电针治疗脊髓损伤神经源膀胱尿失禁临床研究

Clinical Study on Electroacupuncture Treatment for Urinary Incontinence in Spinal Cord Injury-induced Neurogenic Bladder

目的观察电针八髎、会阳治疗脊髓损伤神经源膀胱尿失禁患者的临床疗效。方法将67例脊髓损伤神经源膀胱尿失禁患者随机分为治疗组(34例)和对照组(33例),两组均给予常规药物治疗及物理治疗(physical therapy, PT)、作业治疗(occupational therapy, OT)、间歇导尿等治疗。治疗组加电针八髎、会阳。两组治疗前及治疗后,分别进行残余尿量、导尿次数、导尿量、尿白细胞计数、尿失禁量表问卷评分等评定,进行疗效评价及比较。结果治疗组治疗后导尿次数减少(P<0.05),与对照组比较差异有统计学意义(P<0.05)。治疗组治疗后导尿量增加(P<0.05),与对照组比较差异有统计学意义(P<0.05)。治疗组治疗后膀胱残余尿量减少(P<0.05),与对照组比较差异有统计学意义(P<0.05)。治疗组治疗后尿白细胞计数减少(P<0.05),与对照组比较差异有统计学意义(P<0.05)。治疗组治疗后ICI-Q-SF评分减少(P<0.05),与对照组比较差异有统计学意义(P<0.05)。结论电针八髎、会阳结合康复训练,能明显改善脊髓损伤神经源膀胱尿失禁状况,提高日常生活活动能力,提高康复疗效。

Objective To investigate the clinical efficacy of Electroacupuncture at points Baliao [Shangliao (BL31), Ciliao (BL32), Zhongliao (BL33), Xialiao (BL34)]and Huiyang (BL35) for urinary incontinence in spinal cord injury-induced neurogenic bladder. Method Sixty-seven patients with urinary incontinence in spinal cord injury-induced neurogenic bladder were randomized to a treatment group (34 cases) and a control group (33 cases). Both groups received conventional medication, physical therapy (PT), occupational therapy (OT) and intermittent catheterization. The treatment group received Electroacupuncture at points Baliao and Huiyang in addition. The residual urine volume, the frequency of catheterization and the volume of urine obtained by catheterization were measured, urinary leukocyte count was kept and the urinary incontinence scale questionnaire score was recorded in the two groups before and after treatment. The therapeutic effects were evaluated and compared. Result After treatment, the frequency of catheterization decreased in the treatment group (P<0.05) and there was a statistically significant difference as compared with the control group (P<0.05). After treatment, the volume of urine obtained by catheterization increased in the treatment group (P<0.05) and there was a statistically significant difference as compared with the control group (P<0.05). After treatment, bladder residual urine volume decreased in the treatment group (P<0.05) and there was a statistically significant difference as compared with the control group (P<0.05). After treatment, urinary leukocyte count decreased in the treatment group (P<0.05) and there was a statistically significant difference as compared with the control group (P<0.05). After treatment, the ICI-Q-SF score decreased in the treatment group (P<0.05) and there was a statistically significant difference as compared with the control group (P< 0.05). Conclusion Electroacupuncture at points Baliao and Huiyang plus rehabilitation training can significantly reduce urinary incontinence in spinal cord injury-induced neurogenic bladder, improve the activities of daily living and enhance the therapeutic effect of rehabilitation.