Electric Acupuncture in the Treatment of 36 Cases of Female Urethral Syndrome

Since 1999, the authors have used electricacupuncture to treat 36 cases of female urethralsyndrome with good therapeutic effects as comparedto that of the routine treatment. The following is areport of it.

STUDY ON ACUPUNCTURE AND MOXIBUSTION THERAPY FOR FEMALE URETHRAL SYNDROME

Among 180 patients with female urethral syndrome, 128 were treated by acupuncture and moxibustion and 52 by western medicine as controls. The short-term effective rate in the acupuncture and moxibustion group was 90.6% and the long-term effective rate, 80.4%; whereas the short-term effective rate of the control group was 26.9% (P 0.05). Sixty-nine cases from the acupuncture and moxibustion group and 39 from the control group were subjected before and after treatment to determinations of the maximal bladder pressure, maximal abdominal pressure, bladder-neck pressure, and maximal urethral closure pressure during urination. All these indexes were decreased remarkably in the acupuncture and moxibustion group, while no changes were observed in the control group.

Diagnosis,Treatment and Experience of A Case of Feline Lower Urinary Tract Syndrome

In February 2018,a 2-year-old American shorthair was treated conservatively for cystitis caused by crystalluria.However,as long as drug withdrawal was proceeding,the condition would be repeated,and the condition worsened since August.In order to diagnose and treat the sick cat,clinical examination,laboratory examination,X-ray,B-type ultrasound and other methods were used for diagnosis,and treatment was conducted according to the diagnosis results.The results showed that the cat was caused by ammoniomagnesium phosphate crystals blocking urethra,complicated with postrenal azotaemia and hyperkalemia.The relapse continued after conservative treatment,and the cat finally recovered by modifying urethra surgically.The results showed that the deficiency of drinking water,the change of urine pH,and high dietary magnesium and fiber content could promote the occurrence of the disease.For the problem of urethral obstruction that could not be solved by conservative treatment,operation was done to modify urethral stricture.

Menopausal Status and Metabolic Syndrome in Women in Climacteric Period Treated at a Clinic in Southern Brazil

Background: This study aims to understand the relationship between menopausal status and the presence of Metabolic Syndrome in women from 40 to 65 years, as well as to describe the distribution of each component of Metabolic Syn- drome according to sample characteristics. Methods: A cross-sectional study was conducted with 551 women treated at a clinic in southern Brazil. MetS and its components were defined according to NCEP-ATP III and menopausal status as pre, peri, and post-menopause. Prevalences of menopausal status and of MetS and its components were calculated. Estimates of prevalence ratios crude and adjusted with confidence intervals of 95% were calculated by Poisson Regression with robust variance. Demographic, socioeconomic, behavioral, and reproductive characteristics were considered as potential confounding factors in multivariable models based on a conceptual framework of MetS determination. Results: The prevalence of Metabolic Syndrome in the sample was 56.1% (CI95%: 51.9 to 60.2), being more common among older women (56 to 65 years), with low education, menarche 11 years old, with three or more pregnancies and in the post-menopausal period. In multivariate analysis, there was an increase of prevalence ratios when comparing perimenopause and post-menopause with pre-menopause;however, the confidence intervals include the unit. Regarding the analysis of isolated components in the sample, the most prevalent altered components were: hypertension (84.8%;CI95%: 81.7 to 87.8), waist circumference (66.4%;CI95%: 62.5 to 70.4) and HDL cholesterol (51.7%;CI95%: 47.5 to 55.9). There was a linear increase on mean blood glucose through menopausal status. Conclusions: Our study indicates variation on the distribution of MetS and each component according to menopausal status and other women characteristics. Future studies on MetS should also have foresight to use this type of approach to improve understanding and targeting of actions and programs focusing on women in this period of life.

