火针联合康复训练治疗脊髓损伤后神经源性膀胱临床观察

Efficacy observation of fire-needling therapy and rehabilitation training on spinal cord injury-caused neurogenic bladder

目的:观察火针联合康复训练对脊髓损伤后神经源性膀胱的疗效。方法:将66例脊髓损伤后神经源性膀胱患者随机分为两组各33例。对照组予饮水计划、间歇导尿和盆底肌训练等常规康复治疗,治疗组在对照组基础上联合火针治疗,取穴委中、肾俞、膀胱俞、三阴交、关元、中极。2周为1个疗程,共治疗2个疗程。结果:治疗组总有效率为81.8%,高于对照组的54.5%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者残余尿量(RUV)均较治疗前减少,最大尿流率(Qmax)、最大逼尿肌压力(Pdet-max)均较前增大(P<0.05),两组尿失禁生活质量问卷评分均较前增加(P<0.05),治疗组优于对照组(P<0.05)。结论:火针联合康复治疗可有效改善脊髓损伤后神经源性膀胱患者排尿困难症状,提升生活质量。

Objective:To observe the clinical efficacy of fire-needling therapy and rehabilitation training on spinal cord injury-caused neurogenic bladder.Methods:66 cases of patients with spinal cord injury-caused neurogenic bladder were randomly divided into two groups,33 cases in each group.The control group was treated with routine rehabilitation training such as drinking-water plan,intermittent catheterization and pelvic floor muscle training,etc.while the treatment group was treated plus by fire-needling therapy on the basis of control group,and the selected acupoints were Weizhong(BL 40),Shenshu(BL 23),Pangguangshu(BL 28),Sanyinjiao(SP 6),Zhongji(CV 3)and Guanyuan(CV 4).Two weeks as a course of treatment,and a total of two courses of treatment.Results:The total effective rate of treatment group was 81.8%,which was higher than 54.5%of control group,and the comparative difference between two groups was statistically significant(P<0.05).After treatmentin in two groups,the residual urine volume(RUV)of patients was decreased compared with before treatment,while the maximum urine flow rate(Qmax)and the maximum detrusor pressure(Pdet-max)were increased compared with before treatment(P<0.05);the score of life quality questionnaire for urinary incontinence was increased in two groups compared with before treatment(P<0.05),and the treatment group was better than control group(P<0.05).Conclusion:Fire-needling therapy and rehabilitation training can effectively improve the symptoms of dysuria of patients with spinal cord injury-caused neurogenic bladder,and enhance their quality of life.