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武汉市中医医院脑病科
纸质出版日期:2019
移动端阅览
张京兰, 杨晶, 王翠, 等. 梅花针叩刺联合艾灸治疗卒中后神经源性膀胱的临床观察[J]. 针刺研究, 2019,44(5):363-366.
ZHANG Jing-lan, YANG Jing, WANG Cui, et al. Clinical trials of treatment of post-stroke neurogenic bladder by plum-blossom needle tapping plus moxibustion[J]. Acupuncture research, 2019, 44(5): 363-366.
张京兰, 杨晶, 王翠, 等. 梅花针叩刺联合艾灸治疗卒中后神经源性膀胱的临床观察[J]. 针刺研究, 2019,44(5):363-366. DOI: 10.13702/j.1000-0607.180155.
ZHANG Jing-lan, YANG Jing, WANG Cui, et al. Clinical trials of treatment of post-stroke neurogenic bladder by plum-blossom needle tapping plus moxibustion[J]. Acupuncture research, 2019, 44(5): 363-366. DOI: 10.13702/j.1000-0607.180155.
目的:观察梅花针叩刺联合艾灸治疗卒中后神经源性膀胱(PSNB)的临床疗效。方法:将60例PSNB患者随机分为治疗组和对照组
每组30例。治疗组采用梅花针循经叩刺联合艾灸任脉+间歇导尿治疗
具体操作方法为患者先俯卧位
取软柄梅花针叩刺足太阳膀胱经之肾俞、气海俞、关元俞、小肠俞、膀胱俞、会阳、八髎等穴位
左右膀胱经交替叩刺。梅花针治疗完毕后
患者转为平卧位
暴露剑突至耻骨联合之间的皮肤
艾灸任脉的神阙、关元、气海、中极等穴位
每处灸3~5min
每天1次
每周5次。对照组采用盆底肌肉锻炼+间歇导尿治疗
每天3次
每周7次。两组均治疗2个月。比较两组患者治疗前后症状积分、残余尿量、排尿次数、漏尿次数、排尿量及疗效。结果:治疗组总有效率优于对照组(P<0.05)。与治疗前比较
两组治疗后症状均有好转、症状积分减少
且治疗组改善优于对照组(P<0.05);两组治疗后残余尿量、排尿次数、漏尿次数均减少
排尿量均增加
且治疗组改善优于对照组(P<0.05)。结论:梅花针叩刺联合艾灸治疗PSNB疗效较好
安全性高
可操作性强
便于基层推广。
Objective To observe the therapeutic effect of plum-blossom needle tapping plus moxibustion in the treatment of post-stroke neurogenic bladder(PSNB).Methods A total of 60 PSNB patients were equally randomized into control group(16 men and 14 women
65.6±7.9 years in age
10.1±6.3 months in the duration of disease)and treatment group(18 men and 12 women
63.8±8.5 years in age
9.8±6.5 months in the duration of disease).Patients of the control group were treated by asking the patients to make a pelvic muscular exercise and passive intermittent urethral catheterization.For patients of the treatment group
aplum-blossom needle was used to alternatively tap the bilateral Shenshu(BL23)
Qihaishu(BL24)
Guanyuanshu(BL26)
Xiaochangshu(BL27)
Pangguangshu(BL28)
Huiyang(BL35)
Shangliao(BL31)
etc.
followed by performing moxibustion over the skin of Shenque(CV8)
Guanyuan(CV4)
Qihai(CV6)and Zhongji(CV3)
etc.about 15 min.In addition
patients without spontaneous urination were also received urethral catheterization as those in the control group.The treatment was given once every day except the weekends and for two months.The integrated symptom score was assessed.The frequencies of diurnal urination and urinary incontinence
and the urination volume every time were respectively recorded for consecutive 3 days before and after the treatment
and the residual urine volume was also measured.The therapeutic effect was evaluated based on the status and frequency of diurnal urination and residual urine volume each time.Results Of the two 30 cases in the control and treatment groups
2(6.7%)and 5(16.7%)were cured
8(26.7%)and 12(40.0%)experienced marked improvement in their symptoms
13(43.3%)and 11(36.7%)were improved
7(23.3%)and 2(6.7%)failed
with the effective rates being 76.7% and 93.3%
respectively.The effective rate of the treatment group was significantly higher than that of the control group(P<0.05).After the treatment
the integrated symptom score
residual urine volume
and frequencies of diurnal urination and urinary incontinence were significantly decreased
and the diurnal urination volume was obviously increased in comparison with their own pre-treatment in both groups(all P<0.05). The therapeutic effect of the treatment group was significantly superior to that of the control group in reducing the integrated symptom score
residual urine volume
and frequencies of diurnal urination and urinary incontinence(P<0.05)
and in increasing the diurnal urination volume(P<0.05).Conclusion Plum-blossom needle tapping plus moxibustion is an effective option for the treatment of PSNB in improving symptoms
in reducing the residual urine volume and frequencies of diurnal urination and urinary incontinence
and in increasing the diurnal urination volume
deserving being promoted in primary care.
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