电针治疗脊髓损伤神经源膀胱尿失禁临床研究
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摘要
目的观察电针八髎、会阳治疗脊髓损伤神经源膀胱尿失禁患者的临床疗效。方法将67例脊髓损伤神经源膀胱尿失禁患者随机分为治疗组(34例)和对照组(33例),两组均给予常规药物治疗及物理治疗(physical therapy, PT)、作业治疗(occupational therapy, OT)、间歇导尿等治疗。治疗组加电针八髎、会阳。两组治疗前及治疗后,分别进行残余尿量、导尿次数、导尿量、尿白细胞计数、尿失禁量表问卷评分等评定,进行疗效评价及比较。结果治疗组治疗后导尿次数减少(P<0.05),与对照组比较差异有统计学意义(P<0.05)。治疗组治疗后导尿量增加(P<0.05),与对照组比较差异有统计学意义(P<0.05)。治疗组治疗后膀胱残余尿量减少(P<0.05),与对照组比较差异有统计学意义(P<0.05)。治疗组治疗后尿白细胞计数减少(P<0.05),与对照组比较差异有统计学意义(P<0.05)。治疗组治疗后ICI-Q-SF评分减少(P<0.05),与对照组比较差异有统计学意义(P<0.05)。结论电针八髎、会阳结合康复训练,能明显改善脊髓损伤神经源膀胱尿失禁状况,提高日常生活活动能力,提高康复疗效。
Objective To investigate the clinical efficacy of Electroacupuncture at points Baliao [Shangliao(BL31),Ciliao(BL32), Zhongliao(BL33), Xialiao(BL34)]and Huiyang(BL35) for urinary incontinence in spinal cord injury-induced neurogenic bladder. Method Sixty-seven patients with urinary incontinence in spinal cord injury-induced neurogenic bladder were randomized to a treatment group(34 cases) and a control group(33 cases).Both groups received conventional medication, physical therapy(PT), occupational therapy(OT) and intermittent catheterization. The treatment group received Electroacupuncture at points Baliao and Huiyang in addition. The residual urine volume, the frequency of catheterization and the volume of urine obtained by catheterization were measured,urinary leukocyte count was kept and the urinary incontinence scale questionnaire score was recorded in the two groups before and after treatment. The therapeutic effects were evaluated and compared. Result After treatment, the frequency of catheterization decreased in the treatment group(P<0.05) and there was a statistically significant difference as compared with the control group(P<0.05). After treatment, the volume of urine obtained by catheterization increased in the treatment group(P<0.05) and there was a statistically significant difference as compared with the control group(P<0.05). After treatment, bladder residual urine volume decreased in the treatment group(P<0.05) and there was a statistically significant difference as compared with the control group(P<0.05). After treatment, urinary leukocyte count decreased in the treatment group(P<0.05) and there was a statistically significant difference as compared with the control group(P<0.05). After treatment, the ICI-Q-SF score decreased in the treatment group(P<0.05) and there was a statistically significant difference as compared with the control group(P<0.05). Conclusion Electroacupuncture at points Baliao and Huiyang plus rehabilitation training can significantly reduce urinary incontinence in spinal cord injury-induced neurogenic bladder, improve the activities of daily living and enhance the therapeutic effect of rehabilitation.
Objective To investigate the clinical efficacy of Electroacupuncture at points Baliao [Shangliao(BL31),Ciliao(BL32), Zhongliao(BL33), Xialiao(BL34)]and Huiyang(BL35) for urinary incontinence in spinal cord injury-induced neurogenic bladder. Method Sixty-seven patients with urinary incontinence in spinal cord injury-induced neurogenic bladder were randomized to a treatment group(34 cases) and a control group(33 cases).Both groups received conventional medication, physical therapy(PT), occupational therapy(OT) and intermittent catheterization. The treatment group received Electroacupuncture at points Baliao and Huiyang in addition. The residual urine volume, the frequency of catheterization and the volume of urine obtained by catheterization were measured,urinary leukocyte count was kept and the urinary incontinence scale questionnaire score was recorded in the two groups before and after treatment. The therapeutic effects were evaluated and compared. Result After treatment, the frequency of catheterization decreased in the treatment group(P<0.05) and there was a statistically significant difference as compared with the control group(P<0.05). After treatment, the volume of urine obtained by catheterization increased in the treatment group(P<0.05) and there was a statistically significant difference as compared with the control group(P<0.05). After treatment, bladder residual urine volume decreased in the treatment group(P<0.05) and there was a statistically significant difference as compared with the control group(P<0.05). After treatment, urinary leukocyte count decreased in the treatment group(P<0.05) and there was a statistically significant difference as compared with the control group(P<0.05). After treatment, the ICI-Q-SF score decreased in the treatment group(P<0.05) and there was a statistically significant difference as compared with the control group(P<0.05). Conclusion Electroacupuncture at points Baliao and Huiyang plus rehabilitation training can significantly reduce urinary incontinence in spinal cord injury-induced neurogenic bladder, improve the activities of daily living and enhance the therapeutic effect of rehabilitation.
引文
[1]Siracusa G,Sparacino A,Lentini VL.Neurogenic bladder and disc disease:a brief review[J].Curr Med Res Opin,2013,29(8):1025-1031.
[2]Frankel HL,Coll JR,Charlifue SW,et al.Long-term survival in spinal cord injury:a fifty year investigation[J]Spinal Cord,1998,36(4):266-274.
[3]Abrams P,Larsson G,Chapple C,et al.Factors involved in the success of antimuscarinic treatment[J].BJU Int,1999,83(suppl2):42-47.
