穴位三部曲联合康复训练对逼尿肌反射亢进型神经源性膀胱尿动力学的影响  

Effect of acupoint trilogy combined with rehabilitation training on neurogenic bladder with detrusor hyperreflexes

作　　者：张杏 金梅 王传思 ZHANG Xing;JIN Mei;WANG Chuansi(Department of Rehabilitation Medicine,Lu’an Hospital of Anhui Medical University,Anhui Province,Lu’an237005,China;Department of Anorectal Surgery,Lu’an Hospital of Anhui Medical University,Anhui Province,Lu’an237005,China)

机构地区：[1]安徽医科大学附属六安医院康复医学科,安徽六安237005 [2]安徽医科大学附属六安医院肛肠外科,安徽六安237005

出　　处：《中国医药导报》2024年第7期105-109,共5页China Medical Herald

基　　金：安徽省中医药传承创新科研项目(2020ccyb25)。

摘　　要：目的 探讨穴位三部曲联合康复训练对逼尿肌反射亢进型神经源性膀胱尿动力学、尿道外括约肌肌电图及相关并发症的影响。方法 选择安徽医科大学附属六安医院2019年2月至2023年2月收治的52例逼尿肌反射亢进型神经源性膀胱患者为研究对象。采用随机数字表法分为对照组(26例)予常规间歇导尿护理联合康复训练,观察组(26例)在对照组的基础上采用穴位三部曲,比较两组干预前后的尿动力学、尿道外括约肌肌电图、并发症。结果 干预后,两组最大尿流率、膀胱顺应性、膀胱容量高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05);干预后,两组最大尿流速率时逼尿肌压力低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。干预后,两组肌道外括约肌肌电图检测的排尿前振幅值、常用对数TL值高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。干预后,两组排尿中振幅值低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论 艾灸、推拿、穴位贴敷三部曲联合康复训练有助于改善逼尿肌亢进型神经源性膀胱患者的尿动力学,提高膀胱顺应性,降低尿路感染及损伤等相关并发症发生率。Objective To investigate the effects of acupoint trilogy combined with rehabilitation training on neurogenic bladder with detrusor hyperretlexes,electromyography of external urethral sphincter and related complications of detrusor hyperreflexia.Methods 52 patients with neurogenic bladder with detrusor hyperreflexia treated in Lu’an Hospital of Anhui Medical University from February 2019 to February 2023 were selected as the study objects.Random number table method was used to divide into the control group(26 cases)given routine intermittent catheterization nursing combined with rehabilitation training and observation group(26 cases)treated with acupoint trilogy on the basis of the control group.The urodynamics,electromyogram of external urethral sphincter and complications of the two groups were compared before and after intervention.Results After intervention,Qmax,bladder compliance,and bladder volume in two groups were higher than those before intervention,while those of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).After intervention,the Pdet-Qmax in both groups were lower than those before intervention,while that of the observation group was lower than that of the control group,and the differences were statistically significant(P<0.05).After intervention,the T value and TL value of electromyogram detected in the two groups were higher than before intervention,while those of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).After intervention,the L value of the two groups were lower than those before intervention,while that of the observation group was lower than that of the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Moxibustion,massage,and acupoint applicatio

关 键 词：穴位三部曲 康复训练 逼尿肌亢进型神经源性膀胱 尿动力学 

分 类 号：R259[医药卫生—中西医结合]