| 严宝宝,周红梅,汪蕾蕾,肖洪波.针刺联合低频电刺激治疗产后尿潴留临床疗效评价[J].中国康复,2026,41(7):419-423 |
| 针刺联合低频电刺激治疗产后尿潴留临床疗效评价 |
| Clinical efficacy of acupuncture combined with low-frequency electrical stimulation in the treatment of postpartum urinary retention |
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| DOI：10.3870/zgkf.2026.07.007 |
| 中文关键词: 产后尿潴留 针刺 低频电刺激 尿动力学 |
| 英文关键词: postpartum urinary retention acupuncture low-frequency electrical stimulation urodynamics |
| 基金项目:合肥市中医药研究项目（HFSZYYYJ2023-13） |
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| 中文摘要: |
| 目的：探讨针刺联合低频电刺激治疗产后尿潴留（PUR）的临床疗效。方法：选取2024年7月至2025年9月在安徽省妇女儿童医学中心进行产后康复科的PUR患者，按随机数字法且剔除中途退出及资料不完整者后分为对照组（n=68）、针刺组（n=69）、电刺激组（n=68）和联合组（n=69）4组，共274例。4组均接受常规诱导排尿治疗；在此基础上，对照组给予新斯的明治疗，针刺组给予针刺治疗，电刺激组给予低频电刺激治疗，联合组给予针刺联合低频电刺激治疗，疗程均为3d。比较4组治疗前后膀胱残余尿量（RUV）、排尿情况、尿道疼痛评分、尿动力学指标及临床疗效。结果：治疗前，4组RUV、尿道疼痛评分、储尿时膀胱压力、尿道分布压力比较差异均无统计学意义。治疗后，4组RUV均较治疗前降低（均P<0.01），联合组RUV低于其余3组（均P<0.05），电刺激组低于针刺组和对照组（均P<0.05），针刺组低于对照组（P<0.05）；联合组首次排尿时间短于其余3组（均P<0.05），首次尿量多于其余3组（均P<0.05）；电刺激组首次排尿时间短于对照组和针刺组（均P<0.05），首次尿量高于对照组和针刺组（均P<0.05）；4组尿道疼痛评分均较治疗前降低（均P<0.01），联合组低于对照组和针刺组（均P<0.05）。4组储尿时膀胱压力均较治疗前降低（均P<0.01），联合组和针刺组均低于对照组和电刺激组（均P<0.05）；储尿时尿道分布压力组间比较差异无统计学意义；联合组最大尿流速高于其余3组（均P<0.05），电刺激组高于对照组和针刺组（均P<0.05）；联合组与电刺激组治疗有效率高于对照组（均P<0.05）。结论：针刺联合低频电刺激可有效改善PUR患者膀胱排空功能、排尿情况及部分尿动力学指标，疗效优于常规药物治疗，并具有减少哺乳期全身药物暴露的优势，可作为产后尿潴留的安全、有效综合干预方案。 |
| 英文摘要: |
| Objective: To evaluate the efficacy of acupuncture combined with low-frequency electrical stimulation for postpartum urinary retention (PUR). Methods: A prospective randomized controlled study was conducted among PUR patients treated in the Postpartum Rehabilitation Department of Anhui Women and Children’s Medical Center from July 2024 to September 2025. After excluding dropouts and incomplete cases, patients were randomly assigned to 4 groups: control group (n=68), acupuncture group (n=69), electrical stimulation group (n=68), and combined treatment group (n=69). All groups received routine induced urination therapy. In addition, the control group received neostigmine, the acupuncture group received acupuncture, the electrical stimulation group received low-frequency electrical stimulation, and the combined group received acupuncture plus low-frequency electrical stimulation. The treatment course lasted 3 days. Residual urine volume (RUV), urination outcomes, urethral pain scores, urodynamic parameters, and clinical efficacy were compared before and after treatment. Results: Before treatment, there were no statistically significant differences in RUV, urethral pain score, bladder pressure during urine storage, and urethral distribution pressure among the four groups. After treatment, the RUV of all four groups was lower than that before treatment (all P<0.01). The RUV of the combined group was lower than that of the other three groups (all P<0.05), the RUV of the electrical stimulation group was lower than that of the acupuncture group and the control group(all P<0.05), and the RUV of the acupuncture group was lower than that of the control group (P<0.05). The first micturition time of the combined group was shorter than that of the other three groups (all P<0.05), and the first urine volume in the combined group was greater than that of the other three groups (all P<0.05). The first micturition time of the electrical stimulation group was shorter than that of the control group and the acupuncture group (all P<0.05), and the first urine volume was greater than that of the control group and the acupuncture group (all P<0.05). The urethral pain score of all four groups decreased compared with that before treatment (all P<0.01), and the score of the combined group was lower than that of the control group and the acupuncture group (all P<0.05). Bladder pressure during urine storage in all four groups was lower than that before treatment (all P<0.01), and the pressure in the combined group and the acupuncture group was lower than that in the control group and the electrical stimulation group (all P<0.05). There was no statistically significant difference in urethral distribution pressure during urine storage among groups. The maximum urine flow rate of the combined group was higher than that of the other three groups (all P<0.05), and that of the electrical stimulation group was higher than that of the control group and the acupuncture group (P<0.05). The treatment effective rates of the combined group and the electrical stimulation group were higher than that of the control group (all P<0.05).Conclusion: Acupuncture combined with low-frequency electrical stimulation effectively improves bladder emptying, urination outcomes, and some urodynamic parameters in PUR patients. It is superior to conventional drug therapy and may reduce systemic drug exposure during lactation, making it a safe and effective comprehensive intervention for PUR. |
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