穴位贴敷辅助治疗老年女性膀胱颈梗阻临床观察

Clinical observation of acupoint application therapy on senile female bladder neck obstruction

目的:观察口服西药配合穴位贴敷治疗老年女性膀胱颈梗阻的临床疗效。方法:将50例老年女性膀胱颈梗阻患者随机分为为观察组和对照组各25例,两组均口服盐酸坦洛新胶囊,每晚口服0.2mg,连服100天。观察组同时采用制附子、白芥子、女贞子等药物制成的补肾通瘀油膏穴位贴敷,穴取神阙、三阴交、膀胱俞、中极、三焦俞,隔日1次,8次为一疗程,共贴敷6个疗程。两组治疗前后分别观察排尿指数评分(IPSS)、泌尿症状困扰评分及测定膀胱残余尿量、最大尿流率并比较两组患者临床疗效。结果:治疗后两组IPSS各项评分均较治疗前明显下降(均P<0.01),观察组在改善患者尿不尽感、排尿间隔<2h、憋尿困难、间断性排尿及夜尿次数方面较对照组有明显优势(P<0.05);观察组总有效率为95.65%(22/23),高于对照组的85.71%(18/21,P<0.05);两组治疗后膀胱残余尿量、最大尿流率、泌尿症状困扰评分与治疗前比较差异均有统计学意义(均P<0.05)。结论:穴位贴敷补肾通瘀油膏联合口服盐酸坦洛新胶囊对老年女性膀胱颈梗阻患者的疗效较单用盐酸坦洛新胶囊显著。

Objective To observe the clinical efficacy on senile female bladder neck obstruction treated with acupoint application therapy and western medication. Methods Fifty cases of senile female bladder neck observation were randomized into an obstrvation group and a control group, 25 cases in each one. Tamsulosin hydrochloride capsules were taken orally in the two groups, 0.2 mg every night, continuously for 100 days. In the observation group, with radix aconiti lateralis preparata, semen brassicae and fructus ligustri lucidi contained, bushentongyu plaster was used at Shenque （CV 8）, Sanyinjiao （SP 6）, Pangguangshu （BL 28）, Zhongji （CV 3） and Sanjiaoshu （BL 22）, once every two days. Eight treatments made one session and 6 sessions were required totally. The international prostate symptom score （IPSS）, the bother score （BS）, the residual volume （RV） and the maxi- mal urinary flow rate （MFR） were observed before and after treatment in the two groups. The clinical efficacy was compared between the two groups. Results Every score m IPSS after treatment was reduced apparently as compared with that before treatment in the two groups （all P〈0. 01）. The improvements in feeling of incomplete bladder emptying, mtermitteney〈2 h, urgency, interupted urination and nocturia in the observation group were more advantageous than those in the control group （all P,C0.05）. The total effective rate was 95.65% （22/23） in the observation group, higher than 85.71 % （18/21） in the control group （P〈0.05）. After treatment, RV, MFR and BS were significantly different as compared with those before treatment （all P〈0.05）. Conclusion The combined therapy of acupoint application of bushentongyu plaster and oral administration of tamsulosin hydrochloride capsules achieves the significant efficacy on senile female bladder neck obstruction as compared with the simple administration of tamsulosin hydrochloride capsules.