温针结合膀胱功能训练治疗脊髓损伤后神经源性膀胱的临床研究

Bladder Function Training in the Treatment of Neurogenic Bladder after Spinal Cord Injury Clinical Study Combined with Acupuncture

[目的]观察温针灸结合膀胱功能训练对脊髓损伤后神经源性膀胱的治疗效果。[方法]将90例脊髓损伤后神经源性膀胱患者按照随机数字表法随机分为温针结合膀胱功能训练组(以下简称综合治疗组)30例、温针组30例、膀胱功能训练组30例,膀胱功能训练组给予膀胱功能训练,温针组采用温针针刺俞募穴(肾俞、膀胱俞、关元、中极),综合治疗组综合应用温针组、膀胱功能训练组的治疗方法。1次/d,30d为1疗程,3个疗程后观察患者膀胱容量、膀胱压力、残余尿量及与排尿障碍有关的生活质量评分。[结果]经治疗后,三组患者的膀胱容量、膀胱压力、残余尿量及与生活质量评分均较治疗前显著改善,差异有统计学意义(P<0.05,P<0.01),且综合治疗组的疗效优于温针组与膀胱功能训练组,温针组疗效优于膀胱功能训练组,差异有统计学意义(P<0.05,P<0.01)。[结论]温针俞募穴结合膀胱功能训练对脊髓损伤后神经源性膀胱治疗作用显著,是治疗神经源性膀胱的有效方案之一。

[Objective] To observe the therapeutic effect of acupuncture combined with bladder function training on neurogenic bladder after spinal cord injury. [Methods] 90 cases of spinal cord injury patients with neurogenic bladder were randomly divided into acupuncture combined with bladder function training group（hereinafter referred to as the treatment group） 30 cases, 30 cases in the warm needling group, bladder function training group with 30 cases, bladder function training group received bladder training, warm needle acupuncture with Warmed Needle Acupuncture group on Shu Muxue（BL23,BL28,CV3,CV4）. Comprehensive treatment group combined with bladder function training and warm acupuncture. 1/d, 30 d for a course of treatment, the bladder volume, bladder pressure, residual urine volume and quality of life related to voiding dysfunction were observed after 3 courses of treatment.[Results] After treatment, three groups of patients with bladder capacity, bladder pressure, residual urine volume and urinary dysfunction associated with quality of life scores were significantly improved compared with before treatment, the difference was statistically significant（ P〈0.05）, and the comprehensive training group was significantly higher than that of acupuncture group and bladder function training group, the difference was statistically significant（P〈0.05）. [Conclusion] Acupuncture combined with acupoint Shu Mu bladder function training has significant impact on the treatment of neurogenic bladder after spinal cord injury, is one of the effective methods for the treatment of neurogenic bladder.