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目的探讨盐酸米多君和盆底肌肉锻炼治疗压力性尿失禁(SUI)的临床效果。方法采用单中心、前瞻性随机对照的研究方法,对46例SUI患者进行治疗效果的评价,其中服用盐酸米多君22例(药物组),进行盆底肌肉锻炼24例(锻炼组)。根据治疗前后患者主观和客观临床参数进行疗效评价,并进行治疗前后生活质量评分。结果药物组2例及锻炼组4例患者未按要求完成治疗。根据患者主观临床参数评价SUI的治疗结果,药物组显效率为15％(3／20),有效率为85％(17／20);锻炼组有效率为55％(11／20),无效率为45％(9／20)。根据患者客观临床参数——1 h尿垫试验结果评价SUI的治疗结果,药物组平均溢尿量减少4．2 ml,锻炼组减少0．6 ml,两组比较,差异有统计学意义(P<0．01)。药物组患者治疗后生活质量评分平均提高21分,锻炼组平均提高9分,两组比较,差异有统计学意义(P<0．05)。药物组14例患者及锻炼组24例患者治疗前后性生活质量评分无变化。结论盐酸米多君和盆底肌肉锻炼均为非手术治疗SUI的有效方法;盐酸米多君的治疗效果优于盆底肌肉锻炼。
Objective To investigate the clinical effects of midodrine hydrochloride and pelvic floor muscle exercise in the treatment of stress urinary incontinence (SUI). Methods A single center, prospective, randomized and controlled study was conducted to evaluate the efficacy of 46 patients with SUI. Twenty-two patients (medications group) were treated with midodrine hydrochloride, and 24 patients with pelvic floor muscle exercise (exercise group). According to subjective and objective clinical parameters of patients before and after treatment efficacy evaluation, and quality of life scores before and after treatment. Results Two patients in the drug group and four patients in the exercise group did not complete the treatment as required. According to the clinical subjective evaluation of SUI, the effective rate of drug group was 15% (3/20) and the effective rate was 85% (17/20). The effective rate of exercise group was 55% (11/20) 45% (9/20). According to the objective clinical parameters of patients - 1h urine pad test results to evaluate the results of SUI treatment, drug group average spilled urine decreased 4.2 ml, exercise group decreased 0.6 ml, the two groups, the difference was statistically significant (P <0.01). After treatment, the quality of life scores of the patients in the medicine group increased by 21 points on average and that of the exercise group increased by 9 points on average. There was significant difference between the two groups (P <0.05). 14 patients in the drug group and 24 patients in the exercise group had no change in the quality of life before and after treatment. Conclusion Midodrine hydrochloride and pelvic floor muscle exercise are both effective non-surgical treatment of SUI; Midodrine hydrochloride is superior to pelvic floor muscle exercise.