火针针刺“尿三针”治疗脊髓损伤神经源性膀胱的临床研究

Clinical Study of Fire Needling‘Urine Three-Acupoint’in Treatment of NB after SCI

目的:观察火针针刺“尿三针”治疗脊髓损伤(SCI)神经源性膀胱(NB)的疗效。方法:选择2021年5月--2022年5月收治的120例患者,随机分为对照组和观察组,每组60例。对照组采用普通针刺关元、中极、三阴交、膀胱俞与阴陵泉等穴位治疗。观察组在对照组的基础上火针针刺“尿三针”。比较两组患者的排尿情况、尿动力学参数(最大尿流率Qmax、最大逼尿肌压Pdet-max和残余尿RUV)、临床症状、生活质量变化、总体疗效及不良反应。结果:观察组总有效率为98%(59/60),对照组为75%(45/60),两组比较差异有统计学意义(P<0.05)。两组治疗后日均排尿次数、日均漏尿次数、RUV与NBSS评分均较治疗前减少(P<0.05),日均单次排尿量、Pdet-max、Qmax及I-QOL评分较治疗前增加(P<0.05)。观察组治疗后日均排尿次数、日均漏尿次数、RUV与NBSS评分低于对照组(P<0.05),日均单次排尿量、Pdet-max、Qmax及I-QOL评分大于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:火针针刺“尿三针”能有效改善脊髓损伤NB患者尿动力学指标,缓解排尿困难症状,并能提高患者的生活质量,疗效优于普通针刺治疗。

Objective:To observe the efficacy of fire needling‘urine three-acupoint’in treatment of neurogenic bladder(NB)after spinal cord injury(SCI).Methods:A total of 120 patients were randomly divided into the control group and the observation group,with 60 patients in each group.The control group was treated with ordinary acupuncture at Guanyuan(RN4),Zhongji(RN3),Sanyinjiao(SP6),Pangguangshu(BL28)and Yinlingquan(SP9);on which basis,the observation group was also treated with fire needling urine three-acupoint.Urination,urodynamic parameters[maximum urinary flow rate(Qmax),maximum detrusor pressure(Pdet-max),residual urinary volume(RUV)],clinical symptoms,changes in quality of life,overall efficacy and adverse reactions were compared between the two groups after the treatment.Results:The effective rate was 98%(59/60)in the observation group,which was significant higher than 75%(45/60)in the control group(P<0.05).The daily average urination frequency,daily average urinary leakage frequency,RUV and NBSS score were all decreased(P<0.05),and the daily average single urinary volume,Pdet-max,Qmax and I-QOL score were all increased after the treatment compared with those before the treatment in the two groups(P<0.05).The daily average urination frequency,daily average urinary leakage frequency,RUV and NBSS scores were lower(P<0.05),whereas the daily average single urinary volume,Pdet-max,Qmax and I-QOL score were higher in the observation group than those in the control group after the treatment(P<0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Fire needling‘urine three-acupoint’can effectively improve the urodynamic indicators of patients with NB after SCI,relieve dysuria and enhance their quality of life.Its efficacy is superior to that of ordinary acupuncture.