| 薛霞,李宽,马黎飞,王岫,王春方,孙长城,张颖.基于3D高分辨肛门直肠测压研究针刺对脊髓损伤神经源性肠道的疗效[J].中国康复,2020,35(1):35-38 |
| 基于3D高分辨肛门直肠测压研究针刺对脊髓损伤神经源性肠道的疗效 |
| Clinical effect of acupuncture on neurogenic bowel dysfunction after spinal cord injury based on 3D high-resolution anorectal manometry |
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| DOI： |
| 中文关键词: 针刺 脊髓损伤 神经源性肠道 3D高分辨肛门直肠测压 |
| 英文关键词: acupuncture spinal cord injury neurogenic intestinal dysfunction 3D high-resolution anorectal manometry |
| 基金项目:天津市卫生计生委中医中西医结合课题（2017058） |
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| 中文摘要: |
| 目的：利用3D高分辨肛门直肠测压（3D HR-ARM）观察针刺联合常规康复治疗对脊髓损伤后神经源性肠道（NBD）的疗效。方法：选取外伤致脊髓损伤术后神经源性肠道患者40例，随机分为对照组与研究组各20例，对照组予常规康复治疗，进行肠道功能训练，研究组在此基础上再配合针刺治疗，应用3D HR-ARM、美国脊柱损伤协会（ASIA）评分、神经源性肠道功能障碍（NBD）评分、Barthel指数（BI）对患者进行评定。结果：治疗后，2组肛门括约肌收缩压、直肠压力、直肠肛管压力差、Barthel指数（BI）评分、美国脊柱损伤协会（ASIA）评分较治疗前均明显提高（均P<0.05），便意阈值、神经源性肠道（NBD）评分较治疗前均明显下降（均P<0.05），静息压、高压带长度治疗前后差异无统计学意义，其中，研究组肛门括约肌收缩压、直肠压力、直肠肛管压力差、便意阈值较对照组差异均有统计学意义（均P<0.05）。Pearson相关性分析结果显示：肛门括约肌收缩压、BI评分与ASIA评分成正相关（P<0.05），便意阈值、NBD评分与ASIA评分成负相关（P<0.05）。结论：针刺联合常规康复治疗能更有效地改善脊髓损伤后神经源性肠道功能，3D高分辨肛门直肠测压结果与量表评定具相关性，有望成为神经源性肠道疗效的客观评价指标。 |
| 英文摘要: |
| Objective: To observe the clinical effect of acupuncture on neurogenic bowel dysfunction (NBD) after spinal cord injury based on 3D high-resolution anorectal manometry (3D HR-ARM). Methods: Forty patients with traumatic spinal cord injury in Tianjin Union Medicine Centre were selected and divided into control group and research group randomly. The control group received conventional rehabilitation therapy, and the research group received acupuncture combined with conventional rehabilitation therapy. The patients were assessed by 3D HR ARM, American Spine Injury Association (ASIA) scale, NBD scale and Barthel index (BI). Results: After treatment, the anal sphincter systolic pressure, rectal pressure, rectoanal pressure differential, BI and ASIA scores in the research group and the control group were significantly higher (P<0.05), and the threshold value and NBD score were significantly lower (P<0.05) than those before treatment. There was no significant difference in the resting pressure and high pressure bend length before and after treatment. Among them, there were significant differences in the anal sphincter systolic pressure, rectal pressure, rectoanal pressure differential and the threshold value between two groups (P<0.05). Pearson correlation analysis showed that the anal sphincter systolic pressure and BI score were positively correlated with ASIA score (P<0.05), while threshold value and NBD score were negatively correlated with ASIA score (P<0.05). Conclusions: Acupuncture combined with conventional rehabilitation therapy can improve the intestinal function of patients more effectively. The 3D HR-ARM results are correlated with the score evaluation, which is expected to be an objective evaluation index of neurogenic intestinal efficacy. |
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