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.

目的 探讨尿液前列腺特异性抗原（u-PSA）预测老年良性前列腺增生（BPH）发生急性尿潴留（AUR）的价值。方法 选取东莞市中医院100例老年BPH患者（2020年1月—2021年4月）进行回顾性研究,均口服盐酸坦索罗辛+非那雄胺片治疗,随访1年,记录AUR发生情况,据此分为AUR组、非AUR组。比较2组一般资料,Logistic回归模型分析老年BPH发生AUR的危险因素,受试者工作特征（ROC）分析前列腺体积（PV）、u-PSA对老年BPH发生AUR的预测价值。结果 100例老年BPH患者AUR发生率为26%;AUR组u-PSA水平高于非AUR组,PV大于非AUR组（P<0.05）;Logistic回归模型分析,u-PSA水平及PV增高是老年BPH患者发生AUR的独立危险因素（P<0.05）;ROC曲线分析,u-PSA预测AUR的AUC=0.897,高于AUC_PV（P<0.05）。结论 u-PSA可作为老年BPH继发AUR的量化评估指标,有利于临床早期筛查、诊断,采取针对性干预措施,改善预后。

Objective To investigate the value of urinary prostate-specific antigen（u-PSA）in predicting acute urinary retention（AUR）in elderly patients with benign prostatic hyperplasia（BPH）．Methods A total of 100 elderly patients with BPH in our hospital（from January 2020 to April 2021）were selected for a retrospective study,all of whom were treated with oral tamsulosin hydrochloride + finasteride tablets,followed up for 1 year,and the occurrence of AUR was recorded．The patients were divided into AUR group and non-AUR group．The general data of the two groups were compared．Logistic regression model was used to analyze the risk factors of AUR in elderly BPH patients,and receiver operating characteristic（ROC）was used to analyze the predictive value of prostate volume（PV）and u-PSA for AUR occurrence．Results The incidence of AUR in 100 elderly patients with BPH was 26%;the level of u-PSA in the AUR group was higher than that in the non-AUR group,and the PV was greater than that in the non-AUR group（P<0.05）．Increased PV was an independent risk factor for AUR in elderly patients with BPH（P<0.05）．ROC curve analysis showed that the AUC of u-PSA for predicting AUR was 0.897,which was higher than that of PV（P<0.05）．Conclusions u-PSA can be used as a quantitative evaluation index for AUR secondary to BPH in the elderly,which is conducive to early clinical screening and diagnosing,and taking targeted intervention measures to improve prognosis.