灸法为主治疗急性脑梗死后肾阳虚型神经源性膀胱疗效观察  

Efficacy Observation of Treating Neurogenic Bladder After Acute Cerebral Infarction of Kidney-yang Deficiency Pattern Majorly Using Moxibustion

作　　者：许国梅 魏娟 赵勇 钱景丽 XU Guo-mei;WEI Juan;ZHAO Yong;QIAN Jing-li(The First People’s Hospital of Chongqing Liang Jiang New Area,Chongqing 401121,China)

机构地区：[1]重庆两江新区第一人民医院,重庆401121

出　　处：《上海针灸杂志》2021年第8期926-931,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：重庆市卫生计生委重庆市科委中医药科技项目(ZY201802115)。

摘　　要：目的观察灸法配合西医常规治疗对急性脑梗死后肾阳虚型神经源性膀胱的临床疗效。方法将94例急性脑梗死后肾阳虚型神经源性膀胱患者随机分为治疗组和对照组,每组47例。治疗组采用灸法配合西医常规治疗,对照组采用单纯西医常规治疗。观察两组治疗前后各项血清生化指标[白介素6(IL-6)、血小板分子标志物-1(PAC-1)、神经元特异性烯醇化酶(NSE)、D二聚体(D-D)]、每日排尿情况各项指标(日均单次排尿量、日均尿失禁次数、日均排尿次数)、尿动力学指标(最大尿流速率、最大膀胱容量、残余尿量)、美国国立卫生院卒中量表(NIHSS)评分的变化情况,并比较两组临床疗效。结果两组治疗后各项血清生化指标、每日排尿情况各项指标、尿动力学指标及NIHSS评分与同组治疗前比较,差异均有统计学意义(P<0.05)。治疗组治疗后各项血清生化指标、每日排尿情况各项指标、尿动力学指标及NIHSS评分与对照组比较,差异均有统计学意义(P<0.05)。治疗组总有效率为91.5%,对照组为72.3%,两组比较差异具有统计学意义(P<0.05)。结论灸法配合西医常规治疗是一种治疗急性脑梗死后肾阳虚型神经源性膀胱的有效方法,能减轻炎症反应,促进神经功能修复,改善尿流动力学指标。Objective To observe the clinical efficacy of moxibustion combined with conventional Western medicine treatment in treating neurogenic bladder after acute cerebral infarction of kidney-yang deficiency pattern.Method A total of 94 patients with neurogenic bladder after acute cerebral infarction of kidney-yang deficiency were randomized into a treatment group and a control group,with 47 cases in each group.The treatment group was intervened by moxibustion plus conventional Western medicine treatment,while the control group was given only the conventional Western medicine treatment.Before and after treatment,pertinent serum biochemical indicators[interleukin(IL)-6,platelet activation marker(PAC-1),neuron-specific enolase(NSE)and D-dimer(D-D)],daily voiding parameters(mean voided volume per micturation,mean urinary incontinencefrequency,mean number of voiding),urodynamic indicators[maximum flow rate,maximum bladder capacity and residual volume],and the score of National Institute of Health stroke scale(NIHSS)were observed in the two groups.Clinical efficacy was also compared.Result The serum biochemical indicators,daily voiding and urodynamic parameters,and the NIHSS score changed significantly after treatment in both groups(P<0.05).After treatment,the serum biochemical indicators,daily voiding and urodynamic parameters,and the NIHSS score in the treatment group were significantly different from those in the control group(P<0.05).The total effective rate was 91.5%in the treatment group,versus 72.3%in the control group,and the between-group difference was statistically significant(P<0.05).Conclusion Moxibustion combined with conventional Western medicine treatment is an effective approach for neurogenic bladder after acute cerebral infarction of kidney-yang deficiency pattern;it can reduce inflammatory reactions,promote the repair of neurological function and improve urodynamic parameters.

关 键 词：灸法 膀胱 神经源性 肾阳虚 白介素-6 血小板分子标志物-1 神经元特异性烯醇化酶 D二聚体 尿动力学 脑梗死 中风并发症 康复训练 

分 类 号：R246.6[医药卫生—针灸推拿学]