电针“骶四穴”治疗脑卒中后尿失禁临床疗效观察  

Clinical Observation of the Efficacy of Electroacupuncture at “Four Sacral Points” on Post-stroke Urinary Incontinence

作　　者：陈姗[1] 汪司右[2] 卢静[3] 徐福[1] 宣丽华[1] CHEN Shan;WANG Siyou;LU Jing;XU Fu;XUAN Lihua(The First Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310018,Zhejiang,China;Shanghai Research Institute of Acupuncture and Meridian,Shanghai200030,China;The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China)

机构地区：[1]浙江中医药大学附属第一医院,浙江杭州310018 [2]上海针灸经络研究所,上海200030 [3]南京医科大学第一附属医院,江苏南京210029

出　　处：《辽宁中医药大学学报》2020年第12期164-168,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：浙江省中医药科技计划(2018ZA045)。

摘　　要：目的观察电针"骶四穴"对脑卒中后尿失禁患者的临床疗效。方法采用计算机软件SPSS22.0生成1∶1分配的随机序列数,将符合标准的110例脑卒中后尿失禁(post-stroke urinary incontinence,PSUI)患者分为"骶四穴"组(治疗组)和传统针刺组(对照组)。治疗组予以电针"骶四穴"治疗尿失禁,上肢瘫痪加极泉、尺泽、八邪、外关;下肢瘫痪加环跳、委中、昆仑;舌强语蹇加廉泉、哑门;吞咽障碍加完骨、天柱;口角歪斜加地仓、迎香。对照组采用电针气海、关元、水道(双侧)治疗尿失禁,上下肢瘫痪、舌强语蹇、吞咽障碍和口角歪斜的取穴同治疗组。两组患者视个体情况均使用控制原发疾病的药物。于治疗前后分别采用漏尿日记和国际尿失禁咨询委员会尿失禁问卷简表(ICIQ-UI SF)对两组患者进行疗效评定。结果治疗前两组患者漏尿次数和ICIQ-UI SF评分组间差异无统计学意义(均P>0.05)。治疗2个疗程后,治疗组和对照组在漏尿次数和ICIQ-UI SF评分上均显著降低(均P<0.05);治疗组漏尿次数和ICIQ-UI SF评分减少程度均优于对照组(均P<0.05),治疗组总有效率(78.2%)优于对照组(47.3%)(P<0.05)。结论电针"骶四穴"和传统针刺疗法均能改善PSUI患者的漏尿症状,电针"骶四穴"组的疗效优于传统针刺组,值得临床应用和推广。Objective To observe the therapeutic efficacy of electroacupuncture at"four sacral points"on post-stroke urinary incontinence. Methods A total of 110 eligible patients with PSUI were divided into "four sacral points"group(treatment group)and conventional electroacupuncture(control group)by a ramdom 1∶1 allocation sequence generated by SPSS Statistics V.22.0 using a computer. Participants in the treatment group received electroacupuncture at"four sacral points". Acupuncture was also performed at HT1(Jiquan),LU5(Chize),EX-UE9(Baxie)and SJ5(Waiguan)for participants with upper limb paralysis. For participants with lower limb paralysis,GB30(Huantiao),BL40(Weizhong),BL60(Kunlun)were also used. CV23(Lianquan)and GV15(Yamen)were used for participants with stiff tongue. GB12(Wangu)and BL10(Tianzhu)were used for participants with dysphagia,with the additional use of ST4(Dicang)and LI20(Yingxiang)for participants with deviation of the mouth. Participants in control group received conventional electroacupuncture of CV6(Qihai),CV4(Guanyuan),and ST28(Shuidao,both sides),corresponding to the conventional electroacupuncture treatment of UI. The point selection procedure for participants with upper or lower limb paralysis,stiff tongue,dysphagia and/or deviation of the mouth was the same as that used for the treatment group. All participants received routine medical care for stroke recovery. The incontinent episode diary and International Consultation on Incontinence Questionnaire Urinary Incontinence-Short Form(ICIQ-UI SF)were used as measurements before and after treatment in two groups. Results There was no significant differences between the treatment group and the control group in the number of incontinent episodes and ICIQ-UI SF score before intervention(both P>0.05). After two courses of intervention,the number of incontinent episodes and ICIQ-UI SF score in both treatment group and control group were decreased(both P<0.05). The number of incontinent episodes and ICIQ-UI SF score in treatment group were lower than in cont

关 键 词：尿失禁 脑卒中 逼尿肌过度活动 电针 神经调节 阴部神经 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R694.54[医药卫生—临床医学]