間質性膀胱炎婦女骨盆帶肌肉骨骼功能失調相關性初探

The Evaluation of Correlation between Pelvis Girdle Musculoskeletal Dysfunction and Interstitial Cystitis/ Bladder Pain Syndrome ( IC/BPS ) in FemalePatients. A Preliminary Study

莊雅淨(YA JING ZHUANG)

指導教授 ： 陳怡靜

中山醫學大學/醫學科技學院/物理治療學系/碩士(2019年)

https://doi.org/10.6834/CSMU201900170

摘要

研究目的:本篇研究目的為: 1.探討不同嚴重程度的間質性膀胱炎女性在肌肉骨骼失調的狀況；2.探討間質性膀胱炎女性的肌肉骨骼失調和臨床量表的相關性。研究方法:對象為年齡20歲至65歲之間的間質性膀胱炎女性，共34位。收集間質性膀胱炎相關量表、肌肉骨骼失調檢測(包含:肌肉力量、肌肉柔軟度、肌肉板機點壓痛檢查、骨骼架構等)。根據患者填寫間質性膀胱炎評分量表的總分，將患者依照症狀嚴重程度分為兩組進行組間比較。使用Independent-sample t test和Chi Square test比較兩組之間差異。使用Spearman's rho分析受測者基本資料、相關量表及肌肉骨骼失調檢測項目的相關性。結果：除了焦慮憂鬱量表之外，不同程度間質性膀胱炎患者在間質性膀胱炎評分量表、疼痛急尿量表、女性泌尿生殖系統疼痛與肌肉骨骼失調檢測中的腹肌肌力、闊筋膜張肌和恥骨直腸肌的肌肉壓痛的部分，有組間的差異。在身體質量指數、腰圍、股直肌柔軟度檢測、薦髂關節檢測、肌肉骨骼失調檢測、肌肉壓痛檢測、骨盆底肌耐力收縮後休息張力與相關量表有呈現顯著正相關。腹肌肌力、腹肌耐力、骨盆底肌在咳嗽時是否有反射性收縮、骨盆底最大肌力和耐力、梨狀肌柔軟度檢測與相關量表有呈現顯著負相關。結論：較嚴重的間質性膀胱炎女性腹肌與骨盆底肌肌力表現較差；肌肉壓痛指數表現也較明顯、在肌肉柔軟度與骨骼架構檢測也較常有問題。對間質性膀胱炎病患的檢查，建議應包含骨盆帶肌肉骨骼系統的檢測，將有助於提供完整的治療處方。

關鍵字

間質性膀胱炎 ； 膀胱疼痛症候群 ； 肌肉骨骼功能失調

並列摘要

Purpose: The purposes of this studyare (1) to investigate the condition of musculoskeletal dysfunction in women with different severity of interstitial cystitis. (2) to analyze the correlation between the musculoskeletal dysfunction and the clinical symptom scale in women with interstitial cystitis.Methods: Thirty four women aged from 20 y/o to 65 y/o with interstitial cystitis were recruited in this study. The Interstitial Cystitis Symptom Index and Problem Index (ICSI and ICPI) and the musculoskeletal dysfunction assessments (including muscle strength, muscle flexibility, muscle pressure pain test, skeletal structures, etc.) were conducted during the study. The subjects were divided into two groups according to their severity which was defined by their total scores of ICSI and ICPI. Independent-sample t test and Chi Square test were used to compare the differences between two groups. The correlation among subjects’ information, related index and musculoskeletal dysfunction assessments was analyzed by Spearman's rho. Results: Except Hospital Anxiety and Depression Scale (HADS), significant differences were found between groups of Interstitial Cystitis Symptom Index, VAS scale of Pain and Urgency, Female genitourinary pain, abdominal muscle strength, as well as the myofascial pain of tensor fascia lata and puborectalis. Significant positive correlation was found between Related scale and body mass index, waist circumference, rectus femoris flexibility test, Stork test, musculoskeletal dysfunction assessments, muscle pressure pain test, and pelvic floor resting tension. Whereas significant negative correlation was found between Related scale and abdominal muscle strength, abdominal muscle endurance, reflex contraction ability of pelvic floor muscle during coughing, the maximum muscle strength and endurance of pelvic floor muscle, and piriformis flexibility test.Conclusion: Poorer abdominal muscle strength , more noticeable myofascial pain on tensor fascia lata, pirirformis and pelvic floor muscles, and more common abnormal finding on musculoskeletal exam were found in women with more severe interstitial cystitis. The understanding of the pelvic musculoskeletal dysfunction in subjects with interstitial cystitis would be beneficial to provide a complete advice in treatment prescription.

並列關鍵字

interstitial cystitis ； bladder pain syndrome ； musculoskeletal dysfunction

參考文獻

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