长针骶刺法改善老年中重度膀胱过度活动症疗效及尿流动力学研究  

Effect of Sacral Needling with Long Needles on Improving Moderate to Severe OAB in Elderly and Urodynamics Study

作　　者：姚文平[1] 李明[1] 杨正明[1] 杨励[1] 侍昊 YAO Wenping;LI Ming;YANG Zhengming;YANG Li;SHI Hao(Lianyungang Hospital of Traditional Chinese Medicine,Lianyungang 222004,China;Kangda College of Nanjing Medical University,Lianyungang 222000,China)

机构地区：[1]连云港市中医院,江苏连云港222004 [2]南京医科大学康达学院,江苏连云港222000

出　　处：《针灸临床杂志》2023年第6期35-39,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：国家重点研发计划“中医药现代化研究”重点专项,编号:2017YFC1703602;江苏省中医药管理局课题,编号:MS2021063;连云港市科技计划(社会发展)项目,编号:SF2115;连云港市老龄委课题,编号:L202117。

摘　　要：目的:探讨长针骶刺法治疗老年中重度膀胱过度活动症的临床疗效及对尿流动力学的影响。方法:将70例老年膀胱过度活动症患者随机分为针刺组和药物组,每组各35例。针刺组采用电针结合长针骶刺法治疗,药物组采用琥珀酸索利那新片口服治疗,4周为1个疗程,连续治疗2个疗程。观察治疗前后两组患者排尿日记卡、OABSS评分、OAB-q评分和尿流动力学指标FDV、PVR和MFR的变化。结果:治疗后两组患者排尿日记卡主要临床症状、OABSS评分和OAB-q评分均较治疗前降低(P<0.01),且针刺组排尿日记卡临床症状(平均每天排尿次数、每天夜尿次数与1周总尿急次数)、OABSS评分改善程度优于药物组(P<0.05);针刺组和药物组治疗后OAB-q评分比较差异无统计学意义(P>0.05);治疗后两组患者PVR较治疗前下降(P<0.01),MFR和FDV均较治疗前上升(P<0.01),但是针刺组FDV下降程度大于药物组、MFR上升程度大于药物组,差异均有统计学意义(P<0.05),PVR两组比较差异无统计学意义(P>0.05)。结论:长针骶刺法能明显减少老年患者膀胱过度活动症临床症状,提高患者生活质量,改善尿流动力学指标。Objective:To explore the clinical effect of sacral needling with long needles in treatment of moderate to severe overactive bladder(OAB)in elderly and its influence to urodynamics.Methods:A total of 70 elderly patients with moderate to severe OAB were randomly divided into the acupuncture group and the medication group,with 35 cases in each group.The acupuncture group was treated with sacral electro-needling with long needles,and the medication group was treated with Solifenacin Succinate Tablet.Both groups were treated for two courses of 8 weeks.Urination diary card,OABSS score,OAB-q score and urodynamic indexes of FDV,PVR and MFR were observed before and after the treatment in the two groups.Results:The main clinical symptoms of the urination diary card,OABSS score and OAB-q score were lower after the treatment than those before the treatment in the two groups(P<0.01),and the improvements of clinical symptoms(average number of urination per day,number of nocturnal urination per day,total number of urination urgency per week)and OABSS score were more significant in the acupuncture group than those in the medication group(P<0.05).There was no statistical difference in OAB-q score between the acupuncture group and the medication group after the treatment(P>0.05).PVR was decreased(P<0.01),and MFR and FDV were increased after the treatment compared with those before the treatment in the two groups(P<0.01);the decrease in FDV and the increase degree in MFR were more significant in the acupuncture group than those in the medication group(P<0.05),and there was no statistical difference in PVR between the two groups after the treatment(P>0.05).Conclusion:Sacral needling with long needles can significantly reduce the clinical symptoms of OAB in elderly patients,it can improve the life quality of the patients,improve the urodynamic indexes.

关 键 词：长针骶刺法 电针 琥珀酸索利那新 老年膀胱过度活动症 

分 类 号：R246.1[医药卫生—针灸推拿学]