[4]Brindley GS.The first 500 patients with sacral anterior root stimulator implants:general description[J].Paraplegia,1994,32(12):795-805.
[5]de Sèze M,Wiart L,Joseph PA,et al.Capsaicin and neurogenic detrusor hyperreflexia:a double-blind placebo-controlled study in 20 patients with spinal cord lesions[J].Neurourol Urodyn,1998,17(5):513-523.
[6]Chancellor MB,de Groat WC.Intravesical capsaicin and resiniferatoxin therapy:spicing up the ways to treat the overactive bladder[J].J Urol,1999,162(1):3-11.
[7]Madersbacher H,Wyndaele JJ,Igawa Y,et al.Conservative Management in the Neuropathic Patient[M].Monaco:First International Consultation on Incontinence,1999:777-812.
[8]杨凤翔,王成秀,李娜,等.脊髓损伤后神经源性膀胱的康复研究进展[J].华西医学,2015,30(2):389-392.
[9]秦江,赵亚杰,石秀秀,等.不同时期针刺介入对脊髓损伤后神经源性膀胱排尿功能重建的影响[J].中国针灸,2015,35(2):132-136.
[10]邝雪辉,康玉闻.电温针八髎穴治疗脊髓损伤后神经源性膀胱的临床观察[J].中国中医急症,2018,27(11):2017-2020.
[11]罗庆禄,王诗忠,陈岚榕,等.针刺八髎穴对脊髓损伤神经源性膀胱患者残余尿量和排尿功能的影响[J].福建中医药大学学报,2012,22(1):12-14.
[12]马力.电针八髎穴结合温灸治疗脊髓源性尿失禁30例临床观察[J].湖南中医杂志,2012,28(3):81-83.
[13]戴文晋,王科英,李艳,等.针灸联合低频电刺激对脊髓损伤致神经源性膀胱康复的疗效观察[J].医学信息(下旬刊),2013,26(10):233.
[14]顾旭东,傅建明,姚云海.电针八髎穴为主治疗脊髓损伤排尿障碍64例疗效观察[J].针灸临床杂志,2005,21(4):47-48.
[15]Honjo H,Naya Y,Ukimura O,et al.Acupuncture on clinical symptoms and urodynamic measurements in spinal-cord-injured patients with detrusor hyperreflexia[J].Urol Int,2000,65(4):190-195.
[16]熊杰.针刺对脊髓损伤患者排尿障碍的影响[J].国外医学(中医中药分册),1997,19(1):52-53.
[17]熊杰.针刺中髎穴治疗神经源性膀胱的适应症和界限[J].国外医学(中医中药分册),1997,19(1):53.
[2]Frankel HL,Coll JR,Charlifue SW,et al.Long-term survival in spinal cord injury:a fifty year investigation[J]Spinal Cord,1998,36(4):266-274.
[3]Abrams P,Larsson G,Chapple C,et al.Factors involved in the success of antimuscarinic treatment[J].BJU Int,1999,83(suppl2):42-47.
[4]Brindley GS.The first 500 patients with sacral anterior root stimulator implants:general description[J].Paraplegia,1994,32(12):795-805.
[5]de Sèze M,Wiart L,Joseph PA,et al.Capsaicin and neurogenic detrusor hyperreflexia:a double-blind placebo-controlled study in 20 patients with spinal cord lesions[J].Neurourol Urodyn,1998,17(5):513-523.
[6]Chancellor MB,de Groat WC.Intravesical capsaicin and resiniferatoxin therapy:spicing up the ways to treat the overactive bladder[J].J Urol,1999,162(1):3-11.
[7]Madersbacher H,Wyndaele JJ,Igawa Y,et al.Conservative Management in the Neuropathic Patient[M].Monaco:First International Consultation on Incontinence,1999:777-812.
[8]杨凤翔,王成秀,李娜,等.脊髓损伤后神经源性膀胱的康复研究进展[J].华西医学,2015,30(2):389-392.
[9]秦江,赵亚杰,石秀秀,等.不同时期针刺介入对脊髓损伤后神经源性膀胱排尿功能重建的影响[J].中国针灸,2015,35(2):132-136.
[10]邝雪辉,康玉闻.电温针八髎穴治疗脊髓损伤后神经源性膀胱的临床观察[J].中国中医急症,2018,27(11):2017-2020.
[11]罗庆禄,王诗忠,陈岚榕,等.针刺八髎穴对脊髓损伤神经源性膀胱患者残余尿量和排尿功能的影响[J].福建中医药大学学报,2012,22(1):12-14.
[12]马力.电针八髎穴结合温灸治疗脊髓源性尿失禁30例临床观察[J].湖南中医杂志,2012,28(3):81-83.
[13]戴文晋,王科英,李艳,等.针灸联合低频电刺激对脊髓损伤致神经源性膀胱康复的疗效观察[J].医学信息(下旬刊),2013,26(10):233.
[14]顾旭东,傅建明,姚云海.电针八髎穴为主治疗脊髓损伤排尿障碍64例疗效观察[J].针灸临床杂志,2005,21(4):47-48.
[15]Honjo H,Naya Y,Ukimura O,et al.Acupuncture on clinical symptoms and urodynamic measurements in spinal-cord-injured patients with detrusor hyperreflexia[J].Urol Int,2000,65(4):190-195.
[16]熊杰.针刺对脊髓损伤患者排尿障碍的影响[J].国外医学(中医中药分册),1997,19(1):52-53.
[17]熊杰.针刺中髎穴治疗神经源性膀胱的适应症和界限[J].国外医学(中医中药分册),1997,19(1):53.