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

Abstract

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

CLC Number:

R651.2

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.

References

[1] RABADI M H,ASTON C. Complications and urologic risks of neurogenic bladder in veterans with traumatic spinal cord injury[J]. Spinal Cord, 2014, 53(3):200-203.
[2] FRANKEL H L,COLL J R,CHARLIFUE S W, et al. Long-term survival in spinal cord injury:a fifty year investigation[J]. Spinal Cord, 1998, 36(4):266-274.
[3] TAWEEL W A,SEYAM R. Neurogenic bladder in spinal cord injury patients[J]. Res Rep Urol, 2015, 7:85-99.
[4] EUROPEAN Association of Urology.Guidelines on Neuro-Urology(2015)[EB/OL].http://www.uroweb.org.
[5] 魏志坚,史仲举,姚雪,等.基于流行病学特征的脊髓损伤规范化诊疗体系的建立[J].中华创伤杂志,2017,33(8):675-679.
[6] 许明,张泓,刘继生,等.电针对完全性脊髓损伤后神经源性膀胱大鼠脊髓组织中Caspase-9、细胞色素C及凋亡蛋白酶激活因子-1表达的影响[J].中国康复理论与实践,2017,23(6):628-633.
[7] DEWALL L L,HEESAKKERS J P. Effectiveness of percutaneous tibial nerve stimulation in the treatment of overactive bladder syndrome[J]. Res Rep Urol, 2017, 9:145-157.
[8] LEONG R K,DE WACHTER S G,JOORE M A, et al. Cost-effectiveness analysis of sacral neuromodulation and botulinum toxin A treatment for patients with idiopathic overactive bladder[J]. BJU Int, 2012, 2012(4):159-160.
[9] BERTAPELLE M P, VOTTERO M,POPOLO G D, et al. Sacral neuromodulation and Botulinum toxin A for refractory idiopathic overactive bladder:a cost-utility analysis in the perspective of Italian Healthcare System[J]. World J Urol, 2015, 33(8):1109-1117.
[10] 李凝,吴艳,朱毅,等.SCI后神经源性膀胱针灸康复治疗现状及进展[J].中华全科医学,2010,8(4):490-491,504.
[11] 王彦彬,徐智慧,诸靖宇,等.骶3神经电针治疗脊髓损伤后逼尿肌反射亢进的临床效果[J].中国康复理论与实践,2014,20(3):224-225.
[12] 刘承梅,高玲莉,冯晓东,等.益元灸治疗不完全性脊髓损伤后膀胱功能障碍的临床研究[J].中国康复医学杂志,2017,32(10):1148-1151.
[13] 唐卫东.综合性传统康复疗法对脊髓损伤后神经源性膀胱的疗效分析[J].中医临床研究,2012,4(3):32-33.
[14] 李建军,王方永.脊髓损伤神经学分类国际标准(2011年修订)[J].中国康复理论与实践,2011,17(10):963-972.
[15] 国家中医药管理局.中医病症诊断疗效标准[S].中华人民共和国中医药行业标准ZY/T001.1~001:1994,9~94.
[16] 中国康复医学会康复护理专业委员会.神经源性膀胱护理指南(2011年版)[J]. 中华护理杂志,2011,46(1):104-108.
[17] 廖利民,吴娟,鞠彦合,等.脊髓损伤患者泌尿系管理与临床康复指南[J].中国康复理论与实践,2013,19(4):301-317.
[18] KENNELLY M J,ARENA K C,SHAFFER N, et al. Electrical Stimulation of the urethra evokes bladder contractions in a woman with spinal cord injury[J]. J Am Paraplegia Soc, 2010, 33(3):261-265.
[19] 郑利强,江琼,胡春蓉,等.电针对脊髓损伤后轴突再生影响的研究进展[J].中国康复理论与实践,2017,23(12):1380-1383.
[20] 朱毅,李凝,励建安,等.脊髓损伤后神经源性膀胱尿潴留的针刺康复临床研究[J].中华全科医学,2010,8(12):1495-1497.
[21] 林浩东,侯春林,郑宪友,等.大鼠脊髓损伤后膀胱生理反射弧重建的实验研究[J].中国修复重建外科杂志,2008,22(6):719-723.
[22] 侯春林,衷鸿宾,刘明轩,等.脊髓损伤后膀胱人工反射弧建立的实验研究[J].中国修复重建外科杂志,2000,14(1):10-13.

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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