刘启泉从“通调五脏安脾胃”论治尿道综合征经验

总结刘启泉教授从“通调五脏安脾胃”论治尿道综合征的临证经验。刘教授认为,尿道综合征病位在尿道,核心病机为脾胃不和,湿邪阻滞,水道不利,治疗应以“安脾胃”贯穿始终。同时,该病与五脏不调密切相关,外感、内伤、情志、饮食、劳倦及脏腑失调等均会影响五脏功能继而发病。临床中基于“通调五脏安脾胃”思想,根据患者症状表现,综合运用升清降浊以和胃通淋、养心清心以泻热通淋、益肺泻热以利湿通淋、补肾温阳以化气通淋、疏肝清肝以行气通淋的方法指导治疗,可使五脏调和,水道得利,症状缓解,淋证得瘥。

针灸治疗尿道综合征的选穴规律和特色分析

目的:分析临床中采用针灸治疗尿道综合征的取穴规律和特点。方法:运用计算机检索知网、万方、维普和中国生物医学文献服务系统数据库从建库—2023年8月针灸治疗尿道综合征相关的文献,对录入的数据进行描述性、关联规则以及聚类分析。结果:最后纳入101篇文献,包含77个腧穴,共739次。针灸治疗尿道综合征的核心穴位组合为三阴交-关元-中极-肾俞-膀胱俞-气海;经脉主要选取膀胱经、任脉和脾经;穴位主要集中在下肢、腹部和骶部。结论:本研究探析了针灸治疗尿道综合征的取穴规律和特色,为临床治疗该病提供依据。

黄文政教授治疗尿道综合征验案1则

尿道综合征是一组以反复发作的尿频、尿急或排尿困难、小腹酸胀不适而无明显膀胱、尿道器质性病变和菌尿等为基本特征的非特异性症候群,西医治疗多予以对症治疗,效果往往不佳且容易复发,给患者带来诸多困扰。近年来研究发现,中医药辨证论治尿道综合征效果较为明显。今介绍黄文政教授治疗男性尿道综合征验案1则,以飨同道。

Curative Effect of Special Acupuncture Techniques on Female Urethral Syndrome and its Relationship with the Course of Treatment

Purpose To observe the curative effect of special acupuncture techniques on female urethral syndrome and its relationship with the course of treatment.Method Four abdominal and four sacral empirical points were acupunctured with special techniques and electricity. A difference in curative effect was investigated between different numbers of treatments.Results The clinical cure rate reached 15.2% just after ≤10 (7.3±1.3) treatments. The curative effect was significantly better after 20–40 (32.1±5.8) treatments than after ≤10 (7.3±1.3) treatments ({ie19-1},P<0.05). The clinical cure rate reached 43.5% in the former.Conclusion Special acupuncture techniques have a good clinical effect on female urethral syndrome. The curative effect improves with an increase in the number of treatments. Key words Special Acupuncture Techniques - Urethral Diseases - Urodynamics - syndrome WANG Si-you, professor, the head of clinical research division of Shanghai research institute of acupuncture and meridian, mainly engaged in clinical and experimental studies on acupuncture treatment of urinary dysfunction, the inventor of special acupuncture therapy for urethral syndrome and urinary incontinence.Translator: WANG Si-you

Acupuncture Treatment of Female Urethral Syndrome

Purpose To observe the curative effect of acupuncture on female urethral syndrome. Method A treatment group of 30 patients were treated with acupuncture at points Zhongji ( CV 3 ), Zusanli ( ST 36), Sanyinjiao ( SP 6), Shenshu ( BL 23 ), Pangguangshu ( BL28), Guanyuan (CV 4), Zhaohai (KI 6) and Zhonglushu ( BL 29). A control group of 28 patients were treated with capsule Norfloxacini and capsule Cystocaps.Results Of the treatment group, 26 patients had effectiveness and 4 had ineffectiveness; of the control group,2 patients had effectiveness and 26 had ineffectiveness.There was a significant difference in effective rate between the two groups (P＜0.01). Conclusion The curative effect of acupuncture on female urethral syndrome is better than that of routine treatment.

Observations on the Efficacy of Electroacupuncture plus TDP Irradiation for Treating Noninfectious Urethral Syndrome

Objective： To investigate the efficacy of electroacupuncture plus TDP irradiation for treating noninfectious urethral syndrome. Method： Sixty patients with noninfectious urethral syndrome were randomly divided into an electroacupuncture plus TDP irradiation treatment group of 40 cases and a medication group of 20 cases as a control. Results： The effective rate was 85% in the treatment group and 35% in the control group. There was a significant difference in curative effect between the treatment and control groups（P〈0.01）. Conclusion： Treatment by electroacupuncture plus TDP irradiation has an exact effect on noninfectious urethral syndrome. Its curative effect was significantly better than that in the medication control group.

