摘要
目的:探究“川字灸法”在防治脊髓损伤后神经源性膀胱尿路感染的临床作用。方法:选取山东中医药大学第二附属医院2020年1—12月诊断为完全性脊髓损伤后高顺应性神经源性膀胱的患者60例,采取随机数字表法分为对照组和治疗组,每组各30例。2组均采用常规治疗及护理,治疗组加用隔日1次“川字灸法”配合涂擦温阳利水搽剂(院内协定方),共治疗8周。2组膀胱残余尿量、自主排尿量、尿常规、生活质量指数(QoL)作为主要疗效判断,汉密尔顿抑郁量表17项(HAMD-17)评分作为次要疗效判断。结果:2组治疗前膀胱残余尿量、自主排尿量、QoL、HAMD-17评分比较,差异均无统计学意义(P>0.05)。治疗8周后,2组膀胱残余尿量、自主排尿量、QoL评分与HAMD-17评分明显改善,与治疗前比较,差异均具有统计学意义(P<0.05);治疗组发生了2例尿路感染,对照组发生了9例尿路感染,治疗组发生泌尿系感染明显少于对照组,差异具有统计学意义(P<0.05);治疗结束时,治疗组膀胱残余尿量、自主排尿量、QoL评分与HAMD-17评分分别为(82.53±33.78)mL、(237.23±30.66)mL、(4.13±0.78)分、(6.10±1.90)分,均优于对照组的(109.63±35.21)mL、(87.63±28.35)mL、(4.80±0.89)分、(8.63±2.17)分,差异均具有统计学意义(P<0.05)。结论:“川字灸法”可有效改善脊髓损伤后神经源性膀胱功能,降低残余尿量,增加自主排尿量,减少泌尿系统感染发生,缓解患者抑郁情绪,提高其生活质量,疗效好,具有临床推广价值。
Objective:To explore the clinical effect of Chuanzi moxibustion in the prevention and treatment of neurogenic bladder urinary tract infection caused by spinal cord injury.Methods:A total of 60 patients with highly compliant neurogenic bladder after complete spinal cord injury diagnosed in the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2020 to December 2020 were selected and randomly divided into the control group and the treatment group,with 30 cases in each group.Routine treatment and nursing care were used in both groups.The treatment group was treated with Chuanzi moxibustion every other day combined with rubbing Wenyang Lishui agent(hospital protocol)for eight weeks.The bladder spontaneous urination volume,residual urine volume,urine routine,and the quality of life(QoL)index were observed and compared between the two groups as the efficacy assessment.Hamilton depression scale(HAMD-17)scores were used as the secondary efficacy assessment.Results:There were no significant differences in bladder residual urine volume,spontaneous urination volume,quality of life index,and HAMD-17 before treatment between the two groups.After treatment for eight weeks,bladder residual urine volume,spontaneous urination volume,QoL scores and HAMD-17 scores in both groups were significantly improved,and the differences were statistically significant than before treatment(P<0.05);two cases of urinary tract infection occurred in the treatment group,nine cases of urinary tract infection occurred in the control group,the number of urinary tract infection cases occurred in the treatment group was significantly less than that in the control group,and the differences were statistically significant(P<0.05);at the end of treatment,bladder residual urine volume,spontaneous urination volume,QoL scores and HAMD-17 scores in the treatment group were(82.53±33.78)mL,(237.23±30.66)mL,(4.13±0.78)scores and(6.10±1.90)scores,respectively,which were superior to(109.63±35.21)mL,(87.63±28.35)mL,(4.80±0.89)scores and(8.63±2.17)scores in the control group,and the differences were statistically significant(P<0.05).Conclusion:Chuanzi moxibustion can effectively improve bladder function of patients with spinal cord injury,such as reduce residual urine volume,increase spontaneous urination volume,reduce the occurrence of urinary system infection.It can also improve QoL of patients,relieve depression,and have better efficacy,with clinical promotion value.
作者
周霞
王祥煜
孟祥霞
张佳乐
孙立平
ZHOU Xia;WANG Xiangyu;MENG Xiangxia;ZHANG Jiale;SUN Liping(The Second Affiliated Hospital,Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250001,China;Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250014,China)
出处
《康复学报》
CSCD
2021年第3期209-214,221,共7页
Rehabilitation Medicine
基金
山东省中医药科技发展计划项目(2019-0246)。
关键词
脊髓损伤
尿路感染
川字灸法
神经源性膀胱
spinal cord injury
urinary tract infection
Chuanzi moxibustion
neurogenic bladder
作者简介
通信作者:孟祥霞,E-mail:mengxx1112@163.com。
