基于“穴位敏化”热敏灸治疗脊髓损伤后神经源性膀胱的临床随机对照研究

Effect of heat sensitive moxibustion on neurogenic bladder after spinal cord injury clinical randomized controlled study

目的 基于“穴位敏化”,探讨热敏灸治疗脊髓损伤后神经源性膀胱的有效性及安全性。方法 选择符合纳入排除标准的80例脊髓损伤后神经源性膀胱患者,利用随机数字表将其分为试验组和对照组,每组40例,试验组给予热敏灸,对照组给予常规康复,所有患者治疗4周后,观察治疗前后膀胱容量、膀胱充盈压力、尿流率和膀胱残余尿量指标的变化。结果 治疗4周后,试验组和对照组的膀胱残余尿量,均较治疗前减少(182.85 mL VS 120.98 mL),且试验组较对照组减少更明显,差异有统计学意义(P<0.001)。两组患者治疗后平均膀胱容量及膀胱压力均较治疗前增加,且试验组与对照组比较膀胱容量显著增加(44.18 VS4.82),膀胱压力增加(7.02 VS 1.97)更为明显(P<0.001),试验组的临床疗效也优于对照组(75%VS 52.5%,P=0.036),差异均具有统计学意义。结论 热敏灸法治疗脊髓损伤后神经源性膀胱患者安全有效,可在临床应用推广。

Objective Based on "acupoint sensitization", to explore the efficacy and safety of heat sensitive moxibustion in the treatment of neurogenic bladder after spinal cord injury.Methods 80 patients with neurogenic bladder after spinal cord injury were selected and randomly divided into experimental group and control group with 40 cases in each group. The experimental group was given heat sensitive moxibustion, while the control group was given routine rehabilitation. After 4 weeks of treatment, the differences of bladder volume, bladder filling pressure, urinary flow rate and residual urine volume were observed before and after treatment.Results After 4 weeks of treatment, the residual urine volume of bladder in the experimental group and the control group decreased(182.85 vs 120.98), but the decrease in the experimental group was more significant(P < 0.001). The average bladder volume and bladder pressure of the two groups were increased compared with those before treatment, and the bladder volume and bladder pressure in the experimental group were increased(44.18 vs 4.82) and(7.02 vs 1.97)(P < 0.001). The clinical efficacy of the experimental group was better than that of the control group(75% vs 52.5%, P = 0.036).Conclusion Heat sensitive moxibustion is safe and effective in the treatment of neurogenic bladder after spinal cord injury.