In vivo assessment of structural changes of the urethra in lower urinary tract disease using cross-polarization optical coherence tomography

The paper presents the results of a study of the female urethra in cases of urethral pain syndrome(UPS)and inflammatory diseases of the lower urinary tract using cross-polarization optical coherence tomography(CP OCT).Urethral wall structure was studied in 86 patients;233 CP OCT images were collected.A comparative qualitative analysis of three groups of CP OCT images—"norm","Inflammation"and"UPS"—identified that despite the absence of a clear inflammatory factor in the patient's examination,the urethral tissues in UPS were in an altered state.The changes in the urethral wall with UPS and in cases of inflammation were similar.Using a point scale,three experts independently performed visual scoring of the CP OCT images.Three parameters:epithelial contrast,cavities and the minimum signal depth in the co-channel were evaluated.It was found that,individually,the parameters correlate only weakly with the diag-nosis.Area under the receiver operating characteristic(ROC)curve was from 0.51 to 0.78.The joint use of a number of visual signs has a greater diagnostic value than the use of the criteria individually.Area under the ROC curve using the developed cumulative criterion reached up to 0.87-0.89.This study could form the basis of a scoring system for assessing the state of the urethral tract using CP OCT images in real time.The CP OCT method provides information on the state of urethral tissues that cannot be obtained with traditional cystoscopy.

郑义侯教授从肝论治男性尿道综合征经验撷菁

介绍郑义侯教授从肝论治男性尿道综合征的经验。郑教授认为,男性尿道综合征多属“淋证-气淋”范畴,与肝关系密切,肝郁气滞、膀胱气化不利为其主要病机,临床上常见证型有肝郁气滞型、肝郁化火型、肝郁脾虚型及肝郁肾虚型。治疗以疏肝通淋为治则,以经验方逍遥通淋汤为基础方,加减化裁,配合心理疏导,疗效显著。并附验案一则。

重构本草——金钱草

通过对古籍文献调研、国内外中药现代研究进展及其研究成果的梳理,结合中医临床及中药学等学科领域内的专家学者的认识及应用经验,经问卷调查及多轮专家讨论,形成关于金钱草的以下意见:功效主要为利湿退黄,利尿通淋,解毒消肿。症靶为黄疸和尿道刺激征,标靶为胆囊结石、泌尿系结石、高转氨酶、胆汁反流。现代药理研究发现金钱草及其有效成分具有利胆排石、利尿排石、抗炎抗菌、保肝解毒等作用。本品凡阴疽诸毒,脾虚泄泻者,忌捣汁生服。过敏体质患者慎用。临床使用剂量为1~250 g,内服时当根据不同疾病,或同一疾病的不同阶段进行辨证使用,并积极探索金钱草用量与症靶、标靶的量效关系构建。

完全型Reiter综合征一例

Reiter综合征是以尿道炎、结膜炎和反应性关节炎三联征为主要表现的综合性疾病,临床上完全型典型病例较少见,现报道1例46岁男性患者,口腔外阴、黏膜糜烂伴眼结膜充血1周,后出现左足第一跖趾关节肿痛,伴轻微活动受限。皮肤科查体:双眼结膜充血,口腔、外阴糜烂渗出,左足第一跖趾关节肿胀,触压痛明显。辅助检查:HLA-B27(+),关节超声示左足第一跖趾关节低回声,考虑滑膜增生伴积液。诊断完全型Reiter综合征。

钟光辉从神论治女性尿道综合征经验介绍

介绍钟光辉教授从神论治女性尿道综合征的临床经验。尿道综合征以反复尿频、尿急、尿痛为典型表现,并伴有明显的情绪焦虑,但相关检查无异常。钟光辉教授认为,心神不安、失养是情志异常之根本,膀胱气化失司是尿路症状的关键,故治疗女性尿道综合征应首重调神,从神论治,确立解郁宁心以安神、清热利湿以定神、补益心脾以宁神、温补脾肾以养神的辨证安神之法,配合情绪疏导等综合调理,共同达到安心神而协助膀胱气化之效。

