针刺研究

2021, v.46(11) 958-962

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雷火灸结合电针对脊髓损伤后神经源性膀胱患者尿流动力学的影响
Effect of thunder-fire moxibustion combined with electroacupuncture on urodynamics in patients with neurogenic bladder after spinal cord injury

张海涛;农秋萍;韦林;梁晓宁;梁燕飘;贾艳华;韦宁益;
ZHANG Hai-tao;NONG Qiu-ping;WEI Lin;LIANG Xiao-ning;LIANG Yan-piao;JIA Yan-hua;WEI Ning-yi;Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi University of Science and Technology;Department of Rehabilitation Medicine, Hospital of Guangxi Liuzhou Iron and Steel (Group) Company;

摘要(Abstract):

目的:观察电针和雷火灸联合治疗对脊髓损伤后神经源性膀胱(NB)患者尿流动力学的影响。方法:60例脊髓损伤后NB患者采用随机数字表法分为对照组和观察组,每组各30例。两组患者均执行膀胱管理计划。对照组电针双侧上髎、中髎、下髎及次髎,观察组在电针组基础上采用雷火灸对腰阳关、命门、气海、关元、中极进行温和灸,两组均每次治疗20 min,每日1次,10次为一疗程,共3个疗程。记录两组患者治疗前3 d及治疗后3 d自主排尿次数、单次最大尿量及导尿次数;治疗前后分别记录排尿期最大尿流率、充盈期膀胱压力、排尿期最大膀胱容量、残余尿量,计算膀胱顺应性;对两组患者的临床疗效进行评价。结果:与本组治疗前比较,治疗后两组患者排尿次数、导尿次数均明显减少,单次最大尿量增加(P<0.05),观察组均优于对照组(P<0.05)。治疗后两组充盈期膀胱压力、残余尿量较治疗前减少,观察组较对照组降低更为明显(P<0.05)。两组排尿期最大尿流率、排尿期最大膀胱容量、膀胱顺应性较治疗前升高,观察组较对照组更高(P<0.05)。观察组、对照组有效率分别为90.00%(27/30)、63.33%(19/30),观察组明显高于对照组(P<0.05)。结论:在电针治疗基础上辅以雷火灸,能有效改善脊髓损伤后NB患者膀胱尿流动力学指标,临床效果显著。
Objective To investigate the effect of electroacupuncture combined with thunder-fire moxibustion on urodynamics in patients with neurogenic bladder(NB) after spinal cord injury(SCI). Methods A total of 60 patients with NB after SCI were divided into control group and observation group using a random number table, with 30 patients in each group. Bladder management protocol was performed for both groups. The patients in the control group were given electroacupuncture at Shangliao(BL31), Zhongliao(BL33), Xialiao(BL34), and Ciliao(BL32) at both sides, and those in the observation group were given thunder-fire moxibustion as mild-warm moxibustion at Yaoyangguan(GV3), Mingmen(CV4), Qihai(CV6), Guanyuan(CV4), and Zhongji(CV3) in addition to the treatment in the control group; electroacupuncture or moxibustion was performed for 20 min each time, once a day, with 10 times as one course of treatment, and both groups were treated for 3 courses. Number of times of voluntary urination, maximum single urine volume, and number of times of urethral catheterization were recorded at 3 d before and after treatment; maximum urinary flow rate during urination, maximum bladder capacity during urination, bladder pressure during the bladder filling period, and residual urine volume were recorded before and after treatment, and bladder compliance was calculated; clinical outcome was evaluated for both groups. Results After treatment, both groups had significant reductions in the numbers of times of urination and urethral catheterization(P<0.05) and a significant increase in maximum single urine volume(P<0.05), and the observation group had significantly better results than the control group(P<0.05). After treatment, both groups had significant reductions in residual urine volume and bladder pressure during the bladder filling period, and the observation group had significantly greater reductions than the control group(P<0.05); both groups had significant increases in bladder compliance, maximum bladder capacity during urination, and maximum urinary flow rate during urination, and the observation group had significantly higher values than the control group(P<0.05). The observation group had a significantly higher response rate than the control group [90.00%(27/30) vs 63.33%(19/30), P<0.05]. Conclusion Thunder-fire moxibustion combined with electroacupuncture can effectively improve bladder urodynamics and has a marked clinical effect in patients with NB after SCI.

关键词(KeyWords): 脊髓损伤;神经源性膀胱;电针;雷火灸;尿流动力学
Spinal cord injury;Neurogenic bladder;Electroacupuncture;Thunder-fire moxibustion;Urodynamics

Abstract:

Keywords:

基金项目(Foundation): 广西壮族自治区卫生和计划生育委员会自筹经费科研课题(No.Z20170009)

作者(Author): 张海涛;农秋萍;韦林;梁晓宁;梁燕飘;贾艳华;韦宁益;
ZHANG Hai-tao;NONG Qiu-ping;WEI Lin;LIANG Xiao-ning;LIANG Yan-piao;JIA Yan-hua;WEI Ning-yi;Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi University of Science and Technology;Department of Rehabilitation Medicine, Hospital of Guangxi Liuzhou Iron and Steel (Group) Company;

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DOI: 10.13702/j.1000-0607.20210690

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