Clinical Study On The Effect Of Buzhong Yiqi Decoction Combined With Kegel Exercise On Pelvic Floor Function Of Patients With Spleen-qi Deficiency After Laparoscopic Sacrocolpopexy Of Uterine Prolapse

Objective To explore the effect of Buzhong Yiqi Decoction combined with Kegel exercise on the recovery of pelvic floor function in patients with uterine prolapse undergoing laparoscopic sacrocolpopexy and syndrome differentiation of spleen-qi deficiency syndrome after operation,in order to provide a more reasonable and effective treatment of uterine prolapse with integrated traditional Chinese and Western medicine.Methods From February 2018 to October 2018,90 cases of uterine prolapse(POP-Q score is II degree with clinical symptoms or ?degrees or more)with Spleen-Qi Deficiency Syndrome after laparoscopic sacrocolpopexy were selected from the People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine.According to the random number table method,they were divided into three groups,30 cases in the combined treatment group(Laparoscopic sacrocolpopexy combined with Buzhong Yiqi decoction and Kegel exercises),30 cases in the exercise group(Laparoscopic sacrocolpopexy combined with Kegel exercises)and 30 cases in the simple operation group(Laparoscopic sacrocolpopexy).Total hysterectomy was performed simultaneously in all patients.The internal Chinese medicine buzhong yiqi decoction was taken from the 7th day after operation,with one course of treatment for 15 days,15 days apart,and the next course of treatment was renewed.A total of three courses of treatment were needed,lasting for 3 months.Kegel exercise started from the 3rd day after operation with the guidance of a professional doctor.The time of contraction of the urethra,anus and perineum should not be less than 3 seconds each time.After 2 to 6 seconds of relaxation,the exercise was repeated for 15 to 30 minutes,three times a day for 3 months.Chinese medicine Qi deficiency syndrome scores,pelvic floor function impact questionnaire scores,pelvic floor dysfunction questionnaire scores and the POP-Q quantitative values of the three groups were collected respectively 3 days before treatment and 3 months after treatment.Postoperative syndrome differentiation was performed for patients with spleen-qi deficiency syndrome score of Traditional Chinese Medicine was collected at the same time.Results 1 The Evaluation of curative effect of Traditional Chinese Medical syndromes Compared with the exercise group(76.7%)and the simple operation group(46.6%),the total effective rate of the combined treatment group(93.1%)was higher,and the difference was statistically significant(P<0.05).2 PFDI-20 scores Before and after treatment,there were significant differences in PFDI-20 scores among the three groups(P=0.000<0.05).After treatment,the PFDI-20 scores of the combined treatment group(16.63±3.48)was lower than that of the exercise group(23.38±5.07)and the simple operation group(30.17±6.79).The pairwise comparison between the three groups after treatment was statistically significant(P<0.05).3 PFIQ-7 scores Before and after treatment,there were significant differences in PFIQ-7 scores among the three groups(P=0.000<0.05).After treatment,the PFIQ-7 scores of the combined treatment group(17.57±2.71)was lower than that of the exercise group(20.12±3.47)and the simple operation group(22.85±4.44).The pairwise comparison between the three groups after treatment was statistically significant(P<0.05).4 POP-Q quantitative value Before and after treatment,there were significant differences in Aa,Ba,C,Ap and Bp quantitative value among the three groups(P=0.000<0.05).There was no significant difference in TVL quantitative values among the three groups before and after treatment(P>0.05).After treatment,the quantitative values of Aa,Ba,C,Ap and Bp were compared between the groups,and the differences were statistically significant(P<0.05).Conclusion 1 Buzhong Yiqi Decoction combined with Kegel exercise has a certain clinical effect on improving the relevant Traditional Chinese Medicical syndromes of patients with uterine prolapse undergoing laparoscopic sacrocolpopexy and syndrome differentiation of spleen-qi deficiency syndrome after operation.2 Buzhong Yiqi Decoction combined with Kegel exercise can further improve the POP-Q quantitative value of patients with uterine prolapse,and can significantly reduce PFDI-20 scores and PFIQ-7 scores.By enhancing the supporting role of pelvic floor tissue,it can better improve the pelvic floor function and further improve the quality of life of patients.