耳穴揿针联合雷火灸在老年肾阳衰惫型神经源性膀胱患者中的应用

Application of auricular acupuncture combined with thunder-fire moxibustion for elderly patients with neurogenic bladder of kidney-yang deficiency type

目的观察耳穴揿针联合雷火灸在老年肾阳衰惫型神经源性膀胱患者中的应用效果。方法 90例老年肾阳衰惫型神经源性膀胱患者随机分为耳穴揿针组、雷火灸组与对照组,各30例,对照组采用常规康复训练,如饮水计划、锻炼排尿意识及情志护理等;耳穴揿针组在常规康复训练基础上进行耳穴揿针埋针,雷火灸组在耳穴揿针组的基础上同时使用雷火灸俞募配穴治疗。治疗前及治疗2个疗程后评估3组患者膀胱残余尿量及中医证候积分的差异。结果治疗后雷火灸组、耳穴揿针组及对照组患者残余尿量较治疗前分别减少(71.59±8.00)%、(63.81±8.00)%和(52.98±13.00)%,差异有统计学意义(F=26.71,P<0.01)。治疗后雷火灸组、耳穴揿针组及对照组患者中医证候积分较治疗前分别提高(198.00±8.00)%、(146.00±8.00)%和(133.00±13.00)%,差异有统计学意义(F=8.04,P<0.01)。结论耳穴揿针联合雷火灸俞募配穴治疗,能有效改善老年肾阳衰惫型神经源性膀胱患者的残余尿量,改善临床症状。

Objective To investigate the effect of auricular acupuncture combined with thunder-fire moxibustion for elderly patients with neurogenic bladder of kidney-yang deficiency type. Methods Totally 90 elderly patients with neurogenic bladder of kidney-yang deficiency type were assigned to the auricular acupuncture group, thunder-fire moxibustion group and the control group, with 30 cases in each group. All patients received comprehensive interventions such as daily water intake, urination training and emotional care. The single treatment of auricular acupuncture was carried out in the auricular acupuncture group, and a combined treatment of auricular acupuncture and thunder-fire moxibustion was performed in the thunder-fire moxibustion group. The bladder residual urine volume was assessed before and after 2 courses of treatment. The TCM Syndrome Scale was compared among three groups. Results There was a(71.59±8.00)% reduction of bladder residual urine volume in the thunder-fire moxibustion group, which was higher than(63.81±8.00)% reduction in the auricular acupuncture group and(52.98±13.00)% reduction in the control group(F=26.71,P<0.01). There was a(198.00±8.00)% increase of TCM Syndrome Scale in the thunder-fire moxibustion group, which was higher than(146.00±8.00)% increase in the auricular acupuncture group and(133.00±13.00)% increase in the control group(F=8.04,P<0.01). Conclusion The combined treatment of auricular acupuncture combined with thunder-fire moxibustion can effectively reduce the bladder residual urine volume of elderly patients with neurogenic bladder of kidney-yang deficiency type.