| 王晓红,周宁,王琴,黄晓夫.针灸治疗脊髓损伤后不同类型神经源性膀胱疗效观察[J].中国康复,2014,29(5):362-364 |
| 针灸治疗脊髓损伤后不同类型神经源性膀胱疗效观察 |
| Clinical outcomes of acupuncture for different types of neuropathic bladders following spinal cord injuries |
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| DOI： |
| 中文关键词: 针灸 脊髓损伤 逼尿肌反射亢进 逼尿肌无反射 |
| 英文关键词: acupuncture spinal cord injuries detrusor hyperreflexia detrusor areflexia |
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| 中文摘要: |
| 目的：观察针灸治疗脊髓损伤(SCI)后不同类型神经源性膀胱的疗效。方法：67例SCI患者根据神经源性膀胱的类型分为逼尿肌反射亢进组（A组）和逼尿肌无反射组（B 组），各组患者随机再分为2个亚组，即逼尿肌反射亢进组分为A1组和A2组，逼尿肌无反射组分为B1组和B2组。4组患者均根据膀胱功能制定间歇导尿计划，A1组和A2组采用盆底肌肉训练，B1和B2组采用Crede手法，A1组和B1组患者同时加用针灸治疗。治疗前和治疗后4周应用排尿记录、国际下尿道综合症状评分（LUTS）和尿流动力学分析进行疗效评估。结果：治疗4周后，A1、A2组患者残余尿量、最大逼尿肌压、24h排尿次数及LUTS评分均较治疗前有明显下降（P<0.05），且A1组较A2组下降更显著（P<0.05）；A1、A2组最大膀胱测压容积及最大尿流率均较治疗前有明显增加（P<0.05），且A1组较A2组提高更显著（P<0.05）。治疗后，B1、B2组残余尿量、最大膀胱测压容积及LUTS评分均较治疗前明显下降（P<0.05），且B1组更低于B2组（P<0.05）；B1、B2组最大逼尿肌压、最大尿流率、24h排尿次数均较治疗前明显提高（P<0.05），且B1组最大尿流率、24h排尿次数更高于B2组（P<0.05），B1、B2组最大逼尿肌压比较差异无统计学意义。结论：针灸能够更好改善SCI后神经源性膀胱的症状及尿流动力学结果。 |
| 英文摘要: |
| Objective:To observe therapeutic effects of acupuncture on different types of neuropathic bladder caused by spinal cord injuries.Methods:Sixty-seven patients after spinal cord injuries were assigned to detrusor hyperreflexia group (group A) and detrusor areflexia group (group B),and each group then randomized into two subgroups:A1 and A2,and B1 and B2.All patients accepted intermittent catheterizations according to bladder functions.At the same time,pelvic floor muscle training was given to patients in subgroups A1 and A2,and Crede's technique was given to patients in subgroups B1 and B2.In addition,patients in subgroups A1 and B1 were treated by acupuncture.All patients were assessed by urinary dairies,LUTS and urodynamics pre-treatment and 4 weeks post-treatment.Results:Four weeks after treatment,as compared with those pre-treatment,the urine residual,the maximum detrusor pressure,24-h urine frequency and LUTS scores were reduced significantly (P<0.05),and the maximum cystometric capacity,the maximum uroflow rate were increased greatly in groups A1 and A2 (P<0.05),more significantly in subgroup A1 than in subgroup A2 (P<0.05);The maximum detrusor pressure,the maximum uroflow rate,and 24-h urine frequency in subgroups B1 and B2 were significantly increased (P<0.05),and the maximum uroflow rate and 24-h urine frequency in subgroup B1 were increased as compared with those in subgroup B2 (P<0.05),but maximum detrusor pressure showed no significant difference between subgroups B1 and B2.Conclusion:Acupuncture could ameliorate symptoms of low urinary tracts in different types of neuropathic bladder. |
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