不同电针波形治疗脊髓损伤神经源性膀胱疗效观察

Therapeutic Observation of Electroacupuncture with Different Waves for Neurogenic Bladder Due to Spinal Cord Injury

目的观察不同电针波形治疗脊髓损伤(SCI)神经源性膀胱的疗效。方法将108例SCI神经源性膀胱患者随机分为3组,每组36例。3组取穴相同,针刺得气分别采用连续波、疏密波和断续波,观察治疗前后临床症状积分及尿动力学指标的变化。结果疏密波组总有效率为80.6%,优于连续波组、断续波组。在降低患者尿道闭合压、腹压、功能性尿道长度以及尿道控制带长度方面,以疏密波组的效果最为突出(P<0.05);3组波形电针在升高尿流率方面,效果没有显著性差异(P>0.05)。在升高膀胱压方面,断续波组效果最好(P<0.05,P<0.01);在降低膀胱压方面,连续波组、疏密波组的效果均优于断续波组(P<0.01)。结论 3组不同波形电针对机体的调节作用不同。连续波容易使机体产生适应而作用最小;疏密波更接近人体生物电,其作用最大;断续波兴奋神经、肌肉作用最强,在改善膀胱无力方面效果最明显。

Objective To observe the therapeutic efficacy of electroacupuncture with different waves in treating neurogenic bladder due to spinal cord injury （SCI）. Method Totally 108 patients with SCI-induced neurogenic bladder were randomized into 3 groups, 36 cases in each group. Same acupoints were selected for the three groups, but continuous wave, sparse-dense wave and discontinuous wave were respectively used after needling qi arrival. The symptoms score and urodynamic indexes were observed before and after the intervention. Result The total effective rate was 80.6%in the sparse-dense wave group, better than that in the continuous wave group and discontinuous wave group. The sparse-dense wave group produced a more significant effect in reducing the urethral closure pressure, abdominal pressure, functional urethral length, and urethral control length （P〈0.05）; there were no significant inter-group differences in comparing the effect in increasing the urinary flow rate （P〉0.05）. The discontinuous wave group produced a more significant effect in increasing the bladder pressure （P〈0.05,P〈0.01）; the effect in lowering the bladder pressure was more significant in the continuous wave and sparse-dense wave groups than in the discontinuous wave group （P〈0.01）. Conclusion The three types of electroacupuncture wave can produce different regulatory effects on the body. The continuous wave is the most adaptable one but plays the least effect;the sparse-dense wave is closer to bioelectricity of human body and produces the most significant effect;the discontinuous wave produces the most significant effect in activating nerves and muscles, as well as in improving bladder weakness.