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针刺联合艾灸疗法治疗创伤性脊髓损伤后神经源性膀胱和肠道功能障碍:一例报告。

Combined acupuncture and moxibustion therapy for the treatment of neurogenic bladder and bowel dysfunction following traumatic spinal cord injury: A case report.

作者信息

Zhong Ping, Zeng Hai, Huang Miaochun, Chen Ling, Fu Wenbin

机构信息

Department of Acupuncture and Moxibustion, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China.

College of Traditional Chinese Medicine, Jinan University, Guangzhou, China.

出版信息

Explore (NY). 2023 Jan-Feb;19(1):136-140. doi: 10.1016/j.explore.2021.11.009. Epub 2021 Nov 24.

Abstract

Neurogenic bladder and bowel are two critical autonomic complications following traumatic spinal cord injury (TSCI). Chronic lower urinary tract and bowel dysfunctions can lead to secondary complications, drastically affect the quality of life and significantly increase the risk of hospital readmission and mortality. Other than symptomatic treatments, a few effective therapies are available. Combined acupuncture and moxibustion therapy has positive effects on improving nerve repair and functional recovery in the early phases following TSCI. However, whether it is effective for TSCI-related chronic urinary and bowel dysfunctions remains unknown. This report presents the case of a 26-year-old male patient who experienced neurogenic bladder and bowel dysfunction following TSCI due to an accidental fall from height for more than 10 months and visited our department for combined acupuncture and moxibustion therapy. After 48 treatment sessions, he regained voluntary urination and defecation to a large extent. Urodynamic testing showed recovered bladder compliance and improved detrusor contractility. Symptom assessment with the Qualiveen Short-Form and neurogenic bowel dysfunction scores demonstrated reduced symptom severity. This case suggests that combined acupuncture and moxibustion therapy might help to restore the physiological functions of the lower urinary and digestive tracts following TSCI and might be a promising alternative for the treatment of neurogenic bladder and bowel dysfunction in patients with TSCI.

摘要

神经源性膀胱和肠道功能障碍是创伤性脊髓损伤(TSCI)后两种严重的自主神经并发症。慢性下尿路和肠道功能障碍可导致继发性并发症,严重影响生活质量,并显著增加再次入院和死亡风险。除了对症治疗外,目前仅有少数有效疗法。针刺联合艾灸疗法对改善TSCI早期神经修复和功能恢复具有积极作用。然而,其对TSCI相关慢性泌尿和肠道功能障碍是否有效尚不清楚。本报告介绍了一名26岁男性患者的病例,该患者因意外高处坠落导致TSCI后出现神经源性膀胱和肠道功能障碍超过10个月,前来我科接受针刺联合艾灸治疗。经过48次治疗后,他在很大程度上恢复了自主排尿和排便功能。尿动力学检查显示膀胱顺应性恢复,逼尿肌收缩力改善。采用简明健康状况量表(Qualiveen Short-Form)进行症状评估以及神经源性肠道功能障碍评分显示症状严重程度降低。该病例表明,针刺联合艾灸疗法可能有助于恢复TSCI后下尿路和消化道的生理功能,可能是治疗TSCI患者神经源性膀胱和肠道功能障碍的一种有前景的替代方法。

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