《中国康复理论与实践》 ›› 2016, Vol. 22 ›› Issue (12): 1438-1437.doi: 10.3969/j.issn.1006-9771.2016.12.016

• 临床研究 • 上一篇    下一篇

不同时期针刺对不完全性脊髓损伤患者盆底肌及排尿功能的影响

程瑞动,朱根应,叶祥明,李厥宝,周亮,闻万顺,田亮   

  1. 浙江省人民医院,浙江杭州市 310014。
  • 收稿日期:2016-07-26 出版日期:2016-12-25 发布日期:2017-01-15
  • 通讯作者: 叶祥明(1966-),男,汉族,主任医师,教授,主要研究方向:神经康复。E-mail: yexmdr@126.com。
  • 作者简介:程瑞动(1984-),男,汉族,山东临沂市人,硕士,主治医师,主要研究方向:神经损伤修复与再生。
  • 基金资助:
    1.浙江省中医药科技计划资助项目(No.2011ZA012);2.浙江省重点学科(神经康复学)。

Effects of Acupuncture in Different Stages on Pelvic Floor Muscles and Urinary Function in Patients with Spinal Cord Injury 

CHENG Rui-dong, ZHU Gen-ying, YE Xiang-ming, LI Jue-bao, ZHOU Liang, WEN Wan-shun, TIAN Liang   

  1. Department of Rehabilitation, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, China
  • Received:2016-07-26 Published:2016-12-25 Online:2017-01-15
  • Contact: YE Xiang-ming. E-mail: yexmdr@126.com

摘要: 目的 观察不同时期介入针刺治疗对不完全性脊髓损伤患者盆底肌功能及排尿功能的改善作用。方法 2012年3月~2015年3月,23例不完全性脊髓损伤患者分为对照组(n=8)、早期干预组(n=8)和晚期干预组(n=7)。对照组予常规康复治疗,干预组在此基础上予针刺双侧八髎、阳陵泉、三阴交、太冲。早期干预组拔除导尿管前1周即开始行针刺治疗,晚期干预组拔除导尿管后改间歇导尿并行针刺治疗。分别于治疗前及治疗后6周评估盆底肌肌力、排尿功能情况及生活质量改善情况。结果 治疗前,三组盆底肌肌力、排尿功能指标、生活质量评分均无显著性差异(P>0.05)。治疗后,早期干预组和晚期干预组盆底肌肌力较对照组提高(P<0.05);除对照组与晚期干预组间日排尿次数、安全压力下膀胱容量比较无显著性差异(P>0.05)外,三组间排尿功能指标两两比较均有显著性差异(P<0.05);三组生活质量评分均较前改善(F>0.864, P<0.05),但组间无显著性差异(F=1.558, P<0.05)。结论 针刺治疗能改善不完全性脊髓损伤患者盆底肌肌力,从而改善排尿功能,早期针刺干预疗效更明显。

关键词: 脊髓损伤, 针刺, 盆底肌, 排尿功能, 生活质量

Abstract: Objective To investigate the therapeutic effects of acupuncture on pelvic floor muscles and urinary function in patients with spinal cord injury.Methods From March, 2012 to March, 2015, 23 patients with spinal cord injury were divided into control group (n=8), early intervention group (n=8) and later intervention group (n=7). The control group received routine rehabilitation, the intervention groups received acupuncture at Baliao (BL-31, BL-32, BL-33 BL-34), Yanglingquan (GB-34), Sanyinjiao (SP-6) and Taichong (LR-3) acupoints in addition. The early intervention group was acupunctured one week before removal of catheter, and the later intervention group adopted intermittent catheterization after removal of catheter, and then received acupuncture. The pelvic floor muscles strength, the urine function and quality of life were recorded before and six weeks after intervention.Results There was no significant difference in all the indices before intervention (P>0.05). After intervention, the pelvic floor muscles strength improved in the intervention groups compared with the control group (P<0.05). There was significant difference in the mean frequency of urinary voiding, bladder capacity, time of establishing reflect urination and residual volume of urine after intervention among all the groups (P<0.05), except the mean frequency of urinary voiding and bladder capacity between the control group and the later intervention group (P>0.05). The quality of life improved in all the groups after intervention (F>0.864, P<0.05), however, no significant difference was found among three groups (F=1.558, P<0.05).Conclusion Acupuncture, especially early acupuncture, could improve the pelvic floor muscle strength and bladder function in spinal cord injury patients.

Key words: spinal cord injury, acupuncture, pelvic floor muscles, bladder function, quality of life

中图分类号: