烧山火针法对脊髓损伤逼尿肌反射亢进尿动力学的影响
发布时间：2019-01-07 16:52
【摘要】：目的：通过随机对照研究,观察烧山火针法与捻转补法对脊髓损伤逼尿肌反射亢进患者尿动力学的改善差异,对比两种治疗方法对逼尿肌的抑制状况,初步研究烧山火针法治疗本病的机理,明确其临床效果,为下一步临床应用及实验研究提供客观依据。方法：将符合研究标准的56例脊髓损伤逼尿肌反射亢进患者,按随机化原则分为试验组与对照组,每组各28例患者。试验组采用烧山火针法结合康复训练,对照组采用捻转补法结合康复训练。每日治疗1次,5天为1周期,每个周期休息2天,4周期为1个疗程,共2个疗程。分别在治疗前、治疗2个疗程后对患者进行尿动力学检查,观察两组各指标前后变化。结果：1、残余尿量：组内比较,试验组与对照组治疗后残余尿量较本组治疗前均明显减少,差异具有统计学意义(P0.01)；组间比较,治疗后试验组与对照组残余尿量差异无统计学意义(P0.05)。2、膀胱容量：组内比较,试验组与对照组治疗后膀胱容量较本组治疗前均明显增加,差异具有统计学意义(P0.01)；组间比较,治疗后试验组膀胱容量大于对照组,差异具有统计学意义(P0.05)。3、24h平均漏尿次数：组内比较,试验组与对照组治疗后漏尿次数较本组治疗前均明显减少,差异具有统计学意义(P0.01)；组间比较,治疗后试验组与对照组漏尿次数差异无统计学意义(P0.05)。4、24h平均排尿次数：组内比较,试验组与对照组治疗后24h平均排尿次数较本组治疗前均明显减少,差异具有统计学意义(P0.01)；组间比较,治疗后试验组24h平均排尿次数明显低于对照组,差异具有统计学意义(P0.01)。5、充盈期最大逼尿肌压力：组内比较,试验组与对照组治疗后充盈期最大逼尿肌压力较本组治疗前均明显降低,差异具有统计学意义(P0.01)；组间比较,治疗后试验组与对照组间充盈期最大逼尿肌压力差异无统计学意义(P0.05)。6、排尿期最大尿流率：组内比较,试验组与对照组治疗后排尿期最大尿流率较本组治疗前均明显增加,差异具有统计学意义(P0.01)；组间比较,治疗后试验组排尿期最大尿流率大于对照组,差异具有统计学意义(P0.05)。7、最大尿流率时逼尿肌压力：组内比较,试验组与对照组治疗后最大尿流率时逼尿肌压力与本组治疗前差异均无统计学意义(P0.05)；组间比较,治疗后试验组与对照组间最大尿流率时逼尿肌压力差异无统计学意义(P0.05)。结论：烧山火针法能抑制脊髓损伤逼尿肌反射亢进患者充盈期逼尿肌无抑制性收缩,降低逼尿肌压力,但对排尿期逼尿肌收缩无明显影响。
[Abstract]:Objective: to observe the improvement of urodynamics in patients with detrusor hyperreflexia after spinal cord injury (sci), and to compare the inhibition of detrusor by the two treatment methods. To study the mechanism of burning mountain fire acupuncture to treat this disease, to clarify its clinical effect, and to provide the objective basis for clinical application and experimental research in the next step. Methods: 56 cases of detrusor hyperreflexia with spinal cord injury were randomly divided into experimental group and control group with 28 cases in each group. The experimental group was treated with burn fire acupuncture combined with rehabilitation training, while the control group with twisting and reinforcing method combined with rehabilitation training. Once a day, 5 days for a cycle, each cycle for 2 days, 4 cycles for a course of treatment, a total of 2 courses. Before and after two courses of treatment, the patients were examined with urodynamics, and the changes of each index before and after treatment were observed. Results: 1, residual urine volume: compared with the control group, the residual urine volume in the experimental group and the control group were significantly decreased after treatment, the difference was statistically significant (P0.01). There was no significant difference in residual urine volume between the experimental group and the control group after treatment (P0.05). 2. Bladder capacity: compared with the control group, the bladder volume in the test group and the control group was significantly increased after treatment. The difference was statistically significant (P0.01). After treatment, the bladder volume in the experimental group was larger than that in the control group, and the difference was statistically significant (P0.05). The mean number of urinary leakage within 24 hours after treatment in the trial group and the control group was significantly lower than that in the control group after treatment (P0.05), and the number of urinary leakage in the control group was significantly lower than that in the control group after treatment. The difference was statistically significant (P0.01). There was no significant difference in the frequency of urine leakage between the experimental group and the control group after treatment (P0.05). The difference was statistically significant (P0.01). The mean urination times in the experimental group were significantly lower than those in the control group after treatment (P0.01). The maximal detrusor pressure during filling period was significantly lower in the experimental group than in the control group (P0.01). The maximal detrusor pressure of the experimental group and the control group was significantly lower than that of the control group (P0.01). There was no significant difference in maximal detrusor pressure between the experimental group and the control group after treatment (P0.05). The maximum urinary flow rate in the treatment group and the control group was significantly higher than that before the treatment (P0.01). After treatment, the maximal urinary flow rate in the experimental group was higher than that in the control group, the difference was statistically significant (P0.05), and the detrusor pressure at the maximum uroflow rate was higher than that in the control group. There was no significant difference in detrusor pressure between the experimental group and the control group before treatment (P0.05). There was no significant difference in detrusor pressure between the experimental group and the control group after treatment (P0.05). Conclusion: burning mountain fire acupuncture can inhibit detrusor contraction and detrusor pressure during filling period in patients with detrusor hyperreflexia after spinal cord injury, but it has no obvious effect on detrusor contraction in micturition.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.2
