腹针联合间歇性导尿对脊髓损伤后神经源性膀胱功能的影响

摘要

Objective To observe the effects of abdominal acupuncture combine with intermittent catheter-ization on neurogenic bladder (NB)in patients with spinal cord injury(SCI). Methods 60 NB patients after SCI were randomly divided into two groups. The treatment group (n = 30)received abdominal acupuncture combine with intermittent catheterization,and the control group (n = 30)received abdominal acupuncture only. The residual urine volume and bladder volume before and after three courses were observed in two groups. The curative effect was com-pared. The urodynamic involving daily mean urination frequency,single urine volume,single maximum urine vol-ume,and the life quality score and Lower Urethra Tract Symptom (LUTS)before and after treatment were observed in two groups. Results The residual urine volume after treatment in treatment group was lower than that in before treatment and in control group (P < 0. 05),and the bladder volume was higher (P < 0. 05). The total effective rate in treatment group (76. 7%)was superior to that in control group (53. 3%,P < 0. 05). The daily mean urination frequency,the life quality score and LUTS score after treatment were decreased in treatment group (P < 0. 05),daily mean single urine volume and single maximum urine volume were increased (P < 0. 05). The daily mean single urine volume after treatment in control group were increased (P < 0. 05),and the life quality score was decreased (P <0. 05). The daily mean urination frequency,the life quality score and LUTS score after treatment in treatment group were lower that those in control group (P < 0. 05),the daily single maximum urine volume was higher (P < 0. 05 ). Conclusion Abdominal acupuncture combine with intermittent catheterization has exact improvement effects on NB after SCI which was superior to the treatment in control group,worthy of further investigation.%目的 观察腹针联合间歇性导尿对脊髓损伤后神经源性膀胱(NB)功能的影响.方法 将60例脊髓损伤后NB患者随机分为2组,治疗组30例应用腹针联合间歇性导尿治疗,对照组30例应用单纯腹针治疗.2组治疗3个疗程后观察治疗前后残余尿量及膀胱容量变化;比较2组疗效;观察治疗前后尿动力学(日平均排尿次数、日平均单次尿量、日单次最大尿量)、生活质量评分及国际下尿路症状评分(LUTS)变化.结果 治疗组治疗后残余尿量低于本组治疗前、对照组治疗后(P<0.05),膀胱容量高于本组治疗前、对照组治疗后(P<0.05).总有效率治疗组76.7%,对照组53.3%,2组总有效率比较差异有统计学意义(P<0.05),治疗组疗效优于对照组.治疗组治疗后日平均排尿次数、生活质量评分及LUTS症状评分均较本组治疗前降低(P<0.05),日平均单次尿量、日单次最大尿量升高(P<0.05);对照组治疗后日平均单次尿量较本组治疗前升高(P<0.05),生活质量评分降低(P<0.05);2组治疗后比较,治疗组日平均排尿次数、生活质量评分及LUTS症状评分均低于对照组(P<0.05),日单次最大尿量高于对照组(P<0.05).结论 腹针联合间歇性导尿对脊髓损伤后NB患者膀胱功能的改善作用明显,疗效确切.