补阳还五汤联合盆底肌电刺激治疗脊髓损伤后神经源性膀胱的疗效及对尿流动力学的影响

Therapeutic effect of Buyang Huanwu decoction combined with pelvic floormuscle electrical stimulation on neurogenic bladder after spinal cord injuryand its impact on urodynamics

目的:探究补阳还五汤与盆底肌电刺激用于脊髓损伤后神经源性膀胱(以下简称脊损后膀胱)的疗效。方法:纳入2020年5月至2022年8月我院收治的脊损后膀胱患者102例,随机数表法分为对照组和观察组,每组51例。对照组给予盆底肌电刺激治疗,观察组给予补阳还五汤联合盆底肌电刺激治疗。比较两组疗效及尿流动力学水平。结果:观察组较对照组治疗总有效率明显升高[90.20%(46/51)vs.72.55%(37/51)],差异具有统计学意义(P<0.05)。两组治疗后排尿指标、最大膀胱容量、最大尿流率、最大尿道闭合压、单次尿量、最大尿量、运动评分、感觉评分、生活质量评分较治疗前明显改善,且观察组较对照组改善幅度大,差异具有统计学意义(P<0.05)。结论:补阳还五汤与盆底肌电刺激共同作用于脊损后膀胱,可有效改善患尿功能、神经功能及生活质量,效果显著。

Objective:To explore the changes of patients with neurogenic bladder after spinal cord injury who received pelvic floormuscle electric stimulation and Buyang Huanwu decoction.Methods:A total of 102 patients with neurogic bladder after spinal injury from May 2020 to August 2022 were included and randomly divided into control group and observation group by random number table method,with 51 cases in each group.The control group was treated with pelvic floor muscleelectric stimulation,and the observation group was treated with Buyang Huanwu decoction combined with pelvic floor muscle electric stimulation.The efficacy and urodynamic level of the two groups were compared.Results:The total effective rate of the observation group was significantly higher than that of the control group[90.20%(46/51)vs.72.55%(37/51)],and the difference was statistically significant(P<0.05).Urinary index,maximum bladder volume,maximum urine flow rate,maximum urethral closure pressure,single urine volume,maximum urine volume,score of exercise,sensory and quality of life in the two groups were significantly im‐proved after treatment,and the improvement of the observation group was larger than that of the control group,the difference was statistically significant(P<0.05).Conclusion:Buyang Huanwu decoction combined with pelvic floor muscle electricstimulation can effectively improve the urodynamics,neurological function,and quality of life of patients with neurogenic bladder after spinal cord injury.