[1]鄢恋梅,胡亚飞△,张 芬.间歇导尿配合针灸对脊髓损伤后神经源性膀胱患者膀胱功能恢复的影响*[J].陕西中医,2020,(5):677-681.[doi:DOI:10.3969/j.issn.10007369.2020.05.035]
　YAN Lianmei,HU Yafei,ZHANG Fen..Effects of intermittent catheterization combined with acupuncture and moxibustion on bladder function recovery in patients with neurogenic bladder after spinal cord injury[J].,2020,(5):677-681.[doi:DOI:10.3969/j.issn.10007369.2020.05.035]
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间歇导尿配合针灸对脊髓损伤后神经源性膀胱患者膀胱功能恢复的影响*
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2020年5期
页码:
677-681
栏目:
针灸经络
出版日期:
2020-05-05

文章信息/Info

Title:
Effects of intermittent catheterization combined with acupuncture and moxibustion on bladder function recovery in patients with neurogenic bladder after spinal cord injury
作者:
鄢恋梅1; 胡亚飞1△; 张 芬2
1.湖北省恩施土家族苗族自治州中心医院(恩施 445000); 2.湖北民族学院附属民大医院(恩施 445000)
Author(s):
YAN Lianmei; HU Yafei; ZHANG Fen.
The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture(Enshi 445000)
关键词:
脊髓损伤后神经源性膀胱;  针灸;  间歇导尿;  膀胱功能;  膀胱逼尿肌波幅;  尿流动力学指标
Keywords:
Neurogenic bladder after spinal cord injury;  Acupuncture and moxibustion;  Intermittent catheterization;  Bladder function;  Amplitude of bladder detrusor;  Urodynamic indicators
分类号:
R694
DOI:
DOI:10.3969/j.issn.10007369.2020.05.035
文献标志码:
A
摘要:
目的:探讨间歇导尿配合针灸对脊髓损伤(SCI)后神经源性膀胱(NB)患者膀胱功能恢复的影响。方法:前瞻性研究86例SCI后NB患者的资料,随机分为对照组和观察组,每组43例,对照组给予间歇导尿技术治疗,观察组在以上治疗基础上加予针灸治疗,观察两组患者治疗前及治疗4周后的中医症状积分,评估两组中医证候疗效,对比两组治疗前及治疗4周后的膀胱功能改善情况、膀胱逼尿肌波幅、尿流动力学指标变化,记录两组患者并发症发生病例。结果:治疗4周后,两组患者的小腹坠胀、排尿困难共两项中医症状积分较治疗前显著降低(P<0.05),观察组显著低于对照组(P<0.05); 观察组中医证候总有效率为86.05%,显著高于对照组的67.44%(P<0.05); 治疗4周后,两组患者的膀胱RU及膀胱功能积分较治疗前显著降低(P<0.05),膀胱最大排尿量较治疗前显著增加,两组患者的肛门括约肌扩张或收缩波幅较治疗前显著增加(P<0.05),两组患者的尿流动力学指标中膀胱容量(VH2O)、膀胱的顺应性(BC)较治疗前显著提高,膀胱压(Pves)、逼尿肌压力(Pdet)较治疗前显著降低(P<0.05),观察组上述指标的变化幅度显著大于对照组(P<0.05); 观察组泌尿系统感染、肾结石的发生率为6.98%、0.00%,显著低于对照组的23.26%、9.30%(P<0.05)。结论:间歇导尿配合针灸治疗SCI后NB患者疗效显著,能明显缓解小腹坠痛、排尿困难等症状,提高膀胱功能,增强逼尿肌兴奋性,促进尿流动力学改善,并降低泌尿系统感染和肾结石发生风险。
Abstract:
Objective:To explore the effects of intermittent catheterization combined with acupuncture and moxibustion on bladder function recovery in patients with neurogenic bladder(NB)after spinal cord injury(SCI).Methods:Prospective study was performed on data of 86 patients with NB after SCI,and the patients were randomly divided into control group and observation group,with 43 cases in each group.Control group was treated with intermittent catheterization while observation group was additionally given acupuncture and moxibustion on the basis of the above treatment.The TCM symptoms scores were observed in the two groups before treatment and after 4 weeks of treatment.The efficacy of TCM syndromes was evaluated in the two groups.The improvement of bladder function,amplitude of bladder detrusor and urodynamic indicators were compared between the two groups before treatment and after 4 weeks of treatment,and the occurrence of complications were recorded in the two groups.Results:After 4 weeks of treatment,the scores of two TCM symptoms of abdominal bulge and urination difficulty in the two groups were significantly decreased compared with those before treatment(P<0.05),and the scores in observation group were significantly lower than those in control group(P<0.05).The total effective rate of TCM symptoms in observation group was significantly higher than that in control group(86.05% vs 67.44%)(P<0.05).After 4 weeks of treatment,the bladder RU and bladder function score in the two groups were significantly decreased compared with those before treatment(P<0.05),and the maximum urine output of bladder was significantly increased compared with that before treatment,and the amplitudes of anal sphincter dilatation or contraction in the two groups were significantly increased compared with those before treatment(P<0.05),and the urodynamic indicators of bladder volume(VH2O)and bladder compliance(BC)in the two groups were significantly increased compared with those before treatment while the bladder pressure(Pves)and detrusor pressure(Pdet)were significantly decreased compared with those before treatment(P<0.05),and the changes of the above indicators in observation group were significantly greater than those in control group(P<0.05).The incidence rates of urinary system infection and kidney stones were 6.98% and 0.00% in observation group,which were significantly lower than those in control group with 23.26% and 9.30%(P<0.05).Conclusion:Intermittent catheterization combined with acupuncture and moxibustion has significant efficacy on patients with NB after SCI,and it can significantly relieve symptoms such as abdominal bulge and urination difficulty,improve bladder function,enhance detrusor excitability,promote the improvement of urodynamics,and reduce the risk of urinary system infection and kidney stones.

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备注/Memo

备注/Memo:
*湖北省自然科学科研课题(2017CFB182)
更新日期/Last Update: 2020-05-14