本文選題：益氣縮泉湯　切入點(diǎn)：急迫性尿失禁　出處：《浙江大學(xué)》2016年碩士論文

【摘要】：研究目的根據(jù)國(guó)際尿控協(xié)會(huì)(International Continence Society, ICS)的定義,伴隨突然而強(qiáng)烈的尿意而出現(xiàn)的不自主尿液自尿道外口溢出,稱為急迫性尿失禁(urge urinary incontinence, UUI)是中老年婦女的常見(jiàn)病。盡管這一疾病為非致死性疾病,但會(huì)給患者帶來(lái)焦慮、尷尬和沮喪等不良情緒,導(dǎo)致患者社交障礙,嚴(yán)重影響患者的工作和生活。UUI發(fā)病率并不確定,據(jù)國(guó)內(nèi)外較大樣本調(diào)查,其發(fā)病率在5.8-18.4%。男女均可發(fā)生,女性高于男性,且隨著年齡的增加發(fā)病率也明顯增高。UUI是由于逼尿肌強(qiáng)烈收縮而出現(xiàn)的尿失禁,病因復(fù)雜,確切的發(fā)病機(jī)理并不十分明確。盡管現(xiàn)在有多種治療方法,如生活方式干預(yù),盆底肌肉訓(xùn)練,生物反饋治療,電刺激治療以及藥物治療,甚至手術(shù)治療等,但療效不夠理想也存在一定風(fēng)險(xiǎn),不適合在中老年婦女中廣泛應(yīng)用。我們通過(guò)臨床觀察和分析益氣縮泉湯在治療中老年婦女急迫性尿失禁中的療效,希望為該病的提供一個(gè)新的治療方法。研究方法根據(jù)ICS標(biāo)準(zhǔn),選取中老年婦女急迫性尿失禁患者36例,給予益氣縮泉湯口服,療程42天。所有患者分別于治療前、治療2周和治療6周記錄主觀癥狀,填寫生活質(zhì)量評(píng)分表、排尿日記和國(guó)際尿失禁咨詢委員會(huì)尿失禁問(wèn)卷表(ICIQ-FLUTS)進(jìn)行評(píng)價(jià),以及行血壓,血、尿常規(guī),肝功能、腎功能以及心電圖等檢查,了解該組方對(duì)患者機(jī)體其它方面的影響。完整的臨床資料運(yùn)用SPSS 15.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果經(jīng)治療2-6周后患者的尿頻尿急癥狀明顯改善,表現(xiàn)在每次平均尿量增加、24h平均排尿次數(shù)減少、平均尿失禁次數(shù)減少、夜尿次數(shù)減少、24小時(shí)飲水量增加,治療前后比較統(tǒng)計(jì)學(xué)差異顯著(P0.05)。治療前平均總ICIQ-FLUS評(píng)分為(72.21±14.23),治療后平均總ICIQ-FLUS評(píng)分為(44.90±12.25),平均總ICIQ-FLUS評(píng)分在治療后明顯降低,有顯著性差異(p0.05)。益氣縮泉湯治療前患者的I-PSS評(píng)分為(13.50±2.65),治療2周后為(10.I0±1.72),治療6周后為(6.47±2.35),治療后I-PSS評(píng)分分值下降,有顯著性差異(p0.05)。生活質(zhì)量評(píng)分治療前為(4.88±0.58),治療2周后為(3.36±1.08),治療6周后為(1.88±1.36),治療后生活質(zhì)量評(píng)分下降,有顯著性差異(p0.05)。結(jié)論1.益氣縮泉湯對(duì)中老年婦女急迫性尿失禁治療療效明顯,未發(fā)現(xiàn)明顯副作用。2.采用ICIQ-FLUS問(wèn)卷表填寫,經(jīng)評(píng)定急迫性尿失禁患者服用益氣縮泉湯后其生活質(zhì)量明顯提高,具有較好的臨床治療價(jià)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 鹵14.23g, the average total ICIQ-FLUS score was 44.90 鹵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 鹵2.65g, after 2 weeks it was 10.I0 鹵1.72G, and after 6 weeks it was 6.47 鹵2.350.After treatment, the I-PSS score decreased. The quality of life score was 4.88 鹵0.58 before treatment, 3.36 鹵1.08 after 2 weeks, 1.88 鹵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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R277.5

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