本文選題：溫灸　切入點(diǎn)：糖尿病神經(jīng)源性膀胱　出處：《新疆醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:評(píng)價(jià)溫灸盒溫灸治療糖尿病神經(jīng)源性膀胱(腎氣不足、腎陽虧虛型)的臨床療效及安全性,為其臨床應(yīng)用提供具有一定參考價(jià)值的客觀依據(jù)。方法:采用隨機(jī)平行對(duì)照研究方法將63例腎氣不足、腎陽虧虛型DNB患者按隨機(jī)數(shù)字表法隨機(jī)分為治療組和對(duì)照組,兩組患者均予個(gè)體化基礎(chǔ)治療(糖尿病相關(guān)知識(shí)宣教,糖尿病飲食、運(yùn)動(dòng)指導(dǎo),藥物控制血糖、血脂等),對(duì)照組予口服甲鈷胺片(彌可保)0.5mg/次,每日3次;治療組在此基礎(chǔ)上予溫灸盒溫灸治療,療程4周。觀察患者治療前后的膀胱殘余尿量、中醫(yī)證候積分、美國泌尿科協(xié)會(huì)癥狀指數(shù)積分、HbA1c等指標(biāo)的變化情況,并對(duì)試驗(yàn)過程中呈現(xiàn)出的不良反應(yīng)作好相關(guān)記錄。結(jié)果:1、膀胱殘余尿量:兩組患者治療后的膀胱殘余尿量與治療前比較,均得到有效減少(P0.01),兩組間治療后膀胱殘余尿量比較,治療組的治療效果明顯比對(duì)照組更好(P0.01),提示溫灸盒溫灸聯(lián)合甲鈷胺治療在減少膀胱殘余尿量方面有較好療效。2、中醫(yī)證候積分:臨床研究提示,治療后兩組DNB患者的癥狀均有改善(P0.01),對(duì)兩組間治療后中醫(yī)證候積分進(jìn)行比較,治療組證候積分的減少程度比對(duì)照組鮮明(P0.05),提示溫灸盒溫灸聯(lián)合甲鈷胺治療在改善中醫(yī)癥狀方面有療效較好。3、美國泌尿科協(xié)會(huì)癥狀指數(shù)積分:治療后兩組DNB病患的排尿癥狀指數(shù)積分與治療前比較,均有降低(P0.01),但治療組的治療效果比對(duì)照組更好(P0.01),提示溫灸盒溫灸聯(lián)合甲鈷胺治療具有改善下尿路癥狀的作用。4、糖化血紅蛋白:兩組患者治療后HbA1c較治療前均有下降(P0.01),但兩組間比較無明顯差異(P0.05),提示基礎(chǔ)治療使血糖達(dá)標(biāo)后,溫灸及甲鈷胺治療對(duì)血糖的控制無明顯影響。5、安全性分析:研究觀察過程中,所納入研究的患者在治療前、后各項(xiàng)安全性指標(biāo)檢查結(jié)果均未出現(xiàn)明顯異常,治療過程中均未發(fā)生嚴(yán)峻不良反應(yīng)。結(jié)論:溫灸盒溫灸聯(lián)合甲鈷胺對(duì)腎氣不足、腎陽虧虛型DNB的治療效果優(yōu)于單純使用甲鈷胺治療,具有減少患者膀胱殘余尿量、改善中醫(yī)臨床癥狀、下尿路癥狀的作用,且方法簡便,安全性好,無明顯不良反應(yīng),價(jià)格低廉,能帶來一定的社會(huì)經(jīng)濟(jì)效益,值得臨床更深入的研究。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of warm moxibustion box in the treatment of diabetic neurogenic bladder (deficiency of kidney qi and deficiency of kidney yang). Methods: 63 DNB patients with deficiency of kidney qi and deficiency of kidney yang were randomly divided into treatment group and control group according to random digital table. Patients in both groups were given individualized basic treatment (diabetes related knowledge education, diabetes diet, exercise guidance, drug control of blood sugar, blood lipid, etc.) the control group was given oral mecopromazine 0.5 mg / time, 3 times a day; The treatment group was treated with warm moxibustion box with warm moxibustion for 4 weeks. The changes of bladder residual urine volume, TCM syndromes score and HbA1c index of the American Urology Association were observed before and after treatment. Results: the residual urinary volume of the two groups after treatment was significantly reduced compared with that before treatment, and the residual urinary volume of the two groups was compared with that of before treatment, and the residual urinary volume of the two groups after treatment was compared with that of the control group, and there was no significant difference in the residual urinary volume between the two groups. The therapeutic effect of the treatment group was obviously better than that of the control group, indicating that the warm moxibustion box combined with mecobalamin had a better curative effect on reducing the residual urinary volume of the bladder. After treatment, the symptoms of DNB patients in both groups were improved (P 0.01). The scores of TCM syndromes after treatment were compared between the two groups. The decrease of syndromes in the treatment group was higher than that in the control group (P 0.05), suggesting that the warm moxibustion box combined with mecobalamin had a better effect on improving the symptoms of traditional Chinese medicine. The American Urology Association symptom Index integral: after treatment, the two groups of DNB patients were treated with mild moxibustion box and mecobalamin. To compare the score of urinary symptom index with that before treatment, The results showed that the treatment of warm moxibustion box combined with mecobalamin could improve the symptoms of lower urinary tract. 4. Glycosylated hemoglobin: after treatment, HbA1c in both groups was lower than that before treatment. However, there was no significant difference between the two groups (P 0.05), suggesting that the basic treatment could make the blood sugar standard, but there was no significant difference between the two groups. Warm moxibustion and mecobalamin treatment had no significant effect on blood glucose control. Safety analysis: during the course of study, the safety indexes of the patients included in the study were not abnormal before and after treatment. Conclusion: the effect of warm moxibustion box combined with mecobalamin on renal qi deficiency and deficiency of kidney-yang type DNB is better than that of mecobalamin alone, and it can reduce the residual urine volume of bladder. It can improve the clinical symptoms of traditional Chinese medicine and lower urinary tract symptoms, and the method is simple, safe, no obvious adverse reactions, low price, can bring certain social and economic benefits, and is worthy of further clinical research.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246

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