电针联合芒针透刺治疗卒中后尿失禁的疗效观察

Efficacy Observation of Electroacupuncture Combined with Penetrating Acupuncture with Elongated Needles for Post-stroke Urinary Incontinence

目的观察电针联合芒针透刺治疗急性卒中后尿失禁的临床疗效及对患者膀胱功能及尿流动力学的影响。方法将104例急性卒中后尿失禁患者,随机分为观察组和对照组,每组52例。对照组给予常规治疗和电针治疗;观察组在对照组治疗基础上给予芒针透刺治疗。观察两组治疗前后排尿日记、生活质量(QOL)评分、下尿路症状(LUTS)评分、尿流动力学和膀胱功能变化,并比较两组临床疗效和治疗期间不良反应发生情况。结果治疗后,观察组总有效率(92.3%)明显高于对照组(76.9%),差异有统计学意义(P<0.05)。治疗后,两组平均单次尿量明显提高,每日失禁次数和每日排尿次数明显降低,且观察组排尿日记各项指标显著优于对照组,差异有统计学意义(P<0.05);两组QOL评分和LUTS评分明显降低,且观察组低于对照组,差异有统计学意义(P<0.05);两组尿流动力学指标尿量(UV)、最大尿流率(MFR)以及相对排尿阻力(RVR)明显升高,且观察组高于对照组,差异有统计学意义(P<0.05);两组最大排尿量和膀胱容量明显升高,残余尿量和平均排尿次数明显下降,且观察组的膀胱功能各项指标明显优于对照组,差异有统计学意义(P<0.05)。在治疗期间,两组均未出现明显的不良反应事件。结论在常规治疗的基础上,电针联合芒针透刺治疗急性卒中后尿失禁患者疗效显著,有利于改善患者的膀胱功能和尿流动力学指标。

Objective To observe the clinical efficacy of electroacupuncture plus penetrating acupuncture with elongated needles in treating urinary incontinence after an acute stroke and its impact on patients’bladder function and urodynamics.Method A total of 104 patients with urinary incontinence after an acute stroke were randomized into an observation group and a control group,with 52 cases in each group.The control group was given conven-tional intervention and electroacupuncture treatment;the observation group was given additional penetrating acupuncture with elongated needles.Before and after the treatment,the voiding diary,quality of life(QOL)score,lower urinary tract symptom(LUTS)score,urodynamics,and bladder function were observed.The clinical efficacy and adverse reactions during the intervention period were compared between the two groups.Result After the treatment,the total effective rate in the observation group(92.3%)was notably higher than that in the control group(76.9%),showing statistical significance(P<0.05).After the intervention,the average single urine volume,daily incontinence times,and daily voiding frequency markedly dropped,and the observation group was superior to the control group in comparing the voiding diary parameters,all showing statistical significance(P<0.05).The QOL and LUTS scores notably dropped and were lower in the observation group than in the control group,and the differences were statistically significant(P<0.05).The urodynamic parameters urine volume(UV)and maximum urinary flow rate(MFR)and relative voiding resistance(RVR)increased notably in both groups and were higher in the observation group than in the control group,showing statistical significance(P<0.05).After the intervention,the maximum voided volume and bladder capacity increased,and the residual urine volume and average urination frequency dropped in both groups;the observation group was superior to the control group comparing the bladder function parameters,all showing statistical significance(P<0.05).During the intervention period,there were no significant adverse reactions in either group.Conclusion Electroacupuncture plus penetrating acupuncture with elongated needles based on the conventional treatment can produce significant efficacy in treating urinary incontinence after an acute stroke;it can improve patients’bladder function and urodynamic parameters.