温肾活血利水方治疗糖尿病神经源性膀胱

Wenshen Huoxue Lishui Decotion treatment of diabetic neurogenic bladder

目的探讨自拟中药温肾活血利水方治疗糖尿病神经源性膀胱(DNB)的临床疗效。方法选择邯郸市第一医院2014年1月—2015年12月收治的DNB患者82例,按照数字随机表法分为2组,每组41例,对照组在常规治疗基础上给予硫酸锌注射液和甲钴胺胶囊治疗,治疗组在对照组治疗基础上给予中药温肾活血利水方治疗,疗程4周,比较2组治疗前后尿流动力学指标(包括残尿量、最大膀胱容积、充盈末逼尿肌压力、最大尿流率)、空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1C)和尿8-羟基脱氧鸟苷(8-Ohd G),并比较2组治疗总有效率。结果治疗后治疗组与对照组比较,治疗组残尿量减少(P<0.01),充盈末逼尿肌压力降低(P<0.01),最大膀胱容积和最大尿流率增加(P<0.05,P<0.01);治疗组FBG、2 h PG、Hb A1C及尿8-Ohd G水平低于对照组(P<0.05,P<0.01),治疗总有效率高于对照组(P<0.05),差异均有统计学意义。结论自拟温肾活血利水方可有效改善DNB患者尿流动力学指标,其机制可能与改善氧化应激状态有关。

Objective To investigate the clinical curative effect of TCM Wenshen Huoxue Lishui Decoction on diabetic neurogenic bladder（ DNB）. Methods The 82 patients with DNB addmitted in the first hospital Handan city from January,2014 to December,2015 were divided into two groups according to the digtial random table method,with41 cases in each group,the control group were treated with zinc sulfate and Mecobalamin Capsules injection based on the conventional treatment,the treatment group were treated with Wenshen Huoxue Lishui Decoction based on the control group. After 4 weeks of treatment,urodynamic indicators（ including residual urine volume,maximum bladder volume,filling at the end of the detrusor pressure,maximum urine flow rate）,fasting blood glucose（ FBG）,2 h postprandial blood glucose（ 2 h PG）,glycosylated hemoglobin（ Hb A1C） and urinary 8-hydroxydeoxyguanosine（ 8-Ohd G） before and after treatment were compared,and the total efficiency of the two groups was compared. Results Compared residual urine volume of the treatment group with the control group,residual urine volume of the treatment group decreased（ P〈0. 01）,the end of the filling detrusor pressure decreased（ P〈0. 01）,the maximum bladder capacity and maximum urinary flow rate increased P〈0. 05,P〈0. 01）; FBG,2 h PG,Hb A1 c and urinary 8-OHd G levels of the treatment group were lower than those of the control group（ P〈0. 05,P . 01）,the total efficiency was higher than that of the control group（ P〈0. 05）,the differences were statistically significant. Conclusion TCM Wenshen Huoxue Lishui Decoction can effectively improve urine flow dynamics index in patients with DNB,The mechanism may be related to improving of oxidative stress state.