中医综合康复疗法治疗不完全性脊髓损伤后神经源性膀胱尿潴留的多中心临床随机对照试验

doi:10.13481/j.1671-587x.20190119

吉林大学学报(医学版) ›› 2019, Vol. 45 ›› Issue (01): 100-104.doi: 10.13481/j.1671-587x.20190119

• 临床研究 • 上一篇

中医综合康复疗法治疗不完全性脊髓损伤后神经源性膀胱尿潴留的多中心临床随机对照试验

边静¹, 张为民¹, 王宇峰², 丛德毓¹, 宋柏林¹

1. 长春中医药大学附属医院脑病康复科, 吉林长春 130033;
2. 长春中医药大学附属医院推拿科, 吉林长春 130033

收稿日期:2018-07-29 发布日期:2019-01-28
通讯作者: 王宇峰,副主任医师,硕士研究生导师(Tel:0431-81953713,E-mail:wangchn@126.com) E-mail:wangchn@126.com
作者简介:边静(1983-),女,吉林省公主岭市人,主治医师,医学硕士,主要从事神经系统疾病及吞咽障碍康复评估和治疗方面的研究。

Chinese medicine synthesis rehabilitation in treatment of neurogenic bladder urinary retention after incomplete spinal cord injury: A multicenter randomized controlled clinical trial

BIAN Jing¹, ZHANG Weimin¹, WANG Yufeng², CONG Deyu¹, SONG Bailin¹

1. Department of Encephalopathy Rehabilitation, Affiliated Hospital, Changchun University of Chinese Medicine, Changchun 130033, China;
2. Department of Tuina, Affiliated Hospital, Changchun University of Chinese Medicine, Changchun 130033, China

Received:2018-07-29 Published:2019-01-28
Contact: 国家科技部"十二五"科技支撑计划项目资助课题（2013BAI10B02） E-mail:wangchn@126.com

摘要/Abstract

摘要： 目的：探讨采用中医综合康复疗法治疗不完全性脊髓损伤后神经源性膀胱尿潴留的临床疗效，为该方案的临床推广提供依据。方法：采用中央区组随机方法将符合纳入标准的184例患者分为试验组（89例）和对照组（95例）。2组患者均予以间歇性导尿和膀胱功能训练，试验组患者同时予以电针（20 min/次，每天1次，每周6 d）和推拿（20 min/次，每天1次，每周6 d）治疗，2周1个疗程，共治疗4个疗程。检测2组患者治疗前后膀胱残余尿量、膀胱安全容量和膀胱内压，并进行疗效评估。结果：与治疗前比较，试验组患者治疗后膀胱残余尿量明显降低（P<0.01），膀胱安全容量明显升高（P<0.01），膀胱内压无明显变化（P>0.05）；对照组患者治疗后膀胱残余尿量明显降低（P<0.01），但膀胱安全容量和膀胱内压均无明显变化（P>0.05）。治疗后组间比较，试验组患者膀胱残余尿量明显少于对照组（P<0.01），2组患者膀胱安全容量和膀胱内压比较差异无统计学意义（P>0.05）。结论：中医综合康复治疗可有效减少不完全性脊髓损伤后神经源性膀胱尿潴留患者的膀胱残余尿量，且疗效明显优于间歇性导尿和膀胱功能训练的现代康复治疗。

关键词: 中医, 康复疗法, 脊髓损伤, 尿潴留, 多中心临床随机对照试验

Abstract: Objective: To discuss the curative effect of Chinese medicine synthesis rehabilitation in the treatment of neurogenic bladder dysfunction after incomplete spinal cord injury, and to provide the clinical evidences for its application.Methods: A total of 184 patients meeting the inclusion criteria were randonly divided into trial group (n=89) and control group (n=95) with central area group method. The patients in two groups were given the intermittent catheterization and the urinary functional training. The patients in trial group were treated by the electricity needle (20 min/time, one time a day, 6 d per week) and the massage (20 min/time, one time a day, 6 d per week). All patients in two groups were treated for 4 courses (2 weeks for a course). The residual urine volumes, the bladder securiey capacities,and the intravesical pressures of the patients in two groups were measured before and after treatment,and the curative effects were evaluated.Results: Compared with before treatment the residual urine volume of the patients in trial group was reduced significantly after treatment (P<0.01), the bladder security capacity was significantly increased (P<0.01), and there was no significant change in intravesical pressure (P>0.05); the residual urine volume of the patients in control group was reduced significantly after treatment (P<0.01), there were no significant changes in the bladder security capacity and intravesical pressure (P>0.05).After treatment, the residual urine volume of the patients in trial group was significantly lower than that in control group (P<0.01), while there were no significant differences in the bladder security capacities and intravesical pressures between two groups (P>0.05).Conclusion: Chinese medicine synthesis rehabilitation may reduce the residual urine volume of the patients with neurogenic bladder urinary retention after incomplete spinal cord injury, and its curative effect is superior to modern rehabilitation of intermittent catheterization and urinary bladder function training.

Key words: Chinese medicine, rehabilitation therapy, spinal cord injury, urinary retention, multicenter randomized controlled clinical trial

中图分类号:

R651.2

边静, 张为民, 王宇峰, 丛德毓, 宋柏林. 中医综合康复疗法治疗不完全性脊髓损伤后神经源性膀胱尿潴留的多中心临床随机对照试验[J]. 吉林大学学报(医学版), 2019, 45(01): 100-104.

BIAN Jing, ZHANG Weimin, WANG Yufeng, CONG Deyu, SONG Bailin. Chinese medicine synthesis rehabilitation in treatment of neurogenic bladder urinary retention after incomplete spinal cord injury: A multicenter randomized controlled clinical trial[J]. Journal of Jilin University(Medicine Edition), 2019, 45(01): 100-104.

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中医综合康复疗法治疗不完全性脊髓损伤后神经源性膀胱尿潴留的多中心临床随机对照试验

Chinese medicine synthesis rehabilitation in treatment of neurogenic bladder urinary retention after incomplete spinal cord injury: A multicenter randomized controlled clinical trial

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