芒针针刺秩边、水道对脊髓损伤患者尿潴留的影响

Effects on urinary retention after spinal cord injury treated with acupuncture at Zhibian(BL 54)and Shuidao(ST 28) with elongated needle

目的:比较芒针与毫针治疗脊髓损伤后尿潴留的临床疗效。方法:将66例脊髓损伤后尿潴留患者随机分为芒针组(34例)和毫针组(32例)。两组患者均采用骨科常规治疗和膀胱功能训练,芒针组采用芒针针刺秩边、水道穴,毫针组采用毫针针刺秩边和水道穴,两组针刺均隔日1次,共治疗2个月。分别于治疗前、治疗1个月和2个月后观察两组患者的残余尿量、尿动力学指标(膀胱容量、最大尿流速、膀胱压力)和安全性指标,并比较两组临床疗效。结果:与治疗前比较,两组在治疗1个月和2个月后,膀胱残余尿量明显减少(均P<0.01),膀胱容量、最大尿流速、膀胱压力明显改善(均P<0.01);在治疗1个月和2个月时,芒针组患者的残余尿量均低于毫针组(均P<0.01),芒针组患者膀胱容量、最大尿流速、膀胱压力的改善均优于毫针组(均P<0.01)。芒针组总有效率为94.1%(32/34),高于毫针组的71.9%(23/32,P<0.01)。两组患者在治疗中均未出现肾功能损害,无晕针或断针现象出现。结论:芒针在治疗脊髓损伤后尿潴留方面疗效优于毫针针刺,且具有安全性。

Objective To explore the clinical effects of acupuncture with elongated needle on urinary retention after spinal cord injury. Methods A total of 66 patients with urinary retention after spinal cord injury were randomized into an elongated needle group(34 cases) and a filiform needle group(32 cases). In both of the groups, the routine orthopedic treatment and the bladder function training were adopted. Additionally, in the elongated needle group, the acupuncture at Zhibian(BL 54) and Shuidao(ST 28) was used with the elongated needle. In the filiform needle group, the acupuncture with filiform needle was used at Zhibian(BL 54) and Shuidao(ST 28). In both of the groups, acupuncture treatment was provided once every two days, for 2 months consecutively. Separately, before treatment and after 1, 2 month treatment, the residual urine volume, urodynamic parameters(bladder capacity, peak urinary flow rate and bladder pressure) and safety indicators were observed in the patients of the two groups. The clinical therapeutic effects were compared between the two groups.Results As compared with the results before treatment, the residual urine volume was reduced obviously(all P<0.01),bladder capacity, peak urinary flow rate and bladder pressure were improved obviously(all P<0.01) after 1, 2 month treatment in the two groups. After 1, 2 month treatment, the residual urine volume in the elongated needle group was lower than the filiform needle group(both P<0.01). The improvements in bladder capacity, peak urinary flow rate and bladder pressure in the elongated needle group were superior to the filiform needle(all P<0.01). The total effective rate was 94.1%(32/34) in the elongated needle group, higher than 71.9%(23/32) in the filiform needle group(P<0.01). During treatment,there was no damage of kidney function, no fainting or broken needle happened in the two groups. Conclusion Acupuncture with elongated needle achieves the significant effects on urinary retention after spinal cord injury. This therapy is better than acupuncture with filiform needle and safe in operation.