次髎穴埋线治疗脊髓损伤后神经源性肠道功能障碍(便秘型)的临床研究

Clinical study of catgut-embedding at Ciliao(BL32)for neurogenic bowel dysfunction(constipation type)after spinal cord injury

目的观察次髎穴埋线治疗脊髓损伤后神经源性肠道功能障碍(便秘型)的临床疗效。方法将74例脊髓损伤后神经源性肠道功能障碍(便秘型)患者随机分为研究组38例和对照组36例。两组均接受常规治疗同时,研究组采用次髎穴埋线治疗,对照组采用口服乳果糖治疗。比较两组治疗前后排便频率、排便时间、Wexner便秘评分、神经源性肠道功能障碍(neurogenic bowel dysfunction,NBD)评分及便秘患者生活质量量表(patient-assessment of constipation quality of life,PAC-QOL)各项评分,并对并发症发生率进行评价。结果两组治疗后排便频率较同组治疗前均显著提高,排便时间均显著缩短,PAC-QOL各项评分均显著降低,差异均具有统计学意义(P<0.05)。研究组治疗后排便频率、排便时间及PAC-QOL各项评分与对照组比较,差异均具有统计学意义(P<0.05)。两组治疗2、4周后Wexner便秘评分及NBD评分较同组治疗前均显著降低,差异均具有统计学意义(P<0.05)。研究组治疗2、4周后Wexner便秘评分及NBD评分均明显低于对照组,两组比较差异均具有统计学意义(P<0.05)。研究组治疗期间并发症发生率为5.3%,对照组为5.6%,两组比较差异无统计学意义(P>0.05)。结论对脊髓损伤后神经源性肠道功能障碍(便秘型)患者采取次髎穴埋线治疗,可提升排便频率,缩短排便时间,改善肠道功能障碍与便秘症状,提高患者生活质量,安全性好。

Objective To observe the clinical efficacy of catgut embedding at Ciliao(BL32)in treating neurogenic bowel dysfunction(constipation type)after spinal cord injury.Method Seventy-four patients with neurogenic bowel dysfunction(constipation type)after spinal cord injury were randomly divided into a research group with 38 cases and a control group with 36 cases.Besides the conventional treatment,the research group also received catgut embedding at Ciliao,and the control group received oral lactulose for treatment.Before and after the treatment,the two groups were compared in terms of defecation frequency,defecation time,Wexner constipation score,neurogenic bowel dysfunction(NBD)score,and patient-assessment of constipation quality of life(PAC-QOL)scores.The complication rate was also evaluated.Result After the treatment,both groups showed an increased defecation frequency,shortened defecation time,and reduced PAC-QOL scores,all presenting statistical significance(P<0.05).After the treatment,the two groups had significant differences in the defecation frequency,defecation time,and PAC-QOL scores(P<0.05).After 2 and 4 weeks of treatment,the Wexner constipation and NBD scores dropped significantly in both groups compared to the baseline(P<0.05);the Wexner constipation and NBD scores were significantly lower in the research group than in the control group(P<0.05).The complication rate during the treatment was 5.3%in the research group versus 5.6%in the control group,and the difference was statistically insignificant(P>0.05).Conclusion Catgut embedding at Ciliao can increase defecation frequency,shorten defeca-tion time,improve bowel dysfunction and constipation symptoms,and enhance the quality of life in patients with neurogenic bowel dysfunction(constipation type)after spinal cord injury with a good safety rating.