温阳通利灸联合膀胱功能训练治疗脊髓损伤后神经源性膀胱尿潴留临床研究  

Clinical Study on the Treatment of Neurogenic Bladder Urinary Retention after Spinal Cord Injury by Warming Yang Tongli Moxibustion and Bladder Function Training

作　　者：刘培培 贾露露[2] 牛向宝 刘杏花 刘堃 王鹏[5] LIU Peipei;JIA Lulu;NIU Xiangbao;LIU Xinghua;LIU Kun;WANG Peng(Zhoukou Orthopedic Hospital,Zhoukou 466000,Henan,China;Shijiazhuang First Hospital,Shijiazhuang 050011,Hebei,China;Luanzhou People&apos,s Hospital,Luanzhou 063004,Hebei,China;Anxin County Hospital,Anxin 071600,Hebei,China;Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,Hebei,China)

机构地区：[1]周口骨科医院,河南周口466000 [2]石家庄市第一医院,河北石家庄050011 [3]滦州市人民医院,河北滦州063004 [4]安新县医院,河北安新071600 [5]河北省中医院,河北石家庄050011

出　　处：《实用中医内科杂志》2023年第9期152-156,共5页Journal of Practical Traditional Chinese Internal Medicine

基　　金：河北省中医药管理局项目(2016108)。

摘　　要：目的观察温阳通利灸联合膀胱功能训练治疗脊髓损伤后神经源性膀胱尿潴留临床疗效。方法选择2021年1月—2022年3月在医院诊治的脊髓损伤后神经源性膀胱尿潴留患者130例,按照随机对照研究的基本原则分为对照组(65例)和治疗组(65例)。对照组在常规药物治疗基础上联合膀胱功能训练,治疗组在对照组治疗的基础上联合温阳通利灸治疗。治疗4周后,比较两组临床疗效、治疗前后中医证候积分、排尿情况、尿流动力学指标及生活质量变化情况。结果治疗组和对照组总有效率分别为90.8%和72.3%,差异有统计学意义(P<0.05);两组治疗后小腹胀满、小便排出不畅甚或闭塞、每日小便量少、无排尿感、膀胱区叩诊闻及浊音积分均降低,且治疗组均低于对照组(P<0.05);两组治疗后日排尿次数均减少(P<0.05),且治疗组日排尿次数少于对照组(P<0.05);两组日均单次排尿量、日单次最大尿量均增加(P<0.05),且治疗组日均单次排尿量、日单次最大尿量均多于对照组(P<0.05);两组治疗后最大尿流速、充盈期逼尿肌压力均升高(P<0.05),且治疗组最大尿流速、充盈期逼尿肌压力均高于对照组(P<0.05);两组最大膀胱容量及膀胱残余尿量均降低(P<0.05),且治疗组最大膀胱容量及膀胱残余尿量均低于对照组(P<0.05);两组治疗后社会功能、躯体功能、心理功能、物质生活评分均升高(P<0.05),且治疗组各评分均高于对照组(P<0.05)。结论温阳通利灸联合膀胱功能训练能够缓解脊髓损伤后神经源性膀胱患者尿潴留症状,改善尿流动力学指标和排尿情况,提高患者生活质量,值得向临床推广。Objective To observe the clinical effect of Wenyang Tongli moxibustion combined with bladder function training on neurogenic bladder urinary retention after spinal cord injury.Methods 130 patients with neurogenic bladder uroschesis after spinal cord injury diagnosed and treated in our hospital from January 2021 to March 2022 were selected and divided into the control group(65 cases)and the treatment group(65 cases)according to the basic principles of randomized contrlled study.The con-trol group was treated with conventional medication combined with bladder function training,while the treatment group was trea-ted with Wenyang Tongli moxibustion on the basis of the control group.Affer 4 weeks of treatment,compare the clinical efficacy,traditional Chinese medicine syndrome scores,urination status,urodynamic indicators,and changes in quality of life between the two groups before and after treatment.Result The total effective rates of the treatment group and the control group were 90.8%and 72.3%,respectively,with a statistically significant dfference(P<0.05).After treatment,both groups had lower abdomi-nal distension,poor or even blocked urination,low daily urination volume,no urination sensation,decreased percussion sensation and dullness score in the bladder area,and the treatment group was lower than the control group(P<0.05);After treatment,the daily urination frequency decreased in both groups(P<0.05),and the daily urination frequency in the treatment group was lower than that in the control group(P<0.05);The daily average single urination volume and daily maximum urination volume increased in both groups(P<0.05),and the daily average single urination volume and daily maximum urination volume in the treatment group were higher than those in the control group(P<0.05);After treatment,the maximum urine flow rate and flling period detrusor pressure increased in both groups(P<0.05),and the maximum urine flow rate and filling period detrusor pressure in the treatment group were higher than those in the control group(P

关 键 词：脊髓损伤 神经源性膀胱 尿潴留 温阳通利灸 膀胱功能训练 排尿日记 尿流动力学指标 

分 类 号：R256.5[医药卫生—中医内科学]