电针、艾灸联合个体化康复护理改善老年脊髓损伤神经源性尿失禁临床研究
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R246.9

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2019年度衢州市科技计划项目(2019113)


Clinical Study on Electroacupuncture and Moxibustion Combined with Individualized Rehabilitation Nursing for Improving Neurogenic Urinary Incontinence of Senile Patients with Spinal Cord Injury
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    摘要:

    目的:观察电针、艾灸联合个体化康复护理干预老年脊髓损伤患者在改善神经源性尿失禁方面的临床效果。方法:纳入142 例老年脊髓损伤患者,采用随机数字表法分为观察组和对照组各71 例。2 组均接受常规护理,并接受膀胱功能训练、间歇性导尿以及盆底直流电刺激。观察组加予电针、艾灸联合个体化康复护理治疗。2 组均治疗6 周。治疗前后应用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD) 评价患者的焦虑、抑郁情况,应用尿失禁生活质量问卷(I-QOL) 评价生活质量。比较2 组的临床疗效。统计2 组治疗6 周后首月的尿失禁月发次数。结果:治疗6 周后,观察组临床疗效总有效率87.32%,对照组总有效率71.83%,2 组比较,差异有统计学意义(P<0.05)。2 组HAMA 评分、HAMD 评分、PSQI 评分均较治疗前下降(P<0.05);观察组3 项评分均低于对照组(P<0.05)。2 组心理影响、社会障碍评分及总分均较治疗前提高(P<0.05);观察组心理影响、社会障碍评分及总分均高于对照组(P<0.05)。2 组最大逼尿肌压、残余尿量均较治疗前减少,最大膀胱容量值均较治疗前增加,差异均有统计学意义(P<0.05);观察组最大逼尿肌压、残余尿量均低于和少于对照组,最大膀胱容量值高于对照组,差异均有统计学意义(P<0.05)。2 组患者在治疗期间均未发生严重不良反应,安全性较好。2 组治疗6 周后首月的尿失禁月发次数均少于治疗前(P<0.05),观察组的尿失禁月发次数少于对照组(P<0.05)。结论:将电针、艾灸联合个体化康复护理应用于老年脊髓损伤神经源性尿失禁效果较好,可显著改善患者的膀胱功能和提高生活质量,减轻患者的抑郁、焦虑,安全性好。

    Abstract:

    Abstract:Objective:To observe the clinical effect of electroacupuncture and moxibustion combined with individualized rehabilitation nursing for senile patients with spinal cord injury to improve neurogenic urinary incontinence. Methods:A total of 142 cases of senile patients with spinal cord injury were divided into the observation group and the control group according to the random number table method , with 71 cases in each group. Two groups were given routine nursing as well as bladder function training, intermittent catheterization and pelvic floor direct current stimulation. The observation group was additionally treated with electroacupuncture and moxibustion combined with individualized rehabilitation nursing. Both groups were treated for six weeks. Before and after treatment,Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD) and Incontinence Quality of life Questionnaire(I- QOL) were applied to evaluate anxiety, depression and quality of life respectively. The clinical effects in the two groups were compared. The numbers of urinary incontinence in the first month after six weeks of treatment in the two groups were analyzed. Results:After six weeks of treatment,the total effective rate of clinical effect was 87.32% in the observation group,higher than that of 71.83% in the control group(P<0.05). The scores of HAMA,HAMD and PSQI in the two groups were lower than those before treatment(P<0.05);the above three scores in the observation group were lower than those in the control group(P<0.05). The scores of psychological influence and social disorder and the total scores in the two groups were higher than those before treatment(P<0.05). When compared with those in the control group,the scores of psychological influence and social disorder and the total scores in the observation group were significantly increased(P<0.05). The maximum detrusor pressure and the residual urine volume in the two groups were decreased when compared with those before treatment, and the maximum bladder capacity was increased, differences being significant(P<0.05);when compared with those in the control group,the maximum detrusor pressure and the residual urine volume in the observation group were lower,and the maximum bladder capacity was higher(P<0.05). There was no serious adverse reaction in the two groups,with good safety. The numbers of urinary incontinence in the first month after six weeks of treatment in the two groups were lower than those before treatment(P<0.05), and the number of urinary incontinence in the observation group was lower than that in the control group(P<0.05). Conclusion: The therapy of electroacupuncture and moxibustion combined with individualized rehabilitation nursing for neurogenic urinary incontinence in senile patients with spinal cord injury has a good effect, and can significantly improve their bladder function and quality of life,and relieve their depression and anxiety with good safety.

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曾芳芳,杨润成.电针、艾灸联合个体化康复护理改善老年脊髓损伤神经源性尿失禁临床研究[J].新中医,2022,54(12):219-224

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  • 在线发布日期: 2022-06-22
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