined with pelvic floor muscle training on female patients with stress incontinence of kidney qi deficiency type,and to compare this combined method with pelvic floor muscle training alone,so as to provide scientific and convincing practical basis for the treatment of this disease.Methods: PARTICIPANTS: Combined with the diagnostic criteria,inclusion criteria and exclusion criteria,the patients with stress incontinence(SUI)diagnosed and treated in Acupuncture and Moxibustion Department and TCM Department of Shenyang Women’s and Children’s Hospital from December 2019 to January 2021 were screened,and 60 cases were finally included.Grouping information: All patients were randomly divided into two groups(group A and group B)according to the random number table method,each with 30 cases.The group A(control group)was given pelvic floor muscle training(Scheme A),and the group B(treatment group)was treated with needle warming moxibustion on the basis of the Scheme A(Scheme B).SCHEME A: Instructed the patient to ensure that the bladder was empty before training.During training,the patient was in a supine position,with his/her knees close together and inhaling deeply,so as to ensure the exertion of hip muscles and consciously contract the muscles of anus,perineum and urethra.Instructed the patient to quickly perform the maximum continuous contraction of pelvic floor muscle for 3times,and then relaxed the pelvic floor muscle;Then,performed 3 times of maximum continuous contraction of pelvic floor muscles slowly,and then relaxed the pelvic floor muscles.Training schedule: 20min/ time,3 times/day.SCHEME B: Selection of acupoints: Zhongji,Guanyuan,Ciliao(bilateral),Huiyang(bilateral),Shenshu(bilateral)and Zusanli(bilateral).Acupoint location: Refer to the "Name and Location of Acupoints" in the National Standard of the People’s Republic of China in 2006(GB/T 12346-2006).Selection of medical instruments: acupuncture needles:disposable sterile acupuncture needles(specifications: 0.30mm×40mm,0.30mm×75mm)produced by Suzhou Medical Products Factory Co.,Ltd..Moxa stick: Qing Ai Tiao produced by Suzhou Medical Products Factory Co.,Ltd.(specification: 25g/piece).Patients were divided into two groups.Group 1: Zhongji,Guanyuan and Zusanli.Patients took supine position;Group 2: Ciliao,Shenshu and Huiyang.Patients took prone position.Acupuncture operation: routinely disinfected skin at acupoints.Acupuncture method at the Ciliao and Huiyang: used a 3-inch acupuncture needle to directly puncture the points,and the acupuncture depth was about 50-60 mm.Acupuncture method at the Zhongji,Guanyuan,Shenshu and Zusanli: used a1.5-inch acupuncture needle with a depth of about 20-30 mm.After bring about the desired sensation in the acupuncture treatment,put a piece of hard paper in the acupoint area to prevent burns,and then put a piece of moxa stick(1.8cm×2.0cm)on the needle handle,which was about 2 ~ 3 cm away from the skin,and ignited the moxa stick.The best effect is that patients can feel warm in the deep part of acupoints.After completing a course of moxibustion,removed the ashes and pull out the acupuncture needle.3 moxa sticks/acupoints,leaving needles for 30 min.Acupuncture schedule: once every other day,alternately selected acupoints,three times a week.The operation of pelvic floor muscle function training in group B was consistent with that in group A.TREATMEN COURSE: Four weeks.Observation index: The changes of the scores of ICIQ-SF scale,the amount of urine leakage in 1h urine pad test and the clinical effect of traditional Chinese medicine before and after treatment,and the clinical efficacy of the two groups.Results:1.About the changes of the scores of ICIQ-SF scale: Before treatment,there was no significant difference in ICIQ-SF scores between the two groups(P>0.05).After treatment,the scores of the two groups were significantly reduced(P<0.05),and the reduction degree of the group B was significantly greater than that of the group A(P<0.05).2.About the amount of urine leakage in 1h urine pad test: Before treatment,there was no significant difference between the two groups(P>0.05).After treatment,the amount of the two groups were significantly reduced(P<0.05),showing that both the two treatment schemes can reduce the urine leakage of patients in 1h urine pad test.And the reduction degree of the group B was significantly greater than that of the group A(P<0.05).Compared with the group A,the amount of urine leakage in the group B decreased more significantly(P < 0.05),indicating that needle warming moxibustion can further strengthen the ability of patients to control urine leakage.3.About the Clinical efficacy of traditional Chinese medicine: According to the total clinical effective rate of TCM,the clinical efficacy of TCM in group B(90.00%)was significantly better than that in group A(73.33%)(P<0.05),which indicated that needle warming moxibustion was effective in improving kidney qi deficiency syndrome.4.According to the total clinical effective rate,the clinical efficacy of group B(90.00%)was significantly better than that of group A(63.33%)(P<0.05),indicating that the scheme of group B has obvious curative effect,can comprehensively improve the clinical symptoms of patients,and is worthy of popularization and application.Conclusion:1.Needle warming moxibustion combined with pelvic floor muscle function training program is better than single pelvic floor muscle training program in reducing ICIQ-SF scale score and amount of urine leakage in 1 hour urine pad test and improving clinical symptoms.2.The clinical efficacy of this combined scheme in improving the syndrome of kidney qi deficiency is better than that of pelvic floor muscle training scheme alone.3.Needle warming moxibustion is an effective method to treat female stress incontinence,which can improve the clinical curative effect. |
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