针刺结合盆底肌训练治疗卒中后神经源性膀胱尿潴留临床研究

Effect of acupuncture on neurogenic bladder urinary retention after stroke and its influence on endoplasmic reticulum stress indicators

目的观察针刺辅助治疗卒中后神经源性膀胱尿潴留(NBUAS)临床疗效。方法将我院86例NBUAS患者随机分为对照组与研究组各43例,对照组采用间歇导尿、膀胱功能训练治疗,研究组在对照组的治疗基础上联合针刺治疗,比较两组疗效及内质网应激指标变化。结果治疗后,两组残余尿量低于治疗前,充盈期膀胱压力和最大尿流率水平均高于治疗前,研究组残余尿量低于对照组,充盈期膀胱压力和最大尿流率水平均高于对照组(P<0.05);两组天冬半胱氨酸特异性蛋白酶-12(Caspase-12)、葡萄糖调节蛋白78(GRP78)和内质网应激相关因子CCAAT/增强子结合蛋白(CCAAT/EBPs)水平均低于治疗前,研究组Caspase-12、GRP78和CCAAT/EBPs水平均低于对照组(P<0.05);两组膀胱功能积分优于治疗前,研究组膀胱功能积分优于对照组(P<0.05);两组尿潴留程度分级优于治疗前,研究组尿潴留程度分级优于对照组(P<0.05)。结论针刺辅助治疗NBUAS能有效改善尿动力学,抑制内质网应激,提高膀胱功能,减轻患者尿潴留症状。

Objective To observe the clinical efficacy of acupuncture in treatment of neurogenic bladder uroschesis(NBUAS)after stroke.Methods Eighty-six NBUAS patients were randomly divided into control group and study group,with 43 cases in each group.Control group received intermittent catheterization and bladder function training treatment,while study group received acupuncture treatment on the basis of control group.The efficacy and changes in endoplasmic reticulum stress indicators were compared between the two groups.Results After treatment,the residual urine volume in both groups was lower than before treatment,while the bladder pressure and maximum urine flow rate during the filling phase were higher than before treatment;the residual urine volume in study group was lower than that in control group,and the bladder pressure and maximum urine flow rate during the filling phase were higher than those in control group(P<0.05);the levels of cysteine specific protease-12(Caspase-12),glucose regulatory protein 78(GRP78),and endoplasmic reticulum stress-related factor CCAAT/enhancer binding protein(CCAAT/EBPs)in both groups were lower than before treatment,and were lower in study group than those in control group(P<0.05);the bladder function scores of both groups were better than before treatment,and was better in study group than control group(P<0.05);the degree of urinary retention in both groups was better than that before treatment,and was better in study group than control group(P<0.05).Conclusion Acupuncture assisted treatment can effectively improve urodynamics,inhibit endoplasmic reticulum stress,improve bladder function,and alleviate the symptoms of urinary retention in patients with NBUAS.