小柴胡汤与足三里针刺联合新斯的明穴位注射治疗肛肠科术后尿潴留60例临床观察

Xiao Chaihu Decoction with Tsusanli Acupuncture Point Block with Neostigmine for Anorectal Postoperative Urinary Retention:Clinical Observation of 60 Cases

[目的]观察小柴胡汤与足三里针刺联合新斯的明穴位注射治疗肛肠科术后尿潴留疗效。[方法]使用前瞻性设计方法,对60例住院患者,小柴胡汤（柴胡15g,黄芩、半夏各20g,党参、茯苓各15g,白术30g,陈皮、枳壳各15g,生姜9g,大枣4枚）,水煎服,水煎200mL,顿服;针灸：小柴胡汤服后1∽2h未排尿者,患者仰卧屈膝,取双侧足三里穴,常规消毒,垂直进针1.5∽2cm,顺逆时针交替缓慢旋转,平补平泻法,留针15min;足三里穴位注射,进针处有酸、麻、胀感得气后分别注射新斯的明0.5mg。连续治疗15min为1疗程。观测临床症状、排尿状况（时间、量）、不良反应。连续治疗4疗程,判定疗效。[结果]1剂药后可自解小便,排出通畅14例,足三里注射后30min内排尿26例,注射后30∽60min排尿22例,尿量均达600∽1000mL,无效4例,其中尿点滴而出伴无力1例,因痛不排3例,均行留置导尿处理,总有效率93.33%（56/60）。[结论]小柴胡汤与足三里针刺联合新斯的明穴位注射治疗肛肠科术后尿潴留,疗效满意,无副作用,值得推广。

[ Objective ] To observe Xiao Chaihu Decoction and Tsusanli acupuncture combined neostigmine point injection treatment of anorectal postoperative urinary retention effect. [Methods ] Using the prospective design method, 60 cases of hospitalized patients, Xiao Chaihu Decoction, water decoction, boiling water 200 ml, meal served;Aeupuncture：Xiao Chaihu Decoction suits do not urinate, 1 - 2 h after patients supine, take the double parapodum three mile, regular disinfection, vertical needle into 1.5 - 2 cm, ShunNi clockwise rotate slowly, alternately flat filling-in catharsis, retaining needle 15 rain;the needle has acid, hemp, bilge feeling at after gas injection of neostigmine respectively 0.5 rag. Continuous treatment for 15 min to 1 course of treatment. Observation of clinical symptoms, the condition of urination, adverse reactions, g courses of continuous treatment, judge curative effect. [ Result] After 1 dose can pee, discharge unobstructed 14 cases, the foot three mile 26 patients within 30 minutes after injection of micturition, 22 cases of 30- 60 rain after injection of urination, urine output up to 600 - 1000 ml, 4 cases were invalid, the urine drop out with weakness in 1 case, because of the pain not 3 cases, indwelling catheter in treatment, the total effective rate was 93.33% （ 56/60 ） . Little. [ Conclusion ] This curative effect is distinct, the method is simple, easy to operation, is worthy of reference for clinical promotion.