丹芪缩尿方结合西医常规疗法对糖尿病神经源性膀胱尿流动力学的影响

The effect of Danqi-Suoniao decoction combined with routine western medicine on urodynamics of diabetic neurogenic bladder

目的：探讨丹芪缩尿方结合西医常规疗法对糖尿病神经源性膀胱患者尿流动力学的影响。方法将符合入选标准的糖尿病神经源性膀胱患者34例按随机数字表法分为2组各17例。对照组患者须控制饮食，适当运动并进行膀胱训练，根据病情给予相应的控制血糖、抗感染、导尿等治疗；观察组在对照组基础上加用丹芪缩尿方治疗。共治疗12周。观察2组患者治疗前后尿流动力学及糖化血红蛋白、尿白蛋白排泄率、血脂、血压的变化。结果治疗后，观察组残尿量[（100.71±28.37）ml 比（130.24±44.56）ml，t＝2.719]、膀胱初尿意容量[（136.57±19.42）ml 比（150.65±17.65）ml，t＝2.334]、最大尿意容量[（458.48±107.80）ml 比（520.73±112.47）ml，t＝2.463]均较对照组明显降低（P＜0.01），最大尿流率时逼尿肌压力[（38.64±10.79）cmH2O 比（30.09±9.32）cmH2O，t＝2.708]、最大尿流率[（14.59±4.52）ml/s比（10.27±3.70）ml/s，t＝2.691]、最大尿道压[（60.07±16.65）cmH2O 比（44.68±16.62）cmH2O，t＝2.810]均较对照组明显升高（P＜0.05）。2组治疗后糖化血红蛋白、尿白蛋白排泄率、血脂、血压比较，差异无统计学意义（t＝0.731、0.689、0.719、0.764、0.711、0.737，P 值均＞0.05）。结论在控制血糖及西药口服基础上，丹芪缩尿方可有效治疗糖尿病神经源性膀胱。

Objective Observe the effect of Danqi-Suoniao decoction combined with conventional western medicine on urodynamics of diabetic neurogenic bladder. Methods 34 cases of the patients with diabetic neurogenic bladder were divided into a control group and an observation group,with 17 cases in each group. Both groups were treated control diet,proper exercise and bladder training. On this basis, the control blood was treated with insulin, and the observation group was additionally added Danqi Suoniao Fang on the basis of the control group. After 12 weeks of treatment,the difference of urodynamics,glycosylated hemoglobin, urine albumin excretion rate lipids in blood and blood pressure were observed. Results After 12 weeks of treatment,the residual urine volume （100.71 ± 28.37 ml vs. 130.24 ± 44.56 ml, t=2.719）, the beginning of the bladder to urinate capacity （136.57 ± 19.42 ml vs. 150.65 ± 17.65 ml, t=2.334）, the biggest urinate capacity （458.48 ± 107.80 ml vs. 520.73 ± 112.47 ml, t=2.463） were significantly decreased in observation group than the control group（P〈0.01）; the biggest stress detrusor urine flow rate （38.64 ± 10.79 cmH2O vs. 30.09 ± 9.32 cmH2O, t=2.708）,maximum urinary flow rate （14.59 ± 4.52 ml/s vs. 10.27±3.70 ml/s, t=2.691）, maximum urethral pressure （60.07 ± 16.65 cmH2O vs. 44.68 ± 16.62 cmH2O, t=2.810） were significantly increased in observation group than the control group （P〈0.05）. There was no significant difference in glycosylated hemoglobin,urine albumin excretion rate,lipids in blood and blood pressure （t=0.731, 0.689, 0.719, 0.764, 0.711, 0.737, P〉0.05）. Conclusion Danqi-Suoniao decoction is effective in treating diabetic neurogenic bladder on the basis of controlling blood glucose with western medicine.