中药敷脐联合早期康复训练治疗老年脊髓损伤后并发神经源性膀胱的临床分析

Clinical analysis of the treatment of neurogenic bladder after spinal cord injury in elderly patients with traditional Chinese medicine umbilical application combined with early rehabilitation training

目的 探讨中药敷脐疗法联合早期膀胱功能康复训练对老年脊髓损伤后神经源性膀胱患者的康复效果,为治疗该病症提供方法。方法 选取2019年9月—2022年8月于西安市中医医院收治的老年脊髓损伤后并发神经源性膀胱患者112例,依照数字表法随机分为常规康复组和中药敷脐组,每组56例。2组均接受早期膀胱功能康复训练,在此基础上中药敷脐组加入中药敷脐治疗法。观察并比较2组患者的临床疗效、排尿功能及日常生活活动能力(MBI评分)。结果 4周治疗后,2组患者的临床症状均有改善。中药敷脐组临床有效率明显高于常规康复组(94.64%vs 83.93%),差异有统计学意义(P<0.05);中药敷脐组的残余尿量和膀胱测压容积均低于常规康复组,而排尿次数和平均排尿量均明显多于常规康复组,且尿失禁次数明显少于常规康复组,差异均有统计学意义(P<0.05);治疗2周后和治疗4周后,中药敷脐组的MBI评分均高于常规康复组(P<0.05)。结论 中药敷脐疗法联合早期膀胱功能康复训练可有效提高脊髓损伤后老年神经源性膀胱患者的临床疗效,改善患者的尿动力学相关指标、排尿功能和日常生活活动能力,且效果优于单一的早期膀胱功能康复训练,具有一定临床应用价值。

Objective To explore the rehabilitation effects of Traditional Chinese Medicine(TCM) umbilical application therapy combined with early bladder function rehabilitation training on elderly patients with neurogenic bladder after spinal cord injury,so as to provide a method for the treatment of the disease.Methods A total of 112 elderly patients with neurogenic bladder after spinal cord injury admitted toTraditional Chinese Medicine Hospital of Xi’an City from September 2019 to August 2022 were selected and randomly divided into conventional rehabilitation group and TCM umbilical application group according to the number table method,with 56 cases in each group.Both groups received early bladder function rehabilitation training.On this basis,TCM umbilical application group received TCM umbilical application therapy.The clinical efficacy,urination function and activity of daily living(MBI score) of the two groups were observed and compared.Results After 4 weeks of treatment,the clinical symptoms of both groups were improved.The clinical effective rate of the TCM umbilical application group was significantly higher than that of the conventional rehabilitation group(94.64% vs 83.93%),and the difference was statistically significant(P<0.05).The residual urine volume and bladder cystometry volume in the TCM umbilical application group were lower than those in the conventional rehabilitation group,while the frequencyof urination and the average urination volume were significantly higher than those in the conventional rehabilitation group,and the frequency of urinary incontinence was significantly lower than that in the conventional rehabilitation group.The differences were statistically significant(P<0.05).After 2 and 4 weeks of treatment,the MBI scores of the TCM umbilical application group were higher than those of the conventional rehabilitation group(P<0.05).Conclusion TCM umbilicus application therapy combined with early bladder function rehabilitation training can effectively improve the clinical efficacy of elderly patients with neurogenic bladder after spinal cord injury,improve their urodynamic-related indicators,urination function and activities of daily living,and the effect is better than that of the single early bladder function rehabilitation training,which has certain clinical application value.