1.甘肃中医药大学,甘肃省兰州市城关区定西东路35号,730000
2.甘肃省庆阳市中医医院
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收稿:2023-09-25,
修回:2023-11-05,
纸质出版:2024-01-17
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郭美燕,范乾,李艳等.肾气丸加减联合通督调神针刺辅助治疗脊髓损伤后神经源性膀胱肾阳虚证20例临床观察[J].中医杂志,2024,65(02):192-197.
GUO Meiyan,FAN Qian,LI Yan,et al.Clinical Study of Modified Shenqi Pill (肾气丸) Plus Tongdu Tiaoshen Acupuncture (通督调神针刺) for Neurogenic Bladder After Spinal Cord Injury of Kidney-Yang Deficiency Syndrome[J].Journal of Traditional Chinese Medicine,2024,65(02):192-197.
郭美燕,范乾,李艳等.肾气丸加减联合通督调神针刺辅助治疗脊髓损伤后神经源性膀胱肾阳虚证20例临床观察[J].中医杂志,2024,65(02):192-197. DOI: 10.13288/j.11-2166/r.2024.02.013.
GUO Meiyan,FAN Qian,LI Yan,et al.Clinical Study of Modified Shenqi Pill (肾气丸) Plus Tongdu Tiaoshen Acupuncture (通督调神针刺) for Neurogenic Bladder After Spinal Cord Injury of Kidney-Yang Deficiency Syndrome[J].Journal of Traditional Chinese Medicine,2024,65(02):192-197. DOI: 10.13288/j.11-2166/r.2024.02.013.
目的
2
观察肾气丸加减方口服联合通督调神针刺辅助治疗脊髓损伤后神经源性膀胱肾阳虚证的临床疗效。
方法
2
将46例患者随机分为对照组和治疗组各23例。两组患者均给予常规治疗,即口服甲钴胺片(每次0.5 mg、每日3次)和截瘫常规针刺治疗(每日1次、每周连续6日);对照组在常规治疗的基础上给予膀胱功能康复训练治疗;治疗组在对照组治疗的基础上给予口服肾气丸加减中药汤剂(每日1剂、早晚各150 ml温服)联合通督调神针刺(每日1次、每周连续6日),疗程均为4周。比较两组治疗前后的24 h排尿次数、24 h漏尿次数、24 h单次尿量、膀胱残余尿量、国际下尿路症状(LUTS)评分、中医证候积分,治疗后统计临床疗效、中医证候疗效。
结果
2
本研究最终纳入疗效分析治疗组和对照组患者各20例。与本组治疗前比较,两组治疗后24 h排尿次数、24 h漏尿次数、膀胱残余尿量、LUTS评分、中医证候积分均减少,24 h单次尿量增加(
P
<0.01);且治疗后治疗组各指标改善情况均优于对照组(
P
<0.05或
P
<0.01)。治疗组临床和中医证候总有效率均为85.00%(17例/20例),均高于对照组(临床总有效率为45.00%,9例/20例;中医证候总有效率为60.00%,12例/20例),差异有统计学意义(
P
<0.01)。
结论
2
肾气丸加减方口服联合通督调神针刺辅助治疗脊髓损伤后神经源性膀胱肾阳虚证能显著改善患者临床症状,疗效优于单纯膀胱功能康复训练,其作用机制可能与改善支配膀胱的受损神经功能有关。
Objective
2
To observe the clinical efficacy of modified
Shenqi Pill
(肾气丸) plus
Tongdu Tiaoshen Acupuncture
(通督调神针刺) in the treatment of neurogenic bladder after spinal cord injury of kidney-
yang
deficiency syndrome.
Methods
2
Forty-six patients were randomly divided into 23 cases each in the control group and the treatment group. Both groups were given conventional treatment, i.e. oral methylcobalamin tablets (0.5 mg each time, 3 times a day) and paraplegic conventional acupuncture (once a day, 6 consecutive days a week). The control group was given simple bladder function rehabilitation training on the basis of the conventional treatment; and the treatment group was given modified
Shenqi Pill
orally (1 dose a day, 150 ml each time, taken warmly in morning and evening) and
Tongdu Tiaoshen Acupuncture
(once a day, 6 consecutive days per week) in addition to what were given to the control group. The treatment course lasted for 4 weeks. The 24 h urination frequency, 24 h urine leakage frequency, 24 h single urine volume, bladder residual urine volume, international lower urinary tract symptom (LUTS) score, traditional Chinese medicine (TCM) syndrome score were compared between the two groups, and clinical effectiveness and TCM syndrome effectiveness were compared between the two groups after treatment.
Results
2
Twenty patients in each group were finally analyzed in this study. The number of 24 h urination, the number of 24 h urine leakage, bladder residual urine volume, LUTS score, and the TCM syndrome scores decreased after treatment in both groups, and the 24 h single urine volume increased (
P
<0.01); and much more improvement was found of each index in the treatment group than in the control group (
P
<0.05 or
P
<0.01). The total clinical effectiveness and TCM syndrome effectiveness in the treatment group was 85.00% (17/20) respectively, which were statistically significantly higher than 45.00% (the total clinical effectiveness, 9/20) and 60.00% (TCM syndrome effectiveness, 12/20) in the control group (
P
<0.01).
Conclusion
2
Modified
Shenqi Pill
plus
Tongdu Tiaoshen Acupuncture
can signi-ficantly improve the clinical symptoms of neurogenic bladder patients after spinal cord injury of kidney-
yang
deficiency syndrome, having better effectiveness than simple bladder function rehabilitation training, and its mechanism may be related to the improvement of the injured nerve function innervating the bladder.
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