电针治疗中风后尿失禁:多中心随机对照研究  

Electroacupuncture for post-stroke urinary incontinence:a multi-center randomized controlled study

作　　者：宋丰军[1,2] 蒋松鹤[3] 郑士立[1] 叶天申[4] 张红 朱文宗[2] 陈柄[2] 杨迎民[2] 周龙寿[2] 刘晓霞[2] 王谦[3] 方君辉[1,2] 刘海飞[1,2] 叶必宏[1,2] 

机构地区：[1]温州市中医院针灸科,浙江温州325000 [2]温州市中医院康复科,浙江温州325000 [3]温州医学院附属第二医院 [4]温州医学院附属第一医院 [5]温州市第二医院

出　　处：《中国针灸》2013年第9期769-773,共5页Chinese Acupuncture & Moxibustion

基　　金：浙江省中医药重点学科中西医结合老年康复学项目:2012-XK-A 30;浙江省中医药管理局适宜技术推广项目:2011SA 010

摘　　要：目的：评价电针治疗中风后尿失禁的临床疗效。方法：将中风后尿失禁患者204例随机分为电针组（136例）、留置导尿组（68例）。电针组穴取曲骨、中极、水道、气海、百会等，行电针疗法，每周治疗5次；留置导尿组给予留置导尿，每2～4h放尿1次，定期给予膀胱冲洗，配合膀胱康复训练，4周后评定疗效。观察两组患者治疗前后排尿日记（每次排尿间隔时间、夜尿次数、排尿不畅、尿失禁程度）、膀胱容量、病人满意度等，并评定两组疗效。结果：电针组总有效率为96．2％（125／130），优于留置导尿组的87．5％（56／64，P〈0．05）；治疗后除留置导尿组夜尿次数无改变外，两组排尿日记各项评分与总分均显著改善（均P〈0．001），且电针组均优于留置导尿组（P〈0．001，P〈0．05）；治疗后两组病人满意度、膀胱容量均显著改善（均P〈0．001），电针组亦优于留置导尿组（均P〈0．001）。结论：电针治疗中风后尿失禁疗效显著，可明显改善尿失禁症状，增加膀胱容量，疗效优于常规留置导尿。Objective To evaluate the clinical efficacy of electroacupuncture（EA） for apoplectic urinary inconti- nence. Methods Two hundred and four cases of apoplectic urinary incontinence were randomized into an EA group （136 cases） and an indwelling catheter group （68 cases）. The EA was applied at Qugu （CV 2）, Zhongji （CV 3）, Shuidao （ST 28）, Qihai （CV 6） and Guanyuan （CV 4）, etc. in the EA group,5 times a week. Indwelling catheter was applied in the indwelling catheter group at intervals of 2-4 hours, and periodic bladder irrigation along with bladder rehabilitation training were also given. The efficacies were evaluated after 4 weeks of treatment. Before and after treatment, the urination diary （including the interval of urination, nocturia frequency, urination difficul- ty, urinary incontinence severity）, bladder capacity, patients ＇ satisfaction of the two groups were observed and the efficacy was evaluated. Results The total effective rate was 96.2% （125/130） in the EA group, which was appa- rently superior to 87.5 % （56/64） in the indwelling catheter group （P〈0.05） ; except for nocturia frequency in the indwelling catheter group, the total score and the subitem score in the urination diary were all improved significant- ly after treatment in both groups （all P〈0. 001）, which were more obvious in the EA group （P〈0. 001, P〈 0.05） ;the patients＇ satisfaction and bladder capacity were all improved significantly after treatment in both groups （all P〈0. 001）, which were more obvious in the EA group （both P〈0. 001）. Conclusion The EA has an obvious effect for apoplectic urinary incontinence in urinary incontinence alleviation and bladder capacity increase, which has better efficacy than indwelling catheter therapy.

关 键 词：中风后尿失禁 针刺疗法 电针 针刺效应 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]