【摘要】：目的：通過隨機對照研究,觀察燒山火針法與捻轉(zhuǎn)補法對脊髓損傷逼尿肌反射亢進患者尿動力學的改善差異,對比兩種治療方法對逼尿肌的抑制狀況,初步研究燒山火針法治療本病的機理,明確其臨床效果,為下一步臨床應用及實驗研究提供客觀依據(jù)。方法：將符合研究標準的56例脊髓損傷逼尿肌反射亢進患者,按隨機化原則分為試驗組與對照組,每組各28例患者。試驗組采用燒山火針法結(jié)合康復訓練,對照組采用捻轉(zhuǎn)補法結(jié)合康復訓練。每日治療1次,5天為1周期,每個周期休息2天,4周期為1個療程,共2個療程。分別在治療前、治療2個療程后對患者進行尿動力學檢查,觀察兩組各指標前后變化。結(jié)果：1、殘余尿量：組內(nèi)比較,試驗組與對照組治療后殘余尿量較本組治療前均明顯減少,差異具有統(tǒng)計學意義(P0.01)；組間比較,治療后試驗組與對照組殘余尿量差異無統(tǒng)計學意義(P0.05)。2、膀胱容量：組內(nèi)比較,試驗組與對照組治療后膀胱容量較本組治療前均明顯增加,差異具有統(tǒng)計學意義(P0.01)；組間比較,治療后試驗組膀胱容量大于對照組,差異具有統(tǒng)計學意義(P0.05)。3、24h平均漏尿次數(shù)：組內(nèi)比較,試驗組與對照組治療后漏尿次數(shù)較本組治療前均明顯減少,差異具有統(tǒng)計學意義(P0.01)；組間比較,治療后試驗組與對照組漏尿次數(shù)差異無統(tǒng)計學意義(P0.05)。4、24h平均排尿次數(shù)：組內(nèi)比較,試驗組與對照組治療后24h平均排尿次數(shù)較本組治療前均明顯減少,差異具有統(tǒng)計學意義(P0.01)；組間比較,治療后試驗組24h平均排尿次數(shù)明顯低于對照組,差異具有統(tǒng)計學意義(P0.01)。5、充盈期最大逼尿肌壓力：組內(nèi)比較,試驗組與對照組治療后充盈期最大逼尿肌壓力較本組治療前均明顯降低,差異具有統(tǒng)計學意義(P0.01)；組間比較,治療后試驗組與對照組間充盈期最大逼尿肌壓力差異無統(tǒng)計學意義(P0.05)。6、排尿期最大尿流率：組內(nèi)比較,試驗組與對照組治療后排尿期最大尿流率較本組治療前均明顯增加,差異具有統(tǒng)計學意義(P0.01)；組間比較,治療后試驗組排尿期最大尿流率大于對照組,差異具有統(tǒng)計學意義(P0.05)。7、最大尿流率時逼尿肌壓力：組內(nèi)比較,試驗組與對照組治療后最大尿流率時逼尿肌壓力與本組治療前差異均無統(tǒng)計學意義(P0.05)；組間比較,治療后試驗組與對照組間最大尿流率時逼尿肌壓力差異無統(tǒng)計學意義(P0.05)。結(jié)論：燒山火針法能抑制脊髓損傷逼尿肌反射亢進患者充盈期逼尿肌無抑制性收縮,降低逼尿肌壓力,但對排尿期逼尿肌收縮無明顯影響。
[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.
【學位授予單位】：成都中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.2

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