【摘要】 目的探讨补肾通关饮联合温和灸治疗糖尿病神经源性膀胱患者排尿功能障碍的效果。方法选取2018年3～8月就诊于黑龙江中医药大学附属第一医院肾病科且不同程度依赖导尿的糖尿病神经源性膀胱患者43例,采用随机数字表法分成常规治疗组(20例)与联合治疗组(23例)。常规治疗组在严格控制血糖的基础上接受4周膀胱排尿康复训练(Crede压迫法),联合治疗组在排尿康复训练的基础上加用口服补肾通关饮与中极、关元、气海穴温和灸4周。比较两组治疗前后膀胱残余尿量、尿流动力学指标、美国泌尿科协会症状指数(AUA-SI)评分,以及治疗4周后摆脱导尿管情况及临床疗效。结果两组治疗后膀胱残余尿量均明显少于治疗前(P <0.05),且联合治疗组治疗后膀胱残余尿量减少程度大于常规治疗组(P <0.05)。两组治疗后最大尿流率和平均尿流率均明显高于治疗前(P <0.05),且联合治疗组治疗后最大尿流率和平均尿流率升高程度大于常规治疗组(P <0.05)。两组治疗后AUA-SI评分均明显低于治疗前(P <0.05),且联合治疗组治疗后AUA-SI评分的降低程度大于常规治疗组(P <0.05)。治疗4周后,两组摆脱导尿管情况比较差异有统计学意义(P <0.05)。治疗4周后,联合治疗组的疗效明显优于常规治疗组(P <0.05)。结论单独采用膀胱排尿康复训练或联合补肾通关饮与温和灸均可显著改善糖尿病神经源性膀胱患者的排尿功能,其中联合治疗方案要优于单纯的排尿康复训练。更多还原

【Abstract】 Objective To explore the effect of Bushen Tongguan Decoction combined with mild moxibustion on urinary dysfunction in diabetic neurogenic bladder patients. Methods A total of 43 diabetic neurogenic bladder patients admitted to Department of Nephrology of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from March to August 2018 and depended on catheterization in varying degrees were divided into routine treatment group(20 cases) and combined treatment group(23 cases) by using random number table method. Routine treatment group received 4 weeks bladder voiding rehabilitation training(Crede oppression method) on the basis of strict control of blood sugar, and combined treatment group received oral Bushen Tongguan Decoction and Zhongji, Guanyuan and Qihai points mild moxibustion for 4 weeks on the basis of voiding rehabilitation training. The bladder residual urine volume, urodynamic parameters, AUA-SI score before and after treatment, and the situation of getting rid of catheter and clinical effect after treatment of 4 weeks were compared between two groups. Results After treatment, the residual urine volume of bladder in both groups was significantly less than that before treatment(P < 0.05), and the reduction of residual urine volume of bladder in combined treatment group was greater than that in routine treatment group(P < 0.05). The maximum urinary flow rate and average urinary flow rate after treatment in both groups were significantly higher than those before treatment(P <0.05), and the increase of maximum urinary flow rate and average urinary flow rate in combined treatment group was greater than that in routine treatment group(P < 0.05).After treatment, AUA-SI scores in both groups were significantly lower than those before treatment(P < 0.05), and the reduction of AUA-SI scores in combined treatment group was greater than that in routine treatment group(P < 0.05).After treatment of 4 weeks, there was a significant difference between two groups in getting rid of the catheter(P <0.05). After treatment of 4 weeks, the curative effect of combined treatment group was significantly better than that of routine treatment group(P < 0.05). Conclusion Rehabilitation training of bladder voiding alone or combined with Bushen Tongguan Decoction and mild moxibustion can significantly improve the voiding function of diabetic neurogenic bladder patients, and the combined treatment is better than the simple voiding rehabilitation training.更多还原