摘要
目的:观察针刺联合盆底肌电刺激治疗不完全脊髓损伤术后膀胱功能障碍的临床疗效,及对患者体内血清P物质(SP)和降钙素基因相关肽(CGRP)水平的影响。方法:选取不完全脊髓损伤术后膀胱功能障碍患者82例,采用随机数字表法分为观察组和对照组各41例。对照组采用生物电刺激治疗仪予盆底肌电刺激治疗,观察组在对照组基础上予针刺治疗。2组均连续治疗4周。治疗后比较2组单次尿量和尿管留置时间、尿动力学参数及临床疗效,检测2组血清SP和CGRP水平。结果:观察组总有效率为95.12%,高于对照组的75.10%(P <0.05)。治疗后,观察组单次尿量多于对照组,尿管留置时间短于对照组,差异均有统计学意义(P <0.01)。治疗后,2组最大尿流量、最大尿意膀胱容量、最大尿率时逼尿肌压均较治疗前升高(P <0.01),残余尿量均较治疗前减少(P <0.01)。与对照组比较,观察组治疗后最大尿流量、最大尿意膀胱容量、最大尿率时逼尿肌压均上升更明显(P <0.01),残余尿量减少更多(P <0.01)。治疗后,2组血清SP和CGRP水平均较治疗前升高(P <0.01);观察组血清SP和CGRP水平均高于对照组(P <0.01)。结论:在盆底肌电刺激基础上加用针刺治疗不完全脊髓损伤术后膀胱功能障碍,可进一步改善患者的膀胱功能,提高SP和CGRP含量,提升治疗效果。
Objective：To observe the clinical effect of acupuncture combined with pelvic floor electrical stimulation for postoperative bladder dysfunction of incomplete spinal cord injury,and its effect on the levels of substance P（SP） and calcitonin gene-related peptide（CGRP） in serum of patients. Methods： Selected 82 cases of patients with postoperative bladder dysfunction of incomplete spinal cord injury,and divided them into the observation group and the control group randomly,41 cases in each group. The control group received pelvic floor electrical stimulation via bio-electric stimulation therapeutic apparatus, while the observation group additionally received acupuncture. The treatment for both groups lasted for 4 weeks. After treatment, compared the single urine volume, time of retaining urinary catheter,urodynamic parameters and the clinical effect in both groups, and detected the levels of SP and CGRP in serum of both groups. Results：The total effective rate was 95.12% in the observation group,being significantly higher than 75.10% in the control group（P〈0.05）. After treatment,the single urine volume of patients in the observation group was larger than that in the control group,and the time of retaining urinary catheter was shorter than that in the control group, differences being significant（P〈0.01）. After treatment,the maximal voiding volume,bladder volume at the strongest desire to urinate and maximal detrusor pressure at the maximal voiding rate in both groups were all increased when comparing with those before treatment（P〈0.01）, and the residual urine volume were smaller than that before treatment（P〈0.01）. Comparing with the control group,the maximal voiding volume,bladder volume at the strongest desire to urinate and maximal detrusor pressure at the maximal voiding rate in the observation group were increased more significantly（P〈0.01）,and the residual urine volume in the observation group was much smaller（P〈0.01）. After treatment,levels of SP and CGRP in serum of both groups were higher than those before treatment（P〈0.01）; levels of SP and CGRP in serum of the observation group were higher than those in the control group（P〈0.01）. Conclusion：The additional application of acupuncture based on pelvic floor electrical stimulation for postoperative bladder dysfunction of incomplete spinal cord injury can further improve the bladder function of patients and promote the content of SP and CGRP,thus to enhance the therapeutic effect.
作者
杨灵狄
潘军强
吕雪霞
王法明
毛平安
邓珉珍
YANG Lingdi;PAN Junqiang;LYU Xuexia;WANG Faming;MAO Ping＇an;DENG Minzhen
出处
《新中医》
CAS
2018年第10期162-165,共4页
New Chinese Medicine
