电刺激生物反馈对产后盆底功能障碍患者盆底肌力、盆底肌电位及MMP-2、TIMP-2、TGF-β1水平的影响
| 作者: |
1曾小丹,
1李常虹,
2张春雨
1 海南省妇女儿童医学中心产科，海口 570206 2 海南省妇女儿童医学中心妇女保健科，海口 570206 |
| 通讯: |
曾小丹
Email: ZXD20210506@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2022.01.013 |
| 基金: | 海南省医药卫生科研项目(20A200187)。 |
摘要
目的：探究电刺激生物反馈对产后盆底功能障碍(pelvic floor dysfunctional disease，PFD)患者盆底肌力、盆底肌电位及基质金属蛋白酶-2(matrix metalloproteinase-2，MMP-2)、基质金属蛋白酶组织抑制因子-2(tissue inhibitor of metalloproteinase-2，TIMP-2)、转化生长因子-β1(transforming growth factor-β1，TGF-β1)水平的影响。方法：选取2019年9月至2020年9月海南省妇女儿童医学中心收治的150例产后PFD患者，随机分为3组，每组各50例。其中A组给予Kegel盆底肌训练，B组给予电刺激生物反馈治疗，C组给予Kegel盆底肌训练联合电刺激生物反馈治疗，时间为3个月。对比3组临床疗效及治疗前后的盆底肌力、盆底肌电位、盆腔器官脱垂(pelvic organ prolapse，POP)-Q分期、性生活质量，并检测盆腔壁组织中MMP-2、TIMP-2、TGF-β1表达水平。结果：C组治疗总有效率为92.00%，高于A组(70.00%)和B组(76.00%)，差异有统计学意义(P<0.05)。治疗后，C组盆底手测肌力及I类、II类纤维肌最大电位值均显著高于A组、B组(P<0.05)，且B组显著高于A组(P<0.05)。治疗后，C组POP-Q分期等级与A组、B组相比明显降低(P<0.05)，B组POP-Q分期等级与A组相比，差异无统计学意义(P>0.05)。治疗后，A组、B组、C组盆腔器官脱垂-尿失禁性功能问卷(Pelvic Organ Prolapse/Incontinence Sexual Function Questionnaire-12，PISQ-12)评分分别为26.34±5.67、28.96±5.31、32.88±5.29，差异有统计学意义(P<0.05)。治疗后，C组MMP-2水平显著低于A组、B组(P<0.05)，TIMP-2、TGF-β1水平显著高于A组、B组(P<0.05)，且B组各指标变化优于A组(P<0.05)。结论：电刺激生物反馈治疗产后PFD疗效显著，能够增强患者盆底肌力，改善患者性生活质量。
关键词：
盆底功能障碍；电刺激生物反馈；盆底肌力；性生活质量；基质金属蛋白酶-2；基质金属蛋白酶组织抑制因子-2；转化生长因子-β1
Effects of electrical stimulation biofeedback on pelvic floor muscle strength, pelvic floor muscle potential and levels of MMP-2, TIMP-2 and TGF-β1 in patients with postpartum pelvic floor dysfunction
CorrespondingAuthor: ZENG Xiaodan Email: ZXD20210506@163.com
DOI: 10.3978/j.issn.2095-6959.2022.01.013
Foundation: This work was supported by the Hainan Provincial Medical and Health Research Project Foundation, China (20A200187).
Abstract
Objective: To explore the effects of electrical stimulation biofeedback on pelvic floor muscle strength, pelvic floor muscle potential, matrix metalloproteinase-2 (MMP-2), tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) and transforming growth factor-β1 (TGF-β1) in patients with postpartum pelvic floor dysfunction (PFD). Methods: A total of 150 postpartum PFD patients admitted to Hainan Women and Children’s Medical Center from September 2019 to September 2020 were randomly divided into 3 groups with 50 patients in each group. The A group was given Kegel pelvic floor muscle training, the B group was given electrical stimulation biofeedback therapy, and the C group was given Kegel pelvic floor muscle training combined with electrical stimulation biofeedback therapy for 3 months. The clinical efficacy, pelvic floor muscle strength, pelvic floor muscle potential, pelvic organ prolapses (POP)-Q stage, quality of sexual life, and the expression levels of MMP-2, TIMP-2 and TGF-β1 in pelvic wall tissue were compared between the two groups before and after treatment. Results: The total effective rate of the C group was 92.00%, higher than that of group A (70.00%) and group B (76.00%), and the difference was statistically significant (P<0.05). After treatment, the pelvic floor muscle strength measured by hand and the maximum potential values of class I and class II fibromuscular in the C group were significantly higher than those in the A and B group (P<0.05), and that in B group was significantly higher than that in A group (P<0.05). After treatment, the POP-Q staging grade of the C group was significantly lower than that of the A group and B group (P<0.05), and there was no difference in POP-Q staging grade between B group and A group (P>0.05). After treatment, the scores of Pelvic Organ Prolapse/Incontinence Sexual Function Questionnaire-12 (PISQ-12) in the A group, B group and C group were 26.34±5.67, 28.96±5.31, 32.88±5.29, respectively, and the difference was statistically significant (P<0.05). After treatment, the level of MMP-2 in the C group was significantly lower than that in the A group and B group (P<0.05), and the levels of TIMP-2 and TGF-β1 in the C group were significantly higher than those in the A group and B group (P<0.05), and the changes of indexes in B group were better than those in A group (P<0.05). Conclusion: Electrical stimulation biofeedback is effective in the treatment of postpartum PFD, which can enhance the pelvic floor muscle strength and improve the quality of sexual life.
Keywords：
pelvic floor dysfunction; electrical stimulation biofeedback; pelvic floor muscle strength; quality of sexual life; matrix metalloproteinase-2; tissue inhibitor of metalloproteinase-2; transforming growth factor-β1