益元灸配合膀胱功能训练治疗神经源性膀胱间歇导尿术禁忌证患者的临床研究  

Clinical study of Yiyuan moxibustion combined with bladder function training in the treatment of neurogenic bladder intermittent catheterization contraindications

作　　者：任亚锋[1] 吴明莉[1] 王磊[1] 孙伟娟[1] 牛秋妍 REN Ya-feng;WU Ming-li;WANG Lei;SUN Wei-juan;NIU Qiu-yan(The First Affiliated Hospital of Henan University of CM,Zhengzhou 450000,China;Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学第一附属医院,郑州450000 [2]河南中医药大学,郑州450046

出　　处：《中华中医药杂志》2021年第4期2425-2428,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：河南省中医管理局国家中医临床研究基地科研专项课题(No.2018JDZX010)。

摘　　要：目的:观察益元灸对神经源性膀胱(间歇导尿术禁忌证)患者的临床疗效。方法:38例患者随机分为两组,治疗组(19例)采用益元灸配合膀胱功能训练治疗,对照组(19例)采用膀胱功能训练,治疗6周后,以充盈期逼尿肌压力(Pdet.max)、最大膀胱容积(MBC)、残余尿量(RU)、尿内白细胞数、膀胱平衡状态变化及疗效评价来明确治疗效果。结果:治疗后两组RU显著减少(P<0.05),MBC显著增加(P<0.05),治疗组Pdet.max显著降低(P<0.05),治疗组各指标改善皆优于对照组(P<0.05)。治疗后治疗组尿中白细胞数显著降低(P<0.05),达到膀胱功能平衡状态的例数及总有效率显著高于对照组(P<0.05)。结论:益元灸配合膀胱功能训练能明显改善神经源性膀胱患者的膀胱功能,预防及治疗泌尿系感染;而膀胱功能训练仅对膀胱排空存在一定作用,对泌尿系感染、膀胱功能及顺应性改善不明显。Objective:To observe the clinical effect of Yiyuan moxibustion on patients with neurogenic bladder(contraindication of intermittent catheterization).Methods:A total of 38 patients were randomly divided into 2 groups.The treatment group(19 cases)was treated with Yiyuan moxibustion combined with bladder function training,the control group(19 cases)used bladder function training.After 6 weeks of treatment,maximum detrusor pressure(Pdet.max),maximum bladder cubage(MBC),residual urine(RU),changes in white blood cell count in urine,changes in bladder balance and efficacy evaluation were used to determine the therapeutic effect.Results:After treatment,RU decreased significantly and MBC increased significantly in the two groups(P<0.05),Pdet.max in the treatment group was significantly reduced(P<0.05),the improvement of each index in the treatment group was better than that in the control group(P<0.05).After treatment,the number of white blood cells in urine of treatment group decreased significantly(P<0.05).The number of cases reaching bladder function balance and the efficacy of the treatment group was significantly higher than that in the control group(P<0.05).Conclusion:Yiyuan moxibustion combined with bladder function training can significantly improve the bladder function of neurogenic bladder patients,prevent and treat urinary tract infection.However,bladder function training only has a certain effect on bladder emptying,but has no obvious improvement on urinary tract infection,bladder function and compliance.

关 键 词：神经源性膀胱 脊髓损伤 癃闭 艾灸 间歇导尿术 禁忌证 

分 类 号：R277.5[医药卫生—中医学]