十二井穴接经针刺配合膀胱功能训练治疗中风后尿潴留临床研究

Clinical study on post-stroke urinary retention treated with acupuncture at the twelve jing-well points and bladder function training

目的:探索治疗中风后尿潴留提高疗效的方法。方法:将63例中风后尿潴留患者随机分为观察组(32例)和对照组(31例)。两组均采用常规神经内科临床药物及康复基础治疗,对照组加用间歇导尿和膀胱功能训练治疗,每日导尿的时间和次数由患者是否有自主排尿和残余尿量决定;观察组在对照组治疗基础上加用接经针刺法,按照十二经脉的循行顺序,选取十二井穴(少商、商阳、厉兑、隐白、少冲、少泽、至阴、涌泉、中冲、关冲、足窍阴、大敦),每日1次,治疗20 d。20 d后观察两组临床疗效和残余尿量变化情况。结果:观察组总有效率为90.6%(29/32),优于对照组的67.7%(21/31,P<0.01);两组患者治疗后残余尿量均明显减少(均P<0.01),观察组治疗后残余尿量明显少于对照组(P<0.01)。结论:接经针刺法配合膀胱功能训练治疗中风后尿潴留疗效明显,优于膀胱功能训练等常规西医治疗。

Objective To explore the methods for the therapeutic effect improvement in the treatment of post-stroke urinary retention.Methods Sixty-three patients of post-stroke urinary retention were randomized into an observation group（32 cases） and a control group（31 cases）.The routine clinical medication of neurology and basic rehabilitation were adopted in the two groups.Additionally,in the control group,the intermittent urinary catheterization and bladder function training were applied.The duration and frequency of catheterization were determined by the autonomic urination and residual urine volume every day.In the observation group,on the basis of the treatment as the control group,acupuncture was applied to the twelve jing-well points in the sequence of qi flowing among the twelve meridians [Shaoshang（LU 11）,Shangyang（LI 1）,Lidui（ST 45）,Yinbai（SP 1）,Shaochong（HT 9）,Shaoze（SI 1）,Zhiyin（BL 67）,Yongquan（KI 1）,Zhongchong（PC 9）,Guanchong（TE 1）,Zuqiaoyin（GB 44） and Dadun（LR 1）].Acupuncture was given once a day,20 treatments were required.In 20 treatments,the clinical therapeutic effects and the residual urine volume were observed.Results The total effective rate was 90.6%（29/32） in the observation group,better than 67.7%（21/31） in the control group（P〈0.01））.After treatment,the residue urine volume was all reduced apparently in the patients of the two groups（both P〈0.01）.The result of the residue urine volume in the observation group was lower apparently than that in the control group（P〈0.01）.Conclusion Acupuncture at the jing-well points in the sequence of qi flowing among meridians combined with bladder function training achieve the apparent therapeutic effects on post-stroke urinary retention.The results are better than those achieved by the routine western medicine with bladder function training involved.