温肾利尿方联合电针治疗脊髓损伤后神经源性膀胱尿潴留临床研究

Clinical Study of Wenshen Liniao Prescription Combined with Electropuncture for Neurogenic Bladder Urinary Retention After Spinal Cord Injury

目的:观察温肾利尿方联合电针治疗脊髓损伤后神经源性膀胱尿潴留的临床疗效。方法:选取脊髓损伤后神经源性膀胱尿潴留患者130例,按随机数字表法分为对照组和观察组各65例。对照组采用西医常规治疗,观察组在对照组基础上给予温肾利尿方联合电针治疗。评价2组临床疗效,比较2组治疗前后血清神经营养因子、血清炎症因子、日均单次排尿量、最大尿流速率、最大膀胱容量、残余尿量、中医证候积分及生活质量评分的变化。结果:观察组总有效率为95.38%,高于对照组81.54%(P<0.05)。治疗后,2组血清脑源性神经营养因子(BDNF)较治疗前升高,神经元特异性烯醇化酶(NSE)、高迁移率族蛋白1 (HMGB1)、白细胞介素-1β (IL-1β)、白细胞介素-6 (IL-6)较治疗前降低(P<0.05);且观察组血清BDNF高于对照组,NSE、HMGB1、IL-6、IL-1β低于对照组(P<0.05)。治疗后,2组最大尿流速率、日均单次排尿量、最大膀胱容量较治疗前升高(P<0.05);且观察组最大尿流速率、日均单次排尿量、最大膀胱容量高于对照组(P<0.05)。治疗后,2组残余尿量较治疗前降低(P<0.05),且观察组残余尿量低于对照组(P<0.05)。治疗后,2组健康状况调查简表(SF-36)评分较治疗前升高,中医证候积分较治疗前降低(P<0.05);且观察组SF-36评分高于对照组,中医证候积分低于对照组(P<0.05)。结论:温肾利尿方联合电针治疗脊髓损伤后神经源性膀胱尿潴留有助于减轻炎症反应,改善神经功能和排尿功能,提高临床疗效。

Objective:To observe the clinical effect of the therapy of Wenshen Liniao Prescription combined with electropuncture on neurogenic bladder urinary retention after spinal cord injury.Methods:A total of 130 patients with neurogenic bladder urinary retention after spinal cord injury were selected and divided into the control group and the observation group according to the random number table method,with 65 cases in each group.The control group was given routine treatment in western medicine,and the observation group was additionally treated with Wenshen Liniao Prescription combined with electropuncture based on the treatment of the control group.The clinical effects in the two groups were evaluated;the changes of levels of serum neurotrophic factors and inflammatory factors,average daily single urination volume,maximum urinary flow rate,maximum bladder volume,residual urine volume,traditional Chinese medicine(TCM) syndrome scores and scores of quality of life before and after treatment were compared between the two groups.Results:The total effective rate was 95.38% in the observation group,higher than that of 81.54% in the control group(P<0.05).After treatment,the levels of serum brain-derived neurotrophic factors(BDNF) in the two groups were increased when compared with those before treatment,the levels of neuron-specific enolase(NSE),high mobility group box-1 protein(HMGB1),interleukin-1β(IL-1β) and interleukin-6 were decreased when compared with those before treatment(P<0.05);the serum BDNF level in the observation group was higher than that in the control group,and the levels of NSE,HMGB1,IL-6 and IL-1β were lower than those in the control group(P<0.05).After treatment,the maximum urinary flow rate,average daily single urination volume and maximum bladder volume in the two groups were increased when compared with those before treatment(P<0.05);the above three items in the observation group were higher than those in the control group(P<0.05).After treatment,the residual urine volume in both groups was decreased when compared with that before treatment(P<0.05),and the residual urine volume in the observation group was lower than that in the control group(P<0.05).After treatment,the scores of 36-Item Short-Form(SF-36) in the two groups were increased when compared with those before treatment(P<0.05),and the TCM syndrome scores were decreased when compared with those before treatment(P<0.05);the SF-36 score in the observation group was higher than that in the control group,and the TCM syndrome score was lower than that in the control group(P<0.05).Conclusion:The therapy of Wenshen Liniao Prescription combined with electropuncture for neurogenic bladder urinary retention after spinal cord injury can help mitigate the inflammatory responses,improve the neuromechanism and urinary function,and enhance the clinical effect.