常规康复训练与电针联合温针灸治疗脊髓损伤后神经源性膀胱尿潴留临床研究

Clinical Study on Routine Rehabilitation Training and Electroacupuncture Combined with Warming-Needle Moxibustion for Neurogenic Bladder Urinary Retention After Spinal Cord Injury

目的:观察常规康复训练与电针联合温针灸治疗脊髓损伤(SCI)后神经源性膀胱(NB)尿潴留的疗效。方法:选取84例SCI后NB尿潴留患者,按随机数字表法分为观察组及对照组各42例,对照组接受常规康复训练,观察组在常规康复训练基础上给予电针联合温针灸治疗,2组均连续治疗4周后。观察2组临床疗效,比较2组治疗前后排尿日记、尿流动力学指标变化。结果:观察组临床疗效总有效率为88.10%,高于对照组69.05%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组每日排尿次数、每日尿失禁次数均较治疗前降低,每日单次排尿量均较治疗前上升;观察组每日排尿次数、每日尿失禁次数均低于对照组,每日单次排尿量高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组最大排尿量、最大膀胱容量、膀胱排尿压力指标值均较治疗前升高,残余尿量指标值均较治疗前下降;观察组最大排尿量、最大膀胱容量、膀胱排尿压力指标值均高于对照组,残余尿量指标值低于对照组,差异均有统计学意义(P<0.05)。结论:常规康复训练与电针联合温针灸治疗SCI后NB尿潴留疗效较好,可帮助患者建立规律性排尿习惯,促进膀胱反射的恢复,有利于改善膀胱功能。

Objective:To observe the curative effect of routine rehabilitation training and electroacupuncture combined with warming-needle moxibustion for neurogenic bladder(NB) urinary retention after spinal cord injury(SCI). Methods:A total of 84 cases of patients with NB urinary retention after SCI were randomly divided into the observation group and the control group according to the random number table method, with 42 cases in each group. The control group was given routine rehabilitation training,and the observation group was additionally given electroacupuncture combined with warming-needle moxibustion based on the treatment of the control group. The clinical effects in the two groups were observed;the changes of voiding diary and urodynamic indexes before and after treatment in the two groups were compared. Results:The total effective rate of clinical effect was 88.10% in the observation group,higher than that of 69.05% in the control group,the difference being significant(P<0.05). After treatment,the daily times of urination and urinary incontinence in the two groups were decreased when compared with those before treatment,and the daily single urination volume was increased;the daily times of urination and urinary incontinence in the observation group were lower than those in the control group,and the daily single urination volume was higher, differences being significant(P<0.05). After treatment, the indexes of maximum urination volume,maximum bladder volume and urinary bladder pressure in the two groups were increased when compared with those before treatment,and the indexes of residual urine volume were decreased;the indexes of maximum urination volume, maximum bladder volume and urinary bladder pressure in the observation group were higher than those in the control group,and the index of residual urine volume was lower,differences being significant(P<0.05). Conclusion:The therapy of routine rehabilitation training and electroacupuncture combined with warming-needle moxibustion for NB urinary retention after SCI has a good curative effect,and can help patients establish regular urination habit,promote the recovery of bladder reflex and improve bladder function.