本文選題：中風(fēng)后尿失禁　切入點：縮泉丸　出處：《湖北中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:通過對尿失禁中醫(yī)理論的考究,結(jié)合本科多年來治療中風(fēng)后急迫性尿失禁的臨床經(jīng)驗,提出口服縮泉丸及深刺八毼、陰陵泉等穴輔以電刺激,同時配合關(guān)元電艾灸的治療方案。通過培本固元、縮尿止遺和補(bǔ)太少陰及束約太陽的方法,以期達(dá)到減少病患的尿失禁量和失禁次數(shù),促進(jìn)尿失禁程度恢復(fù)的目的;同時比較普通手法刺激與電刺激的療效差異,以期達(dá)到提高療效的目的。研究方法:選擇武漢市中醫(yī)醫(yī)院腦病科住院診斷為缺血性腦中風(fēng)后急迫性尿失禁的病患90名,使用數(shù)字表法隨機(jī)平均分為三組,均與本次研究的選入標(biāo)準(zhǔn)和剔除標(biāo)準(zhǔn)相合。治療一組采用口服縮泉丸化裁湯劑以及針刺八毼穴、雙腎俞、陰陵泉等穴,于雙側(cè)次毼穴、中毼穴分別任選兩穴加以電針,留針30分鐘,5次/周,同時使用電艾灸關(guān)元、中極兩穴,保持溫度約40℃左右,溫灸30分鐘,治療4周。治療二組治療取穴同治療一組,區(qū)別在于針刺得氣后次毼、中毼穴不接電針,施以傳統(tǒng)行針手法,行針約160次/分,每次行針角度180度-270度,間隔10分鐘行針一次,平補(bǔ)平瀉,艾灸操作同治療一組;并且不服用縮泉丸湯劑,同樣治療4周。對照組采用膀胱訓(xùn)練方法,讓病患自己進(jìn)行有意識的盆底肌收縮訓(xùn)練,收縮與放松肌肉各維持5~10秒,每日5-10次,每次5組,并且叮囑病患按時排尿,1.5小時排尿一次,時間逐漸延長,訓(xùn)練4周。以治療前后排尿量、尿失禁程度、臨床癥狀評分、病患滿意度為觀察指標(biāo),進(jìn)行治療前后比較,研討中藥配合針灸對缺血性腦中風(fēng)后小便失禁的臨床治療機(jī)理及療效。結(jié)果:(1)治療后治療一組恢復(fù)10例、明顯好轉(zhuǎn)12例、好轉(zhuǎn)6例、無好轉(zhuǎn)2例,總有效率為93.3%;治療二組恢復(fù)4例、明顯好轉(zhuǎn)10例、好轉(zhuǎn)8例、無好轉(zhuǎn)8例,總有效率為73.3%,膀胱訓(xùn)練組恢復(fù)1例、明顯好轉(zhuǎn)6例、好轉(zhuǎn)11例、無好轉(zhuǎn)12例,總有效率為60.0%。(2)治療一組治療中風(fēng)后小便失禁臨床癥狀評分明顯高于治療二組和膀胱訓(xùn)練組[1.30±1.02、1.90±1.06、2.20±1.03]。(3)治療一組與治療二組治療中風(fēng)后尿失禁臨床癥狀評分比較有明顯優(yōu)勢[1.30±1.02、1.90±1.06]。(4)治療后治療一組與治療二組和對照組病患滿意度對比具有明顯優(yōu)勢[2.20±0.92、1.73±0.94、1.23±0.85]。(5)經(jīng)治療治療一組對小便失禁程度分級影響明顯優(yōu)于治療二組、膀胱訓(xùn)練組[P0.05]。(6)經(jīng)治療治療一組病患均次排尿量及日均排尿次數(shù)明顯優(yōu)于治療二組和對照組。結(jié)論:縮泉丸配合普通針刺及艾灸治療缺血性腦中風(fēng)后尿失禁較膀胱訓(xùn)練效果明顯,并且針灸中輔以電針治療較傳統(tǒng)行針手法治療效果較佳,中藥及針灸聯(lián)合診治能夠明顯改善病患小便失禁癥狀和生活品質(zhì)。
[Abstract]:Objective: Based on the theory of traditional Chinese medicine for urinary incontinence is exquisite, combined with years of clinical experience in the treatment of urinary incontinence after stroke, the oral suoquanwan and deep needling eight He, yinlingquan acupoints combined with electrical stimulation, at the same time with the treatment of electric moxibustion Guanyuan. Through the training of the solid element, polyuria bushenzhiyi and too little about the sun Yin and beam method, in order to reduce the patient's urinary incontinence and incontinence, promote the degree of urinary incontinence recovery purposes; at the same time, compare the curative effect of manipulation stimulation and electrical stimulation of the common difference, in order to achieve the purpose to improve the efficacy. Research methods: encephalopathy Department of Wuhan Hospital of traditional Chinese medicine for the diagnosis of ischemic stroke after incontinence patient 90, using randomly divided into three groups, and the study inclusion criteria and exclusion criteria. A consistent treatment group with oral administration of suoquanwan Decoction to cut 鍙?qiáng)閽堝埡鍏绌?鍙岃偩淇，

本文編號：1722490