论著
目的 探究益气活血汤剂联合热敏灸在脊髓损伤(SCI)后尿潴留患者中的应用效果。方法 选取2019年7月—2021年7月我院SCI后尿潴留患者80例,根据治疗方案不同分为观察组、对照组,各40例。对照组给予益气活血汤剂,观察组在此基础上进行热敏灸治疗。观察2组疗效、治疗前后排尿情况、膀胱功能、尿动力学指标[膀胱容量(VH2O)、膀胱顺应(BC)、逼尿肌压力(Pdet)、膀胱压力(Pves)、平均尿流速(Qave)]及不良事件发生率。结果 观察组总有效率92.50%高于对照组70.73%(P<0.05);治疗后观察组膀胱功能积分、平均排尿次数、平均漏尿次数、平均尿量、残余尿量均低于对照组(P<0.05);治疗后与对照组相比,观察组Pves较低,VH2O、Pdet、Qave、BC较高(P<0.05);观察组不良事件率2.50%与对照组5.00%相比,无差异(P>0.05)。结论 热敏灸联合益气活血汤剂治疗SCI尿潴留患者效果确切,可改善患者排尿异常症状,促进膀胱功能恢复,且安全可靠。
Objective To explore the effect of Yiqi Huoxue Decoction combined with heat sensitive moxibustion in patients with urinary retention after spinal cord injury (SCI). Methods From July 2019 to July 2021, 80 patients with urinary retention after SCI in our hospital were selected and divided into observation group and control group according to different treatment plans, 40 cases in each group. The control group was given Yiqi Huoxue decoction, and the observation group was treated with heat sensitive moxibustion additionally. Efficacy, urination before and after treatment, bladder function, urodynamic indexes [bladder volume (VH2O), bladder compliance (BC), pressure of detrusor (Pdet), pressure of vesical (Pves), average flow rate (Qave)] and incidence of adverse events in 2 groups were observed. Results The total effective rate of observation group was 92.50%, higher than that of control group (70.73%, P<0.05). After treatment, bladder function score, average times of urination, average times of urine leakage, average urine volume and residual urine volume in the observation group were lower than those in the control group (P<0.05). After treatment, compared with the control group, the observation group had lower Pves, higher VH2O, Pdet, Qave and BC (P<0.05). The adverse event rate of the observation group (2.50%) was not significantly different from control group (5.00%, P>0.05). Conclusions Heat sensitive moxibustion combined with Yiqi Huoxue decoction is effective in the treatment of SCI patients with urinary retention, which can improve the symptoms of abnormal urination and promote the recovery of bladder function, and is safe and reliable.
临床诊疗
目的 对比热敏灸联合“合谷刺法”与温灸针“合谷刺法”治疗肩周炎的疗效。方法 2015年7月—2017年1月,筛选康复科收治的慢性肩周炎患者120例,按照随机数字表达法分组,对照1组、对照组2组、观察组各入选40例。对照1组采取温针灸“合谷刺法”,对照2组采取传统取穴针刺疗法,观察组热敏灸联合“合谷刺法”。对比3组疗效,治疗前后肩关节功能ASES量表(American Shoulder and Elbow Surgeons shoulder index)、VAS肩关节疼痛评分、肩关节活动度。结果 3组均未见退出例。观察组愈显率82.5%高于对照1组50.0%、对照组2组55.0%,差异有统计学意义(P<0.05),观察组整体疗效与对照2组差异无统计学意义(P>0.05)。治疗后,观察组、对照1组、对照2组VAS肩关节疼痛评分低于治疗前,观察组治疗后差值高于对照1组、对照2组,ASES评分高于治疗前,观察组治疗前后差值高于对照1组、对照2组,差异有统计学意义(P<0.05)。治疗后,观察组、对照1组、对照2组前屈上举角度、外展上举与后伸角度、水平内收外展角度高于治疗前,观察组高于对照1组、对照2组,差异有统计学意义(P<0.05)。结论 热敏灸联合“合谷刺法”与温灸针“合谷刺法”在治疗肩周炎疗效肯定,但前者减轻疼痛、改善功能方面有明显的优势。