针灸结合三氧直肠灌注对不完全性脊髓损伤小便障碍的疗效研究  

Effectiveness Study of Acupuncture Combined with Trioxy Rectal Perfusion on Urination Disorder in Incomplete Spinal Cord Injury

作　　者：付崇[1] 罗娟 FU Chong;LUO Juan(Jiangbin Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China;The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530022,China)

机构地区：[1]广西壮族自治区江滨医院,广西南宁530021 [2]广西中医药大学第一附属医院,广西南宁530022

出　　处：《中医药学报》2024年第6期69-74,共6页Acta Chinese Medicine and Pharmacology

基　　金：广西壮族自治区中医药管理局自筹经费科研课题(GXZYA20220202)。

摘　　要：目的:观察针灸结合三氧直肠灌注对不完全性脊髓损伤小便障碍患者逼尿肌损伤修复及膀胱功能、应激状态和尿动力学的影响。方法:选择2022年7月—2023年7月于广西壮族自治区江滨医院治疗的86例不完全性脊髓损伤小便障碍患者,按照随机数字表法分为两组,三氧直肠灌注组43例,基础治疗的同时给予患者三氧直肠灌注治疗;针灸联合组43例,三氧直肠灌注组治疗基础上给予患者针灸治疗。比较两组临床疗效,治疗前、后评价中医证候,记录两组患者每次排尿量、膀胱安全容量,给予患者国际下尿路功能症状(LUTS)、尿失禁生活质量问卷(I-QOL)评价,测定膀胱顺应性、充盈期膀胱压力、最大尿流速时逼尿肌压力,检测热休克蛋白70(HSP70)、活性氧(ROS)、超氧化物歧化酶(SOD)水平。结果:针灸联合组总有效率较三氧直肠灌注组高(P<0.05);中医证候评分较三氧直肠灌注组降低(P<0.01);膀胱安全容量、每次排尿量大于三氧直肠灌注组(P<0.01),I-QOL评分高于三氧直肠灌注组(P<0.01),LUTS评分少于三氧直肠灌注组(P<0.01);最大尿流速时逼尿肌压力、充盈期膀胱压力低于三氧直肠灌注组(P<0.05),膀胱顺应性高于三氧直肠灌注组(P<0.01);HSP70、ROS水平低于三氧直肠灌注组(P<0.05),SOD水平高于三氧直肠灌注组(P<0.01)。结论:针灸结合三氧直肠灌注治疗不完全性脊髓损伤小便障碍患者,可抑制氧化应激,促进修复受损逼尿肌,改善尿动力学,提升膀胱功能、排尿功能、临床疗效及生活质量。To observe the effects of acupuncture combined with trioxy rectal perfusion on detrusor injury repair,bladder function,stress state and urodynamics in patients with incomplete spinal cord injury with urination disorder.Method:Eighty-six patients with incomplete spinal cord injury and urinary dysfunction treated at Jiangbin Hospital of Guangxi Zhuang Autonomous Region from July 2022 to July 2023 were selected.They were randomly divided into a trioxy rectal perfusion group(n=43)and an acupuncture combined group(n=43)using a random number table.The former received trioxy rectal perfusion while receiving basic treatment,and the latter received the same plus acupuncture therapy.The clinical efficacy of the acupuncture combined group and the trioxy rectal perfusion group was compared.Traditional Chinese medicine(TCM)syndromes were evaluated before and after treatment.The volume of each urination,bladder safe capacity,International Lower Urinary Tract Function Symptom Score(LUTS),and Incontinence Quality of Life Questionnaire(I-QOL)were recorded for both groups.Bladder compliance,bladder pressure during filling,and detrusor pressure at maximum urinary flow rate were measured.Additionally,levels of heat shock protein 70(HSP70),reactive oxygen species(ROS),and superoxide dismutase(SOD)were detected.Results:The total efficacy of the acupuncture combined group was higher than that of the trioxy rectal perfusion group(P<0.05).The TCM syndrome scores in the acupuncture combined group were lower than those in the trioxy rectal perfusion group(P<0.05).Bladder safe capacity and volume of each urination in the acupuncture combined group were greater than those in the trioxy rectal perfusion group,and I-QOL scores were higher than those in the trioxy rectal perfusion group(P<0.05).The LUTS scores in the acupuncture combined group were lower than those in the trioxy rectal perfusion group(P<0.05).The detrusor pressure at maximum urinary flow rate and bladder pressure during filling in the acupuncture combined group were lower than

关 键 词：三氧直肠灌注 不完全性脊髓损伤 小便障碍 氧化应激状态 逼尿肌修复 膀胱功能 

分 类 号：R256.53[医药卫生—中医内科学]