针刺八髎穴联合中频刺激治疗脊髓损伤后神经源性膀胱临床疗效及对尿流动力学的影响  

Therapeutic effect of acupuncture at Baliao acupoint combined with medium frequency therapy on spinal cord injury-induced neurogenic bladder and its impact on urodynamics

作　　者：潘秋银 李登科[1] 苏晓勇 王琼[3] 孙文琳[2] 祁玉军[2] PAN Qiuyin;LI Dengke;SU Xiaoyong;WANG Qiong;SUN Wenlin;QI Yujun(Department of Acupuncture,the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University,Huai'an,Jiangsu 223300;Department of Rehabilitation Medicine,the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University,Huai'an,Jiangsu 223300;Acupuncture and Massage Rehabilitation Center,the First Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410007)

机构地区：[1]南京医科大学附属淮安第一医院针灸科,江苏淮安223300 [2]南京医科大学附属淮安第一医院康复医学科,江苏淮安223300 [3]湖南中医药大学第一附属医院针灸推拿康复中心,湖南长沙410007

出　　处：《河北中医》2024年第9期1528-1531,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：湖南省中医药管理局2022年度中医药科研计划项目(编号:D2022054);湖南省卫生健康委员会2023年度科研计划课题(编号:D202319017905)。

摘　　要：目的观察针刺八髎穴联合中频电刺激对脊髓损伤后神经源性膀胱患者的治疗效果,及对其排尿功能、尿流动力学的影响。方法将86例脊髓损伤后神经源性膀胱患者按照随机数字表法分为治疗组和对照组,各43例。2组均予常规膀胱功能训练,对照组加中频刺激治疗,治疗组在对照组基础上加针刺八髎穴。2周为1个疗程,连续治疗2个疗程后统计疗效。比较2组治疗前后排尿情况(包括日均单次排尿量、日均导尿次数、日均漏尿次数)、尿流动力学相关指标(膀胱残余尿量、最大逼尿肌压、最大膀胱测压容积)。结果治疗组总有效率88.37%(38/43),对照组总有效率69.77%(30/43),治疗组总有效率高于对照组(P<0.05)。治疗后2组日均单次排尿量均升高(P<0.05),日均导尿次数、日均漏尿次数均下降(P<0.05);与对照组比较,治疗后治疗组日均单次排尿量上升(P<0.05),日均导尿次数、日均漏尿次数均显著下降(P<0.05)。治疗后2组残余尿量显著减少(P<0.05),最大逼尿肌压、最大膀胱测压容积均显著增加(P<0.05);与对照组比较,治疗后治疗组残余尿量显著减少(P<0.05),最大逼尿肌压、最大膀胱测压容积显著上升(P<0.05)。结论针刺八髎穴联合中频刺激治疗脊髓损伤后神经源性膀胱效果优于中频刺激治疗,能有效改善其排尿功能和尿流动力学。Objective To analyze the therapeutic effect of acupuncture at Baliao acupoint combined with medium frequency electric stimulation on spinal cord injury-induced neurogenic bladder and its impacts on urination function and urodynamics.Methods A total of 86 patients with spinal cord injury-induced neurogenic bladder were divided into the control group(n=43)and the treatment group(n=43)according to a random number table.All patients were given routine bladder training and medium frequency electric stimulation,and those in the treatment group were additionally given acupuncture at Baliao acupoint.Treated for 2 courses(2 week as a course of treatment),the aim was to compare urination(including daily average volume of single urinary,daily average frequency of catheterizations and urine leakage)and urodynamic related indicators(bladder residual urine volume,maximum detrusor pressure,maximum cystometric capacity)between the two groups before and after treatment.The curative effect was assessed.Results The total effective rate of the treatment group was obviously higher than that of the control group(88.37%[38/43]vs 69.77%[30/43],P<0.05).After treatment,the daily average volume of single urinary,maximum detrusor pressure,maximum cystometric capacity in the both groups were obviously increased(all P<0.05),while the daily average frequency of catheterizations and urine leakage,and bladder residual urine volume were obviously decreased(all P<0.05),with significant inter-group difference for the above indexes(all P<0.05).Conclusion For patients with spinal cord injury-induced neurogenic bladder,acupuncture at Baliao acupoint and medium frequency electric stimulation can effectively improve urination function and urodynamics,and its effect is superior to medium frequency electrical stimulation alone.

关 键 词：膀胱 神经原性 脊髓损伤 针刺疗法 八髎穴 中频电刺激 

分 类 号：R651.21[医药卫生—外科学] R694.5[医药卫生—临床医学] R245.31