Zhang Hai-Tao, Nong Qiu-Ping, Wei Lin, Liang Xiao-Ning, Liang Yan-Piao, Jia Yan-Hua, Wei Ning-Yi
Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi University of Science and Technology, Liuzhou 545002, Guangxi Zhuang Autonomous Region, China.
Department of Rehabilitation Medicine, Hospital of Guangxi Liuzhou Iron and Steel (Group) Company, Liuzhou 545002, Guangxi Zhuang Autonomous Region.
Zhen Ci Yan Jiu. 2021 Nov 25;46(11):958-62. doi: 10.13702/j.1000-0607.20210690.
To investigate the effect of electroacupuncture combined with thunder-fire moxibustion on urodynamics in patients with neurogenic bladder (NB) after spinal cord injury(SCI).
A total of 60 patients with NB after SCI were divided into control group and observation group using a random number table, with 30 patients in each group. Bladder management protocol was performed for both groups. The patients in the control group were given electroacupuncture at Shangliao (BL31), Zhongliao (BL33), Xialiao (BL34), and Ciliao (BL32) at both sides, and those in the observation group were given thunder-fire moxibustion as mild-warm moxibustion at Yaoyangguan (GV3), Mingmen (CV4), Qihai (CV6), Guanyuan (CV4), and Zhongji (CV3) in addition to the treatment in the control group; electroacupuncture or moxibustion was performed for 20 min each time, once a day, with 10 times as one course of treatment, and both groups were treated for 3 courses. Number of times of voluntary urination, maximum single urine volume, and number of times of urethral catheterization were recorded at 3 d before and after treatment; maximum urinary flow rate during urination, maximum bladder capacity during urination, bladder pressure during the bladder filling period, and residual urine volume were recorded before and after treatment, and bladder compliance was calculated; clinical outcome was evaluated for both groups.
After treatment, both groups had significant reductions in the numbers of times of urination and urethral catheterization (<0.05) and a significant increase in maximum single urine volume (<0.05), and the observation group had significantly better results than the control group (<0.05). After treatment, both groups had significant reductions in residual urine volume and bladder pressure during the bladder filling period, and the observation group had significantly greater reductions than the control group (<0.05); both groups had significant increases in bladder compliance, maximum bladder capacity during urination, and maximum urinary flow rate during urination, and the observation group had significantly higher values than the control group (<0.05). The observation group had a significantly higher response rate than the control group [90.00% (27/30) vs 63.33% (19/30), <0.05].
Thunder-fire moxibustion combined with electroacupuncture can effectively improve bladder urodynamics and has a marked clinical effect in patients with NB after SCI.
探讨电针联合雷火灸对脊髓损伤(SCI)后神经源性膀胱(NB)患者尿动力学的影响。
将60例SCI后NB患者采用随机数字表法分为对照组和观察组,每组30例。两组均实施膀胱管理方案。对照组患者双侧上髎(BL31)、中髎(BL33)、下髎(BL34)、次髎(BL32)行电针治疗,观察组在对照组治疗基础上,于腰阳关(GV3)、命门(CV4)、气海(CV6)、关元(CV4)、中极(CV3)行雷火灸温和灸;电针或艾灸每次20分钟,每日1次,10次为1个疗程,两组均治疗3个疗程。记录治疗前后3天的自主排尿次数、最大单次尿量、导尿次数;记录治疗前后排尿期最大尿流率、排尿期最大膀胱容量、膀胱充盈期膀胱压力、残余尿量,并计算膀胱顺应性;评估两组临床疗效。
治疗后,两组排尿次数及导尿次数均显著减少(<0.05),最大单次尿量显著增加(<0.05),且观察组效果显著优于对照组(<0.05)。治疗后,两组残余尿量及膀胱充盈期膀胱压力均显著降低,且观察组降低幅度显著大于对照组(<0.05);两组膀胱顺应性、排尿期最大膀胱容量及排尿期最大尿流率均显著增加,且观察组数值显著高于对照组(<0.05)。观察组有效率显著高于对照组[90.00%(27/30)比63.33%(19/30),<0.05]。
雷火灸联合电针可有效改善膀胱尿动力学,对SCI后NB患者有显著临床疗效。