电针八髎穴联合金匮肾气丸汤剂治疗肾阳虚型脑卒中后神经源性膀胱的临床观察  

Clinical Observation on Electroacupuncture at Baliao Points Combined withJingui Shenqi Wan Decoction in the Treatment of Post-stroke NeurogenicBladder of Kidney-Yang Deficiency Type

作　　者：秦思 覃渝茜 陈洋 唐虹 杨廷彦 QIN Si;TAN Yu-Qian;CHEN Yang;TANG Hong;YANG Ting-Yan(Sichuan Bayi Rehabilitation Center/Sichuan Rehabilitation Hospital,Chengdu 611135 Sichuan,China)

机构地区：[1]四川省八一康复中心/四川省康复医院,四川成都611135

出　　处：《广州中医药大学学报》2024年第9期2266-2271,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家中医药管理局资助项目(编号:lc20160220);四川省科技计划资助项目(编号:2021YFS0017)。

摘　　要：【目的】观察电针八髎穴联合金匮肾气丸汤剂治疗肾阳虚型脑卒中后神经源性膀胱(PSNB)的临床疗效。【方法】将86例肾阳虚型PSNB患者随机分为观察组和对照组,每组各43例,对照组给予电针八髎穴及常规康复治疗,观察组在对照组治疗的基础上,给予金匮肾气丸汤剂治疗,连续治疗4周。治疗4周后,评价2组临床疗效,观察2组患者治疗前后改良Barthel指数量表(MBI)评分的变化情况,以及每日排尿情况和尿动力学指标的变化情况。比较2组患者治疗前后血清超氧化物歧化酶(SOD)水平的变化情况。【结果】(1)观察组总有效率为95.35%(41/43),对照组为79.07%(34/43)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的每日排尿情况包括日均排尿次数、日均单次排尿量和日均尿失禁次数均明显改善(P<0.05),且观察组在改善日均排尿次数、日均单次排尿量和日均尿失禁次数方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的尿动力学指标包括最大膀胱容量、最大尿流速率、残余尿量、膀胱顺应性、最大尿道压和逼尿肌压力均明显改善(P<0.05),且观察组在改善最大膀胱容量、最大尿流速率、残余尿量、膀胱顺应性、最大尿道压和逼尿肌压力方面明显优于对照组,差异均有统计学意义(P<0.05)。(4)治疗后,2组患者的血清SOD水平均明显改善(P<0.05),且观察组在改善血清SOD水平方面明显优于对照组,差异有统计学意义(P<0.05)。(5)治疗后,2组患者的MBI评分均明显改善(P<0.05),且观察组在改善MBI评分方面明显优于对照组,差异有统计学意义(P<0.05)。【结论】电针八髎穴联合金匮肾气丸汤剂治疗肾阳虚型PSNB,能明显改善患者的排尿功能,有效改善患者的尿流动力学指标,下调患者的血清SOD水平,提高患者的日常生活质量,疗效显著。Objective To observe the clinical efficacy of electroacupuncture at Baliao points combined with Jingui Shenqi Wan Decoction in the treatment of post-stroke neurogenic bladder of kidney-yang deficiency type.Methods A total of 86 patients with post-stroke neurogenic bladder(PSNB)of kidney-yang deficiency type were randomly divided into observation group and control group,with 43 cases in each group.The control group was given electroacupuncture at Baliao points and routine rehabilitation treatment.On the basis of the treatment of the control group,the observation group was treated with Jingui Shenqi Wan Decoction for four weeks.After four weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes of Modified Barthel Index(MBI)score,daily urination and urodynamic indexes of the two groups were observed before and after treatment.The changes of serum superoxide dismutase(SOD)level were compared before and after treatment between the two groups.Results(1)The total effective rate was 95.35%(41/43)in the observation group and 79.07%(34/43)in the control group.The curative effect of the observation group was superior to that of the control group,and the difference was statistically significant(P<0.05).(2)After treatment,the daily urination conditions of the two groups of patients,including the average daily urination times,the average daily single urination volume and the average daily urinary incontinence times,were significantly improved(P<0.05),and the improvement of the average daily urination times,the average daily single urination volume and the average daily urinary incontinence times in the observation group were significantly superior to those in the control group,and the differences were statistically significant(P<0.05).(3)After treatment,the urodynamic indexes including maximum bladder capacity,maximum urinary flow rate,residual urine volume,bladder compliance,maximum urethral pressure and detrusor pressure in the two groups were significantly improved(P<0.05),and the improvemen

关 键 词：电针八髎穴 金匮肾气丸 神经源性膀胱 脑卒中 肾阳虚 尿流动力学 血清超氧化物歧化酶 临床观察 

分 类 号：R246.9[医药卫生—针灸推拿学]