针刺联合康复训练治疗脊髓损伤后神经源性膀胱临床研究

Clinical Study on Acupuncture Combined with Rehabilitative Training for Neurogenic Bladder After Spinal Cord Injury

目的:观察针刺联合康复训练治疗脊髓损伤后神经源性膀胱的疗效。方法:选择103例脊髓损伤后神经源性膀胱患者,按随机数字表法分为研究组53例与对照组50例。对照组在脊髓损伤恢复期给予常规基础治疗,并在此基础上实施康复功能训练,研究组在对照组治疗基础上实施针刺治疗,连续治疗2个月。比较2组临床疗效、中医症状积分、膀胱功能及泌尿系统感染发生率。结果:研究组总有效率为90.57%,对照组总有效率为68.00%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医症状积分均降低(P<0.05),研究组中医症状积分降低幅度大于对照组(P<0.05);2组残余尿量均减少(P<0.05),研究组残余尿量少于对照组(P<0.05);2组膀胱压力、膀胱容量均增大(P<0.05),研究组膀胱压力、膀胱容量均大于对照组(P<0.05)。研究组泌尿系统感染发生率为1.89%,对照组泌尿系统感染发生率为14.00%,2组比较,差异有统计学意义(P<0.05)。结论:针刺联合康复训练治疗脊髓损伤后神经源性膀胱能显著提高临床疗效,缓解患者临床症状,改善膀胱功能,减少泌尿系统感染。

Objective:To observe the curative effect of acupuncture combined with rehabilitative training for neurogenic bladder after spinal cord injury. Methods:A total of 103 cases of patients with neurogenic bladder after spinal cord injury were divided into the study group and the control group according to the random number table method,53 and 50 cases in each group respectively. The control group was given routine treatment during convalescence of spinal cord injury, and was additionally given rehabilitative training;the study group was additionally treated with acupuncture based on the treatment of the control group. Both groups were treated for two months. The clinical effect,Chinese medicine syndrome scores,the bladder function and the incidence of urinary system infection in the two groups were compared. Results:The total effective rate was 90.57% in the study group and 68.00% in the control group, the difference being significant(P<0.05). After treatment,Chinese medicine syndrome scores in the two groups were decreased(P<0.05),and the decrease of the score in the study group was greater than that in the control group(P<0.05);residual urine volume in the two groups was decreased(P<0.05),and the volume in the study group was less than that in the control group(P<0.05);bladder pressure and ladder volume in the two groups were increased(P<0.05), and the bladder pressure and ladder volume in the study group were larger than those in the control group(P<0.05). The incidence of urinary system infection was 1.89% in the study group and14.00% in the control group, the difference being significant(P<0.05). Conclusion: The therapy of acupuncture combined with rehabilitative training can effectively improve clinical effect on neurogenic bladder after spinal cord injury,relieve clinical symptoms,improve bladder function and reduce urinary system infection.