文章摘要
屈 方,张普敬,蔡 蕊,王玉滢,付潇潇.补中益气汤联合低频脉冲电刺激促进产后盆底功能障碍的效果及血清松弛素、CTGF和MMP-1水平的影响[J].,2023,(24):4760-4764
补中益气汤联合低频脉冲电刺激促进产后盆底功能障碍的效果及血清松弛素、CTGF和MMP-1水平的影响
Effect of Bu Zhong Yi Qi Tang Combined with Low-frequency Pulse Electrical Stimulation on Promoting Postpartum Pelvic Floor Dysfunction and the Influence of Serum Relaxin, CTGF and MMP-1 Levels
投稿时间:2023-05-27  修订日期:2023-06-23
DOI:10.13241/j.cnki.pmb.2023.24.032
中文关键词: 补中益气汤  盆底功能障碍  血清松弛素  低频脉冲电刺激  结缔组织生长因子  机制金属蛋白酶-1
英文关键词: Bu Zhong Yi Qi Tang  Low frequency pulse electrical stimulation  Pelvic floor dysfunction  Serum Relaxin  Connective tissue growth factor  Mechanism Metalloproteinase-1
基金项目:陕西省重点研发计划项目(2023-YBSF-305)
作者单位E-mail
屈 方 西北妇女儿童医院盆底与产后康复中心 陕西 西安 710061 qufangjiayou@163.com 
张普敬 西北妇女儿童医院盆底与产后康复中心 陕西 西安 710061  
蔡 蕊 西北妇女儿童医院盆底与产后康复中心 陕西 西安 710061  
王玉滢 西北妇女儿童医院盆底与产后康复中心 陕西 西安 710061  
付潇潇 西北妇女儿童医院盆底与产后康复中心 陕西 西安 710061  
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中文摘要:
      摘要 目的:探讨补中益气汤联合低频脉冲电刺激促进产后盆底功能障碍的效果及血清松弛素(RLX)、结缔组织生长因子(CTGF)和基质金属蛋白酶-1(MMP-1)水平的影响。方法:选取我院2022年4月到2023年4月收治的150例产后盆底功能障碍患者作为研究对象,分为观察组与对照组,各组均75例。对照组患者采取低频脉冲电刺激治疗,观察组患者采取补中益气汤联合低频脉冲电刺激治疗,对比两组患者的临床疗效,治疗前后盆底表面肌电变化情况,并分别在治疗前后应用盆腔脏器官脱垂-尿失禁性功能问卷(PISQ-12)、国际尿控协会盆腔脏器脱垂定量分析量表(POP-Q)、尿失禁问卷表简表(ICI-Q-SF)评估两组患者的性功能、盆腔脱垂程度及尿失禁情况,并对比治疗前后血清RLX、CTGF和MMP-1表达水平。结果:观察组总有效率93.33%明显高于对照组78.67%(P<0.05);两组患者治疗前耐力收缩(Ⅱ类肌)、持续收缩和快速收缩(Ⅰ类肌)、前静息电位、后静息电位肌电水平对比无差异(P>0.05),治疗后观察组快速收缩(Ⅰ类肌)高于对照组(P<0.05),静息电位与后静息电位低于对照组(P<0.05);两组患者治疗前PISQ-12、POP-Q和ICI-Q-SF评分对比无明显差异(P>0.05),治疗后两组患者PISQ-12、ICI-Q-SF评分升高,观察组较对照组高,POP-Q评分均降低,观察组较对照组低(P<0.05);两组患者治疗前RLX、CTGF和MMP-1表达水平对比无差异(P>0.05),治疗后两组患者RLX、CTGF和MMP-1表达水平均降低,且观察组低于对照组(P<0.05)。结论:补中益气汤联合低频脉冲电刺激可提升产后盆底功能障碍的临床疗效,改善盆底肌表面肌电变化,改善患者性功能、盆腔脱垂程度及尿失禁情况,且能够降低血清松弛素、CTGF和MMP-1表达水平。
英文摘要:
      ABSTRACT Objective: To explore the effect of Bu Zhong Yi Qi Tang combined with low-frequency pulse electrical stimulation on promoting postpartum pelvic floor dysfunction and the influence of serum Relaxin (RLX), connective tissue growth factor (CTGF) and mechanism metalloproteinase-1 (MMP-1) levels. Methods: 150 patients with postpartum pelvic floor dysfunction admitted to our hospital from April 2022 to April 2023 were selected as the research subjects. They were divided into an observation group and a matched group using a lottery method, with 75 patients in each group. The patients in the matched group were treated with low-frequency pulse electrical stimulation, and the patients in the observation group were treated with Bu Zhong Yi Qi Tang combined with low-frequency pulse electrical stimulation. The clinical effects of the two groups were compared, and the changes of pelvic floor surface myoelectricity before and after treatment were compared. The pelvic organ prolapse Urinary incontinence sexual function questionnaire (PISQ-12), the International Association for Urinary Control pelvic organ prolapse quantitative analysis scale(POP-Q) Urinary incontinence questionnaire short form (ICI-Q-SF) was used to evaluate the sexual function, pelvic prolapse and Urinary incontinence of the two groups of patients, and the serum RLX, CTGF and MMP-1 expression levels were compared before and after treatment. Results: The total effective rate of 93.33% in the observation group was significantly higher than 78.67% in the matched group(P<0.05); There was no significant difference in the EMG levels of endurance contraction (Class II muscle), continuous contraction and rapid contraction (Class I muscle), anterior Resting potential and posterior Resting potential between the two groups before treatment (P>0.05). After treatment, the rapid contraction (Class I muscle) in the observation group was higher than that in the matched group (P<0.05), and the Resting potential and posterior Resting potential were lower than those in the matched group(P<0.05); There was no significant difference in the PISQ-12, POP-Q, and ICI-Q-SF scores between the two groups of patients before treatment (P>0.05). After treatment, the PISQ-12, ICI-Q-SF scores of the two groups of patients increased, and the observation group was higher than the matched group, while the POP-Q scores decreased. The observation group was lower than the matched group(P<0.05); There was no significant difference in the expression levels of RLX, CTGF, and MMP-1 between the two groups of patients before treatment (P>0.05). After treatment, the expression levels of RLX, CTGF, and MMP-1 decreased in both groups of patients, and the observation group was lower than the matched group (P<0.05). Conclusion: Bu Zhong Yi Qi Tang combined with low-frequency pulse electrical stimulation can improve the clinical efficacy of postpartum pelvic floor dysfunction, improve the changes of pelvic floor muscle surface electromyography, improve patients' sexual function, pelvic prolapse and Urinary incontinence, and reduce the expression levels of serum Relaxin, CTGF and MMP-1.
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