[Abstract]:Objective: to observe the improvement of urodynamics in patients with detrusor hyperreflexia after spinal cord injury (sci), and to compare the inhibition of detrusor by the two treatment methods. To study the mechanism of burning mountain fire acupuncture to treat this disease, to clarify its clinical effect, and to provide the objective basis for clinical application and experimental research in the next step. Methods: 56 cases of detrusor hyperreflexia with spinal cord injury were randomly divided into experimental group and control group with 28 cases in each group. The experimental group was treated with burn fire acupuncture combined with rehabilitation training, while the control group with twisting and reinforcing method combined with rehabilitation training. Once a day, 5 days for a cycle, each cycle for 2 days, 4 cycles for a course of treatment, a total of 2 courses. Before and after two courses of treatment, the patients were examined with urodynamics, and the changes of each index before and after treatment were observed. Results: 1, residual urine volume: compared with the control group, the residual urine volume in the experimental group and the control group were significantly decreased after treatment, the difference was statistically significant (P0.01). There was no significant difference in residual urine volume between the experimental group and the control group after treatment (P0.05). 2. Bladder capacity: compared with the control group, the bladder volume in the test group and the control group was significantly increased after treatment. The difference was statistically significant (P0.01). After treatment, the bladder volume in the experimental group was larger than that in the control group, and the difference was statistically significant (P0.05). The mean number of urinary leakage within 24 hours after treatment in the trial group and the control group was significantly lower than that in the control group after treatment (P0.05), and the number of urinary leakage in the control group was significantly lower than that in the control group after treatment. The difference was statistically significant (P0.01). There was no significant difference in the frequency of urine leakage between the experimental group and the control group after treatment (P0.05). The difference was statistically significant (P0.01). The mean urination times in the experimental group were significantly lower than those in the control group after treatment (P0.01). The maximal detrusor pressure during filling period was significantly lower in the experimental group than in the control group (P0.01). The maximal detrusor pressure of the experimental group and the control group was significantly lower than that of the control group (P0.01). There was no significant difference in maximal detrusor pressure between the experimental group and the control group after treatment (P0.05). The maximum urinary flow rate in the treatment group and the control group was significantly higher than that before the treatment (P0.01). After treatment, the maximal urinary flow rate in the experimental group was higher than that in the control group, the difference was statistically significant (P0.05), and the detrusor pressure at the maximum uroflow rate was higher than that in the control group. There was no significant difference in detrusor pressure between the experimental group and the control group before treatment (P0.05). There was no significant difference in detrusor pressure between the experimental group and the control group after treatment (P0.05). Conclusion: burning mountain fire acupuncture can inhibit detrusor contraction and detrusor pressure during filling period in patients with detrusor hyperreflexia after spinal cord injury, but it has no obvious effect on detrusor contraction in micturition.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.2
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