基于“肺为水之上源”探讨呼吸训练对SCI神经源性膀胱的影响  

Effects of Breathing Training on SCI Neurogenic Bladder Based on “Lung Being Upper Source of Water”

作　　者：高振梅[1] 胡春雨 毕鸿雁[1] 丁元庆[1] GAO Zhenmei;HU Chunyu;BI Hongyan;Tutor： DING Yuanqing(Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Shan- dong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学附属医院

出　　处：《山东中医药大学学报》2018年第4期311-314,共4页Journal of Shandong University of Traditional Chinese Medicine

基　　金：山东省自然基金培养基金项目联合专项(编号:ZR2015HL094)

摘　　要：目的 ：观察呼吸训练对脊髓损伤（SCI）后神经源性膀胱膀胱功能及肺功能的影响,探讨“肺为水之上源”理论在疾病康复过程中的作用机制。方法：59例T10~L1平面脊髓损伤的神经源性膀胱患者,随机分为观察组29例和对照组30例,观察组采用呼吸训练结合膀胱功能训练,治疗组仅采取膀胱功能训练,共治疗4周。观察治疗前后两组患者的膀胱容量、膀胱内压力、残余尿量、尿失禁生活质量问卷（I-QOL）、膀胱压力分级以及第1秒用力肺活量（FEV1.0）、用力肺活量（FVC）的变化。结果：治疗4周后,观察组总有效率93.33%,对照组73.33%,两组疗效比较差异有统计学意义（P〈0.05）;观察组的膀胱内压、残余尿量、I-QIL等方面与对照组比较差异有统计学意义（P〈0.05）。结论 ：呼吸训练可以显著改善SCI患者的肺功能和SCI后神经源性膀胱患者的膀胱容量,降低膀胱压力,减少残余尿量,是对中医学“肺为水之上源”理论的有力支持。Objective：To observe the effects of breathing training on bladder function and lung function of neurogenic bladder after spinal cord injury（SCI）,and to explore the mechanism of ＂lung being upper source of water＂ theory in the process of rehabilitation. Methods：Total 59 neurogenic bladder patients with T10-L1 spinal cord injury were randomly divided into the observation group（29 cases） and control group（30 cases）. The observation group used breathing training combined with bladder function training. The treatment group only used bladder function training for a total of 4 weeks. The changes of bladder volume,intravesical pres- sure,residual urine volume,urinary incontinence quality of life questionnaire（I-QOL）,bladder pressure grad- ing,and first-second forced vital capacity（FEV1.0）,forced vital capacity（FVC） were observed before and af- ter treatment in both groups. Results：After 4 weeks of treatment,the total effective rate was 93.33% in the observation group and 73.33% in the control group. The curative effect between the two groups was statisti- cally significant（P〈0.05）. The intravesical pressure,residual urine volume,I-QIL and other aspects of the observation group were compared with the control group,there was a statistical significance between thegroups （P〈O.05）. Conclusions： Breathing training can significantly improve the lung function of SCI pa- tients and the bladder capacity of patients with neurogenic bladder after SCI,reduce bladder pres- sure and decrease residual urine volume,which is a strong support for the theory of ＂lung being upperSOllI＇ce of ＂ water.

关 键 词：肺为水之上源 呼吸训练 脊髓损伤 神经源性膀胱 

分 类 号：R223.11[医药卫生—中医基础理论] R694.5[医药卫生—中医学]