电针促进马尾神经损伤所致慢性尿潴留患者排尿功能恢复病例序列研究  

A Case Series Study of Electroacupuncture in Promoting the Recovery of Voiding Function in Patients with Chronic Urinary Retention Secondary to Cauda Equina Injury

作　　者：何欣 汪汐 龙子临 刘志顺[2] HE Xin;WANG Xi;LONG Zilin;LIU Zhishun(Beijing University of Chinese Medicine,Beijing 100029,China;Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院广安门医院,北京100053

出　　处：《中国中医药信息杂志》2023年第4期145-150,共6页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家重点研发计划(2017YFC1703602)。

摘　　要：目的 初步观察电针是否可作为改善马尾神经损伤所致慢性尿潴留(CUR)患者膀胱排尿功能的一种治疗方法。方法 采用前瞻性病例序列研究设计。为患者提供4~12周电针治疗,视患者是否能够坚持治疗而定。当患者自主排尿后残余尿量(PVR)较基线期下降50%认为治疗有效。根据治疗第4、8、12周收集的CUR患者相关数据分别分析患者自主排尿后PVR变化、治疗有效患者比例、不需导尿术患者中腹压排尿比例、大便潴留患者比例和不同排尿困难程度患者比例。结果 共观察患者30例,其中19例完成12周治疗。第4、8、12周治疗有效比例分别为13.33%(4/30)、38.46%(10/26)、63.16%(12/19)。与基线期比较,患者PVR在所有疗效评价时间点均有所降低,大便潴留患者比例逐渐下降,重度排尿困难(包括排尿不能)患者比例在治疗第4、8、12周呈逐渐下降趋势。结论 电针可能是改善马尾神经损伤所致CUR患者膀胱排尿功能的一种替代治疗方法。Objective To explore whether electroacupuncture(EA) can be a treatment method for the recovery of bladder voiding function in patients with chronic urinary retention(CUR) secondary to cauda equina injury.Methods Prospective case series study was adopted.This study provided patients with EA for 4-12 weeks,depending on whether the patient can adhere to the treatment or not.When the postvoid residual(PVR) decreased by 50% compared with the baseline after spontaneous urination,the treatment was considered effective.The changes of PVR after spontaneous urination,the proportion of respondents,the proportion of patients with abdominal pressure urination without catheterization,the proportion of patients with stool retention and the proportion of patients with degree of difficulty with urination were analyzed according to the relevant data of CUR patients collected after 4,8and 12 weeks of treatment.Results Totally 19 patients completed 12 weeks of treatment among the 30 patients observed in this study.The proportion of respondents after 4,8 and 12 weeks of treatment was 13.33%(4/30),38.46%(10/26) and 63.16%(12/19),respectively.Compared with the baseline,the PVR of patients decreased significantly at all therapeutic evaluation time points,and the proportion of patients with stool retention gradually decreased.The proportion of patients with severe dysuria(including dysuria) decreased gradually after 4,8 and 12weeks of treatment.Conclusion EA may be an alternative treatment for improving bladder voiding function in patients with CUR secondary to cauda equina injury.

关 键 词：电针 慢性尿潴留 马尾神经损伤 

分 类 号：R246.6[医药卫生—针灸推拿学]