热奄包敷关元穴对围绝经期尿道综合征患者临床疗效的影响

目的探讨热奄包敷关元穴对围绝经期尿道综合征(US)的临床疗效。方法选取2021年1月—2022年11月收治的围绝经期US患者112例,以随机数字表法分为观察组和对照组(各56例),对照组口服酒石酸托特罗定片、谷维素,观察组增加热奄包敷关元穴治疗。评估患者中医症状评分、OABSS评分、WHOQOL-BREF评分、抑郁汉密尔顿(HAMD-17)评分,及临床疗效。结果治疗后观察组中医证候评分、OABSS评分、WHOQOL-BREF评分、HAMD-17评分改善程度皆优于对照组(P<0.01);观察组患者总有效率94.56%,高于对照组的82.14%(P<0.05)。结论常规西药治疗基础上热奄包敷关元穴治疗围绝经期US能改善患者中医症状、排尿症状和生活质量,提高临床疗效。

针灸治疗女性尿道综合征的尿动力学研究

女性尿道综合征180例,其中针灸治疗组128例,西药对照组52例。针灸治疗组近期有效率为90.6％,远期疗效为80.4％;西药对照组近期有效率为26.9％(P<0.01)。治疗后针灸治疗组最大尿流率平均升高4.6ml/s(P<0.001),平均尿流率升高3.lml/s(P<0.001),而西药对照组无明显变化(P>0.05)。对针灸治疗组69例和西药对照组39例进行了治疗前后排尿期最大膀胱压、最大腹压及膀胱颈部压力、最大尿道闭合压测定,治疗后针灸治疗组以上指标均明显下降,对照组未见明显变化。

萘哌地尔治疗女性尿道综合征的临床体会

目的:探讨萘哌地尔(Naftop id il)治疗女性尿道综合征的有效性和安全性。方法:38例患者采用自身对照试验,洗脱期1周,治疗期4周,应用萘哌地尔片25mg,每晚口服。以尿道综合征症状评分(FUSS)为主要疗效指标,以生活质量评分(QOL)为次要观察指标。结果:治疗2周后患者症状开始好转,4周后疗效显著。治疗前后的FUSS、QOL相比较,差异显示均有统计学意义(P<0.01及P<0.05),总有效率为76.31%。结论:萘哌地尔治疗女性尿道综合征有效、安全。

不同针刺方法对女性尿道综合征膀胱容量影响的临床观察

目的:对不同针刺方法对尿道综合征患者膀胱容量的影响进行客观评价。方法:将81例女性尿道综合征患者随机分为电针加手法针刺组、手法针刺组,采用膀胱容量以及最大尿流率等指标评价,并于1个疗程后进行疗效比较。结果:两组治疗后膀胱容量和最大尿流率与治疗前相比均有显著性差异(P<0.05),但电针加手法针刺组治疗后膀胱容量增量较手法针刺组显著(P<0.05),而最大尿流率变化两组之间无显著性差异(P>0.05)。结论:电针加手法针刺和手法针刺均可通过增加膀胱容量和尿流率而改善排尿状况。电针加手法针刺方法对膀胱功能的改善较手法针刺更显著。

三维超声在胎儿膀胱增大相关疾病诊断中的应用

目的探讨三维超声在产前诊断胎儿膀胱增大及相关疾病鉴别诊断中的应用价值。方法回顾性分析20胎经引产后尸体解剖或出生后随访证实膀胱增大的胎儿临床及声像图资料。结果 20胎中,8胎后尿道瓣膜,2胎尿道闭锁,7胎梅干腹综合征,1胎膀胱输尿管反流,1胎肛门闭锁、尿道下裂,1胎正常。膀胱增大胎儿超声均表现为下腹部巨大无回声区,不同原因所致膀胱增大的声像图表现各具特征。结论三维超声可清晰显示胎儿膀胱的解剖形态,有助于诊断膀胱增大相关疾病。