Clinical Study On The Treatment Of Postpartum Stress Incontinence With Tuina Of Jinggutongzhi Manipulation Combined With Pelvic Floor Muscle Training

Objective:The purpose of this study is to explore the clinical efficacy of joint treatment of Tuina with Jinggutongzhi combined with PFMT in the treatment of PSUI,compare it with simple pelvic floor muscle training,study its efficacy advantages,and provide a new method for the clinical treatment of postpartum stress urinary incontinence Therapeutic methods and provide curative effect basis for clinical promotion and application.Methods:Seventy-two patients who met the inclusion criteria of the subject and were recruited from the Tui-Na and gynecology clinics of Yunnan Provincial Hospital of Traditional Chinese Medicine,the postpartum rehabilitation center of Dianchi Resort and the community between January 2022 and December 2022 were selected and divided into a test group and a control group of 36 patients each using the randomized grouping method.Both groups received pelvic floor muscle training,20 minutes each time,3 times a day,for a total of 6 weeks.In the treatment group,on the basis of pelvic floor muscle treatment,combined muscle and bone manipulation therapy was added,each time for 20 minutes,twice a week,a total of 12 times.Before and after treatment,the leak volume of 1h urine pad test,the score of ICI-Q-SF and the score of I-QOL of the two groups were collected,using SPSS26.0 statistical software Analyzes were performed and clinical efficacy was assessed.Result:1.After statistical data analysis,there were statistically significant differences in age,frequency of delivery,mode of delivery,Ingelman-Sundberg scale,1-hour urine pad test,ICI-Q-SF score,and I-QOL score between the two groups before intervention(P>0.05),the data are comparable.2.Comparison of 1h urine pad testAfter the intervention,the amount of urine leakage in the 1-hour pad test in the test group was significantly reduced compared with that before the intervention,and the difference was statistically significant(P<0.05);and the amount of urine leakage in the treatment group was significantly lower than that in the control group(P<0.05).The difference is statistically significant.3.ICI-Q-SF score comparisonAfter the intervention,the ICI-Q-SF score in the treatment group was lower than that before the intervention,and the ICI-Q-SF score in the treatment group was significantly lower than that in the control group(P<0.05).4.Comparison of I-QOL scoresAfter the intervention,the I-QOL score of the test group improved compared with that before the intervention,and the difference was statistically significant(P < 0.05).5.Comparison of curative effect evaluationAfter treatment,there were 33 cases in the treatment group: 6 cases were cured,25 cases were effective,and 2 cases were ineffective.The total effective rate was 94%.In the control group,there were 34 cases: 23 cases were effective,2 cases were cured,9 cases were invalid,and the overall effective rate was 74%.The total effective rate of the experimental group was higher than that of the control group.The data were analyzed by rank sum test,Z =-2.512,P = 0.012(P<0.05).Conclusion:1.Both pelvic floor muscle training alone and Tuina of Jinggutongzhi combined with pelvic floor muscle training have therapeutic effects on PSUI.However,compared with purely using pelvic floor muscle training,the Tuina of Jinggutongzhi technique combined with pelvic floor muscle training is more effective in improving the clinical symptoms of patients with PSUI,reducing urine leakage in the 1-hour pad test,and improving the quality of life.2.The total effective rate of Tuina of Jinggutongzhi manipulation combined with pelvic floor muscle training is higher than that of pelvic floor muscle training group.It is suggested that the manipulation of "Treating muscle and bone together" combined with pelvic floor muscle training should be popularized in clinic.