关元穴灸法结合间歇导尿对脊髓损伤后神经源性膀胱尿流动力学的影响

目的研究关元穴灸法结合间歇导尿对脊髓损伤后神经源性膀胱尿流动力学的影响。方法选择脊髓损伤后神经源性膀胱患者60例,随机分为观察组和对照组各30例。对照组根据患者膀胱容量及残余尿量进行无菌间歇导尿;观察组除无菌间歇导尿外还予关元穴灸法治疗,采用灸架悬灸关元穴,大约距皮肤2 cm,以皮肤轻微发红为度,每次1 h,每天1次,治疗4周为1个疗程。2组患者治疗前后行常规尿流动力学测定,包括平均膀胱容量（V H2O）、膀胱顺应性（BC）、膀胱压力（P ves）和逼尿肌压力（P det）等参数。结果2组治疗后V H2O和BC均较治疗前显著升高（P〈0.01）,且观察组改善作用优于对照组（P〈0.01或P〈0.05）;2组治疗后P ves和P det均较治疗前显著降低（P〈0.01）,且观察组改善作用优于对照组（P〈0.05）。结论关元穴灸法结合间歇导尿可以很好地改善脊髓损伤后神经源性膀胱的尿流动力学,使患者膀胱恢复有规律地储存和排出尿液的功能,从而提高患者的生活和生存质量。

Urodynamic influence of Guanyuan Moxibustion together with intermittent urethral catheterization on neurogenic bladder with spinal cord injury

Objective To study the urodynamic influence of Guanyuan Moxibustion together with intermittent urethral catheterization on neurogenic bladder with spinal cord injury. Methods 60 cases of neurogenic bladder with spinal cord injury （SCI） were randomly divided into observation group （30 cases） and control group （30 ca- ses）. The control group was treated with sterile intermittent catheterization according to the bladder capacity and re- sidual urine volume （RUV）. In addition to sterile intermittent catheterization, the observation group was also inter- vened with Guanyuan suspending moxibustion. The ignited moxa stick is pointed about 2 cm from Guanyuan for 1 h until the skin becomes reddish once daily for 4 weeks. The two groups were determined with routine urodynamies before and after treatment including the indexes of VH2O, BC, P Pdet Results In both groups, VH2o and BC were much higher while Pves and Pet, were much lower than that of before treatment （P〈0.01）. The improving function of observation group was superior to that of control group （P〈0.01 or P〈0.05 ）. Conclusion The thera- py of Guanyuan Moxibustion together with intermittent urethral catheterization benefits the patients＇ recovery of col- lecting and discharging urine regularly and improves the quality of life.