摘要
目的 观察温阳通利方穴位贴敷联合间歇性导尿及膀胱功能训练治疗脊髓损伤后神经源性膀胱尿潴留的临床疗效。方法 将患者80例采用随机数字表法分为观察组与对照组各40例。对照组患者给予常规间歇性导尿及膀胱功能训练,观察组患者在对照组基础上给予温阳通利方穴位敷贴贴敷于神阙、关元穴,每次4~6 h,每日1次,6 d为1个疗程,治疗4个疗程后比较两组患者治疗前后排尿日志情况、尿流动力学、尿路感染及临床疗效情况。结果 治疗后,观察组和对照组日平均排尿次数、单次平均排尿量、单次最大排尿量均有明显改善(P <0.05),且观察组相较于对照组改善更为显著(P <0.05);治疗后观察组和对照组膀胱残余尿量、膀胱内压均明显下降(P <0.05),且观察组相较于对照组下降更为显著(P <0.05);两组逼尿肌压力、平均尿流速、最大尿流速和膀胱安全容量均显著增加(P <0.05),且观察组相较于对照组增加更为明显(P <0.05);观察组尿路感染率为5.00%,显著低于对照组的20.00%(P <0.05);观察组治疗总有效率为92.50%,显著高于对照组的85.00%(P <0.05)。结论 温阳通利方穴位贴敷治疗脊髓损伤后神经源性膀胱尿潴留疗效确切,可显著减少患者排尿次数和残余尿量,增大排尿量及尿流速度,协调逼尿肌和括约肌反射活动,有效控制尿路感染情况,促进膀胱功能的重建。
Objective:To observe the clinical efficacy of Wenyang Tongli Prescription acupoint application combined with intermittent catheterization and bladder function training in the treatment of neurogenic urinary retention after spinal cord injury.Methods:A total of 80 patients with neurogenic bladder retention after spinal cord injury were divided into observation group(n = 40)and control group(n = 40)by random number table.The control group was given regular intermittent catheterization and bladder function training;on this basis,the observation group was given Wenyang Tongli Prescription acupoint application on the CV 8 and Guanyuan,every 4~6 h,1 time a day,six days for a period of treatment.After 4 courses of treatment,the urination log,urodynamics,urinary tract infection and clinical efficacy were compared between the two groups before and after treatment.Results:After treatment,the average daily urination frequency,single average urination volume and single maximum urination volume were significantly improved in both groups(P < 0.05),and the improvement in the observation group was more significant than that in the control group(P < 0.05).After treatment,the residual urine volume and vesical pressure(PVES)in both groups were significantly decreased(P < 0.05),and the decrease in observation group was more significant than that in control group(P < 0.05).The detrusor pressure(Pdet),average flow rate(Qave),maximum urinary flow rate(Qmax)and safe bladder volume in both groups were significantly increased in both groups(P <0.05),and the increase in observation group was more significant than that in control group(P < 0.05).The urinary tract infection rate was 5.00% in the observation group,which was significantly lower than 20.00% in the control group(P < 0.05).The total effective rate was 92.50% in the observation group,which was significantly higher than 85.00% in the control group(P < 0.05).Conclusion:Wenyang Tongli Prescription acupoint application in the treatment of neurogenic bladder after spinal cord injury urinary retention has definite curative effect,which can significantly reduce the number of micturition and residual urine,increase urine output and urinary flow rate,coordination and detrusor sphincter reflex activity,effectively control urinary tract infection,promote the reconstruction of the bladder function,and is worth further clinical application.
作者
牛丽
李彦杰
彭俊峰
秦合伟
郭宁
孙钰斌
刘昊源
张淑芹
牛雨晴
Niu Li;Li Yanjie;Peng Junfeng;Qin Hewei;Guo Ning;Sun Yubin;Liu Haoyuan;Zhang Shuqin;Niu Yuqing(Henan University of Traditional Chinese Medicine,Henan,Zhengzhou 450046,China)
出处
《中国中医急症》
2022年第6期993-996,1008,共5页
Journal of Emergency in Traditional Chinese Medicine
基金
河南省中医药科学研究专项课题(2019ZYBJ14)
河南省中医药拔尖人才培养项目(豫中医科教[2018]35号)
专利:一种治疗脊髓损伤后尿潴留的外敷中药及制备方法(ZL 201910860373)。
关键词
神经源性膀胱
尿潴留
脊髓损伤
穴位贴敷
康复疗法
Neurogenic bladder
Urinary retention
Spinal cord injury
Acupoint application
Rehabilitation therapy
作者简介
通信作者:李彦杰,电子邮箱:yanjieli2008@126.com。
