针刺治疗脑卒中后排尿障碍随机平行对照研究

Randomized Parallel Controlled Study on Acupuncture for Treatment of Urination Disorders after Stroke

[目的]观察针刺治疗脑卒中后排尿障碍疗效。[方法]使用随机平行对照方法,将40例住院患者按病志号抽签方法简单随机分为两组。对照组20例中药汤剂,补气活血,通经活络:生黄芪60g,当归尾9g,赤芍6g,川芎9g,桃仁10g,红花3g,言语不利加菖蒲、远志;口角、眼角歪斜加白附子、全蝎、僵蚕、葛根、白芷;体麻木加陈皮、半夏、茯苓;上肢偏废严重加桂枝;下肢瘫软无力加桑寄生、牛膝;便秘加火麻仁、郁李仁、肉苁蓉,水煎100mL,1剂/2d,3次/d。治疗组20例针刺,取中膂、次髎、肾俞、曲骨、中极、水道(双侧),口眼歪斜配地仓、颊车、内庭、太冲;语言不利配哑门、廉泉、通里、关冲,以中度刺激为主,得气后留针15min,隔日1次。连续治疗4周为1疗程。观测临床症状、排尿障碍、不良反应。治疗1疗程(4周),判定疗效。[结果]治疗组痊愈46例,显效8例,有效5例,无效3例,总有效率85.00%;对照组痊愈2例,显效3例,有效6例,无效9例,总有效率55.00%;治疗组疗效优于对照组(P<0.05,P<0.01)。排尿障碍程度IV度、III度、II度、I度两组无显著差异(P>0.05)。[结论]针刺治疗脑卒中后排尿障碍,可有效提高痊愈率和愈显率,无严重不良反应,值得深入研究。

[Objective] To observe the therapeutic effect of acupuncture on urination disorder after stroke. [Method] 40 patients were randomly divided into two groups according to the random number method. The control group of 20 cases of traditional Chinese medicine decoction, invigorating qi and promoting blood circulation, activate collaterals： astragalus 60 g, angelica tail 9g, Radix Paeoniae Rubra 6g, Chuanxiong 9g, peach 10 g, safflower 3g, Shichangpu, negative words, eyes askew quarrel Polygala; white monkshood, scorpion, Jiangcan, Gegen, Angelica; numbness and skin, pinellia, Chen Fuling; upper limb without severe lower limb paralysis with Guizhi; Ghassan parasitism, Niuxi; constipation with huomaren, Yu Li Ren, Cistanche, decoction 100 mL, 1 doses of/2d, 3 times/d. The treatment group of 20 cases were in the backbone, acupuncture, Ciliao, Shenshu, Qugu, polar, channel（bilateral）, Kouyanwaixie with Dicang, Jiache, Neiting, Taichong; language disadvantage with yamen, Lianquan, Tongli, Guan Chong, with moderate stimulation, after the gas needle 15 min, 1 every other day. Continuous treatment for 4 weeks for a course of 1. Clinical symptoms, voiding dysfunction and adverse reactions were observed. Treatment for 1 courses（4 weeks）, determine the efficacy. [Results] The treatment group 46 cases were cured, 8 cases markedly effective, 5 cases effective, 3 cases ineffective, the total efficiency of 85%; control group 2 cases were cured, 3 cases were cured, 6 cases effective, 9 cases ineffective, the total efficiency of 55%; the treatment group than the control group（P〈0.05, P〈0.01）. There was no significant difference in IV, III, II and I in two groups（P〉0.05）. [Conclusion] acupuncture treatment of urination disorders after stroke can effectively improve the cure rate and recovery rate, no serious adverse reactions, worthy of further study.