Meng Zhaoxiang, Wang Tong, Yin Zhenglu, Wang Jibing
Zhongguo Zhen Jiu. 2015 Jan;35(1):17-20.
To evaluate the clinical efficacy of electroacupuncture (EA) combined with transperineal injection of botulinum toxin-A (BTX-A) on neurogenic bladder caused by spinal cord injury.
One day af ter surgery, 35 cases of spinal cord injury accompanied with neurogenic bladder were randomly divided into a BTX-A plus EA group (20 cases, group A) and a BTX-A group (15 cases, group B). The two groups were both treated with regular rehabilitation training of bladder function and injection of 200 IU (4 ml) BTX-A through perineum external urethral sphincter; the group A was additionally treated with EA at Zhongji (CV 3), Guanyuan (CV 4), Shenshu (3BL 23), Huiyang (BL 35) and Baliao (Shangliao (BL 31), Ciliao (BL 32), Zhongliao (BL 33), Xialiao (BL 34)), once a day, 40 min per treatment. The treatment was given 6 times per week for 4 weeks. The urination status in two groups before and after treatment was observed, and urodynamics examination and urethral pressure test were also made.
After 4-week treatment, mean times of urinary incontinence, mean urethral catheter output, pressure of bladder and volume of urinary incontinence were all improved in two groups (all P<0.05), which were more significant in the group A (all P<0.05). The residual urine, maximum bladder capacity, maximum urethral closure pressure and maximum urine flow rate were all improved in two groups after treatment (all P<0.01); the improvement of residual urine, maximum bladder capacity, maximum urethral closure pressure in the group A was more significant than that in the group B (all P<0.05).
Electroacupuncture com bined with transperineal injection of BTX-A could effectively improve the urination dysfunction in patients with neurogenic bladder after spinal cord injury.
评估电针（EA）联合经会阴注射A型肉毒毒素（BTX-A）治疗脊髓损伤所致神经源性膀胱的临床疗效。
术后1天，将35例脊髓损伤伴神经源性膀胱患者随机分为BTX-A加电针组（20例，A组）和BTX-A组（15例，B组）。两组均接受膀胱功能常规康复训练，并经会阴外尿道括约肌注射200 IU（4 ml）BTX-A；A组加用电针针刺中极（CV 3）、关元（CV 4）、肾俞（BL 23）、会阳（BL 35）和八髎（上髎（BL 31）、次髎（BL 32）、中髎（BL 33）、下髎（BL 34）），每日1次，每次40分钟。每周治疗6次，共4周。观察两组治疗前后的排尿情况，并进行尿动力学检查和尿道压力测试。
治疗4周后，两组患者的平均尿失禁次数、平均导尿量、膀胱压力和尿失禁量均有所改善（均P<0.05），A组改善更显著（均P<0.05）。两组治疗后残余尿量、最大膀胱容量、最大尿道闭合压和最大尿流率均有所改善（均P<0.01）；A组残余尿量、最大膀胱容量、最大尿道闭合压的改善程度优于B组（均P<0.05）。
电针联合经会阴注射BTX-A可有效改善脊髓损伤后神经源性膀胱患者的排尿功能障碍。
