盆底肌训练联合电针治疗不完全脊髓损伤后膀胱功能障碍:随机对照试验  

Pelvic floor muscle training combined with electroacupuncture for bladder dysfunction after incomplete spinal cord injury:a randomized controlled trial

作　　者：李振兴[1] 杨翔宇 周宾宾[1] 苏婷 LI Zhenxing;YANG Xiangyu;ZHOU Binbin;SU Ting(First Affiliated Hospital of Guangxi University of CM,Nanning 530001,China;Ruikang Hospital Affiliated to Guangxi University of CM,Nanning 530001)

机构地区：[1]广西中医药大学第一附属医院,南宁530001 [2]广西中医药大学附属瑞康医院,南宁530001

出　　处：《中国针灸》2024年第9期983-988,共6页Chinese Acupuncture & Moxibustion

基　　金：广西壮族自治区中医药管理局自筹项目:GZZC2020041;国家自然科学基金资助项目:81660814。

摘　　要：目的:观察盆底肌训练联合电针治疗不完全脊髓损伤(SCI)后膀胱功能障碍的疗效。方法:将90例不完全SCI后膀胱功能障碍患者随机分为电针组(30例)、盆底肌训练组(30例,脱落1例)和联合组(30例,脱落1例)。3组患者均予常规康复措施。电针组予电针治疗,穴取中极、关元、命门、腰阳关及双侧肾俞、次髎、膀胱俞,选择连续波,频率100 Hz,留针30 min,每天1次,每周6次,连续治疗6周;盆底肌训练组采用盆底肌训练,每天2次,共治疗6周;联合组予电针、盆底肌训练联合治疗。比较各组患者治疗前后日均排尿次数、日均漏尿次数、尿动力学指标(残余尿量、最大膀胱容量、膀胱顺应性、最大尿流率)及综合生活质量评定量表(GQOLI-74)评分。结果:与治疗前比较,各组患者治疗后日均排尿次数、日均漏尿次数减少(P<0.05),残余尿量、最大膀胱容量、膀胱顺应性降低(P<0.05),最大尿流率及GQOLI-74评分升高(P<0.05)。联合组日均排尿次数、日均漏尿次数、残余尿量、最大膀胱容量、膀胱顺应性、最大尿流率及GQOLI-74评分治疗前后差值大于电针组和盆底肌训练组(P<0.05);电针组与盆底肌训练组以上指标治疗前后差值比较差异无统计学意义(P>0.05)。结论:盆底肌训练联合电针干预能够有效缓解不完全SCI后膀胱功能障碍患者排尿情况,改善膀胱功能,提高患者生活质量。Objective To observe the efficacy of pelvic floor muscle training combined with electroacupuncture(EA)for bladder dysfunction after incomplete spinal cord injury(SCI).Methods Ninety patients with bladder dysfunction after incomplete SCI were randomly divided into an EA group(30 cases),a pelvic floor muscle training group(30 cases,1 case dropped out),and a combined group(30 cases,1 case dropped out).All groups received routine rehabilitation.The EA group received EA at Zhongji(CV 3),Guanyuan(CV 4),Mingmen(GV 4),Yaoyangguan(GV 3),bilateral Shenshu(BL 23),Ciliao(BL 32),and Pangguangshu(BL 28),with continuous waves at frequency of 100 Hz,and the needles were retained for 30 min,once daily,6 times a week for 6 weeks.The pelvic floor muscle training group underwent pelvic floor muscle training two times a day,for 6 weeks.The combined group received both EA and pelvic floor muscle training.The daily average number of urinations,daily average number of urinary leakages,urodynamic indexes(residual urine volume,maximum bladder capacity,bladder compliance,and maximum urine flow rate),and generic quality of life inventory-74(GQOLI-74)were compared before and after treatment in each group.Results Compared before treatment,the daily average number of urinations and urinary leakages were decreased(P<0.05),residual urine volume,maximum bladder capacity,and bladder compliance were reduced(P<0.05),and maximum urine flow rate and GQOLI-74 scores were increased(P<0.05)after treatment in all groups.After treatment,the combined group showed greater differences in the daily average number of urinations,daily average number of urinary leakages,residual urine volume,maximum bladder capacity,bladder compliance,maximum urine flow rate,and GQOLI-74 score compared to the EA group and the pelvic floor muscle training group(P<0.05).There was no statistically significant differences in the changes in these indexes between the EA group and the pelvic floor muscle training group(P>0.05).Conclusion Pelvic floor muscle training combined with EA can

关 键 词：膀胱功能障碍 不完全脊髓损伤 电针 盆底肌训练 随机对照试验 

分 类 号：R246.2[医药卫生—针灸推拿学]