电针“膀胱组穴”治疗脑卒中后神经源性膀胱尿潴留的疗效分析
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摘要
目的观察电针"膀胱组穴"治疗脑卒中后神经源性膀胱(PSNB)尿潴留的临床疗效。方法纳入2015年1月—2017年1月收治的80例脑卒中后神经源性膀胱尿潴留患者,按就诊顺序随机分成2组,每组40例。治疗组在常规治疗基础上,采取电针"膀胱组穴"治疗。对照组在常规治疗的基础上,采用间歇导尿治疗,以膀胱最大容量及残余尿量作为评价指标进行疗效对比。结果治疗前两组的膀胱最大容量、残余尿量为两组比较差异无统计学意义(P>0.05);治疗后,对照组患者的膀胱最大容量为(263.60±43.02)mL、残余尿量为(97.15±31.16)m L,治疗组患者膀胱最大容量为(285.66±41.36)mL、残余尿量为(75.12±30.51)mL,两组膀胱最大容量及残余尿量均较前减少,治疗组改善更明显(t_1=2.249、t_2=3.073,P<0.05);治疗组与对照组的临床治疗总有效率分别为94.74%、66.67%,差异有统计学意义(χ~2=9.496,P<0.05)。结论电针"膀胱组穴"治疗脑卒中后神经源性膀胱尿潴留疗效确切,值得临床推广。
Objective To observe the clinical efficacy of electroacupuncture on "bladder group acupoints" in the treatment of post stroke neurogenic bladder(PSNB) urinary retention. Methods Eighty patients with neurogenic bladder urinary retention after stroke from January 2015 to January 2017 were randomly divided into two groups chronologically, 40 cases in each group. On the basis of conventional treatment, the treatment group was treated with electroacupuncture on "bladder group acupoints ", and the control group was given intermittent catheterization.The maximum volume of bladder and residual urine volume were used as evaluation indicators for comparison.Results There was no difference in the maximum bladder volume and residual urine volume between the two groups before treatment(P>0.05). After treatment, the maximum bladder capacity of the control group was(263.60 ±43.02)m L and the residual urine volume was(97.15 ±31.16) mL, the maximum volume of bladder in the treatment group was(285.66±41.36) m L, and the residual urine volume was(75.12±30.51) mL. The maximum volume and residual urine volume of the bladder in both groups were lower than before, and the treatment group improved more obviously(t_1=2.249、t_2=3.073,P<0.05). The total effective rate of clinical treatment in the treatment group and the control group was 94.74% and 66.67%, respectively, and the difference was statistically significant(χ~2=9.496, P<0.05).Conclusion Electroacupuncture on "bladder group acupoints" is effective in the treatment of neurogenic bladder urinary retention after stroke,which is worthy of clinical promotion.
Objective To observe the clinical efficacy of electroacupuncture on "bladder group acupoints" in the treatment of post stroke neurogenic bladder(PSNB) urinary retention. Methods Eighty patients with neurogenic bladder urinary retention after stroke from January 2015 to January 2017 were randomly divided into two groups chronologically, 40 cases in each group. On the basis of conventional treatment, the treatment group was treated with electroacupuncture on "bladder group acupoints ", and the control group was given intermittent catheterization.The maximum volume of bladder and residual urine volume were used as evaluation indicators for comparison.Results There was no difference in the maximum bladder volume and residual urine volume between the two groups before treatment(P>0.05). After treatment, the maximum bladder capacity of the control group was(263.60 ±43.02)m L and the residual urine volume was(97.15 ±31.16) mL, the maximum volume of bladder in the treatment group was(285.66±41.36) m L, and the residual urine volume was(75.12±30.51) mL. The maximum volume and residual urine volume of the bladder in both groups were lower than before, and the treatment group improved more obviously(t_1=2.249、t_2=3.073,P<0.05). The total effective rate of clinical treatment in the treatment group and the control group was 94.74% and 66.67%, respectively, and the difference was statistically significant(χ~2=9.496, P<0.05).Conclusion Electroacupuncture on "bladder group acupoints" is effective in the treatment of neurogenic bladder urinary retention after stroke,which is worthy of clinical promotion.
引文
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[2]苗广宇.电针配合温针灸治疗中风后小便失禁30例[J].中国中医药,2014,12(5).
[3]彭夏培,张青,朱江.脑卒中后神经源性膀胱患者尿路感染的相关因素分析[J].中华医院感染学杂志,2014,24(14):3518-3520.
[4]中国老年医学学会神经医学分会,天津市卒中学会.卒中后神经源性膀胱诊治专家共识[J].中国卒中杂志,2016,11(12):1057-1066.
[5]王燕,张立宁.脑卒中患者神经源性膀胱康复治疗进展[J].解放军医学院学报,2015,36:1255-1258.
[6]饶明俐.中国脑血管病防治指南[M].北京:人民卫生出版社,2007:85-116.
[7]潘才钰,程一升,吴志鹏,等.间歇导尿联合针刺治疗脑卒中后神经源性膀胱的疗效观察[J].中医药,2013,51(30):94-96.
[8]马艳,刘军花,王茉莉,等.综合护理干预配合穴位按摩在脑卒中后尿潴留患者的应用[J].中西医结合护理(中英文),2016(2):66-69.
[9]Song FJ,Jiang SH,Zheng SL,et al.Electroacupuncture for post-stoke urinary incontinence:a multi-center randomized controlled study[J].Zhongguo Zhen Jiu,2013,33:769-773.
[10]丛惠伶,廖利民.中枢神经系统对排尿的控制和调节[J].中国康复理论与实践,2008(14):1011-1013.