[论著]益肾调督灸法结合膀胱训练对脊髓损伤术后神经源性膀胱尿流动力学的影响

Time:2016-02-22 00:39:01 来源:430074武汉,湖北省中医院(光谷院区)针灸科等 作者:高淑芳

《国际中医中药杂志》[ISSN:1673-4246/CN:CN11-5398/R]

卷: 37 期数: 2015年10期

页码: 894-896

栏目: 论著

出版日期: 2015-10-12

文章信息/Info

Title: A clinical observation on Yishen-Tiaodu moxibustion combined with bladder training in the treatment of neurogenic bladder after spinal cord injury operation

作者: 高淑芳 430074武汉,湖北省中医院(光谷院区)针灸科

Author(s): Gao Shufang.' target="_blank" rel="external"> Gao Shufang. Department of Acumoxa, Hubei Provincial Hospital of TCM (Guanggu), Wuhan 430074, China

关键词: 神经源性膀胱; 益肾调督; 灸法; 膀胱训练

Keywords: Neurogenic bladder; Yishen-Tiaodu' target="_blank" rel="external"> Yishen-Tiaodu;  Moxibustion;  Bladder training

DOI: 10.3760/cma.j.issn.1673-4246.2015.10.009

摘要: 目的 探讨益肾调督灸法结合膀胱训练对脊髓损伤(spinal cord injury, SCI)术后神经源性膀胱(neurogenic bladder, NB)患者尿流动力学的影响。方法 将符合纳入标准的SCI术后NB患者72例按随机数字表法分为2组各36例,对照组进行膀胱训练,治疗组在对照组基础上配合益肾调督灸法治疗,共治疗3个月。观察2组治疗前后NB患者尿流动力学改变,以及尿常规与肾功能指标的变化。结果 治疗后,治疗组膀胱初感觉[(90.2±6.9)ml比(53.1±6.9)ml,t=22.812]、最大排尿量[(302.1±37.8)ml比(207.7±40.9)ml,t=10.170]、最大膀胱容量[(399.8±74.1)ml比(330.9±50.2)ml,t=4.619]均高于对照组(P值均<0.01),残余尿量[(82.9±32.9)ml比(109.8±51.8)ml,t=2.630]均低于对照组(P<0.01);治疗组24 h尿蛋白[(70.8±9.1)mg比(96.3±14.9)mg,t=8.763]、尿素[(5.7±2.1)mmol/L比(9.3±2.9)mmol/L,t=6.033]、肌酐[(100.8±19.6)μmol/L比(119.2±19.7)μmol/L,t=3.973]、尿素氮[(5.2±1.8)mmol/L比(6.7±2.4)mmol/L,t=3.000]均低于对照组(P<0.01)。结论 益肾调督灸法结合膀胱训练可有效改善SCI术后NB尿流动力学,减少尿路感染的发生。

Abstract: objective To evaluate effect of the Yishen-Tiaodu moxibustion combined with bladder training to treat neurogenic bladder after spinal cord injury operation. Methods 72 patients met the inclusion criteria of neurogenic bladder were divided into two groups according to random number table: a control group was treated with bladder training, and a treatment group on the basis of the control group was treated with Yishen-Tiaodu moxibustion therapy. Both groups were treated for 3 months. The urodynamics as well as the change of urinalysis and kidney function were observed in both groups. Results The original bladder feeling (90.2 ± 6.9 ml vs. 53.1 ± 6.9 ml, t=22.812)、maximum urinary output(302.1 ± 37.8 ml vs. 207.7 ± 40.9 ml, t=10.170), the maximum bladder capacity (399.8 ± 74.1 ml vs. 330.9 ± 50.2 ml,t=4.619) in the treatment group were higher than the control group after treatment (P<0.01). Residual urine volume (82.9 ± 32.9 ml vs. 109.8 ± 51.8 ml, t=2.630) in the treatment group was lower than the control group (P<0.01); the 24h urinary protein (70.8 ± 9.1 mg vs. 96.3 ± 14.9 mg, t=8.763), Urea (5.7 ± 2.1 mmol/L vs. 9.3 ± 2.9 mmol/L, t=6.033), Scr (100.8 ± 19.6 μmol/L vs. 119.2 ± 19.7 μmol/L, t=3.973), BUN (5.2 ± 1.8 mmol/L vs. 6.7 ± 2.4 mmol/L, t=3.000) in the treatment group were significantly decreased than the control group(P<0.01). Conclusions Yishen-Tiaodu moxibustion combined with bladder training could effectively improve urodynamics for the neurogenic bladder in patients with SCI, and decrease the incidence of urinary tract infections.

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