广西医学

目的探讨电针刺“骶四穴”联合排尿功能训练对前列腺电切术后尿失禁患者排尿功能及控尿能力的影响。方法将122例前列腺电切术后尿失禁患者随机分为对照组及观察组，每组61例。对照组患者接受排尿功能训练，观察组患者在对照组治疗方案的基础上行电针刺“骶四穴”，两组均治疗8周。比较两组患者干预前和干预8周后的24 h尿失禁次数、24 h总排尿次数、24 h总排尿量、屏气漏尿点压（VLPP）、最大尿道闭合压（MUCP）、焦虑自评量表（SAS）评分、抑郁自评量表（SDS）评分、尿失禁生活质量（I⁃QoL）问卷评分，以及干预8周后的临床疗效。结果干预8周后，观察组的总有效率、VLPP、MUCP、I⁃QoL问卷各维度评分及总分高于干预前及对照组，24 h尿失禁次数和24 h总排尿次数少于干预前及对照组，24 h总排尿量多于对照组，SAS评分、SDS评分低于干预前及对照组（P<0.05）。结论相较于单纯排尿功能训练，电针刺“骶四穴”联合排尿功能训练可更有效地提升前列腺电切术后尿失禁患者的临床疗效，改善其排尿功能及控尿能力，缓解焦虑、抑郁等负性情绪，全面提升患者的生活质量。

Objective To investigate the effect of electroacupuncture at “sacral four acupoints” combined with urinary function training on urinary function and urinary continence ability in patients with urinary incontinence after transurethral resection of the prostate. Methods A total of 122 patients with urinary incontinence after transurethral resection of the prostate were randomly divided into control group or observation group, with 61 cases in each group. The control group received urinary function training alone, based on which the observation group received electroacupuncture at “sacral four acupoints”. Both groups were treated for 8 weeks. The 24⁃hour urinary incontinence frequency, 24⁃hour total frequency of urination, 24⁃hour total volume of urination, valsalva leak point pressure (VLPP), maximum urethral closure pressure (MUCP), Self⁃Rating Anxiety Scale (SAS) and Self⁃Rating Depression Scale (SDS), Incontinence Quality of Life (I⁃QoL) questionnaire score before intervention and 8 weeks after intervention, as well as clinical efficacy after 8 weeks of intervention were compared between the two groups. Results After 8 weeks of intervention, the observation group exhibited higher total effective rate, VLPP, MUCP, various dimensions scores and total score of I⁃QoL questionnaire as compared with before intervention and the control group, whereas the observation group interpreted less frequency of 24⁃hour urinary incontinence and 24⁃hour total urination, while a largervoloume of 24⁃hour total urination, and lower SAS and SDS scores as compared with before intervention and the control group (P<0.05). Conclusion Compared with simple urinary function training, electroacupuncture at “sacral four acupoints” combined with urinary function training can effectively improve clinical efficacy in patients with urinary incontinence after transurethral resection of the prostate, ameliorate their urinary function and urinary continence ability, relieve negative emotions such as anxiety and depression, and comprehensively enhance the quality of life in patients.