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目的：探究隔姜蒜督灸治疗脑卒中后尿失禁的效果。方法：把60例脑卒中后尿失禁患者按照随机数字表法分为观察组和对照组各30例。两组均进行常规康复治疗，观察组在对照组基础上联合隔姜蒜督灸治疗。常规康复治疗日1次，每周5次，隔姜蒜督灸每周3次，两组均治疗4周。治疗前后使用24 h排尿日记、尿流动力学测定和尿失禁程度量表记录患者情况，并比较两组的治疗效果。结果：治疗后两组24 h排尿次数和尿失禁次数、单次尿量和最大膀胱容量、逼尿肌漏尿点压、残余尿量、尿失禁评分等评价指标均较治疗前有所改善（P<0.05），观察组比对照组改善更为明显，差异具有统计学意义（P<0.05）。结论：隔姜蒜督灸治疗脑卒中后尿失禁疗效确切，可明显改善漏尿等症状，有效调节膀胱排尿、储尿功能。
Abstract：Objective:To explore the effect of indirect moxibustion with ginger and garlic on post-stroke urinary incontinence(PSUI). Methods :Sixty patients with PSUI were divided into observation group and control group by random number table method,30 cases in each group. Both groups underwent routine rehabilitation treatment,and the observation group was further treated with indirect moxibustion of ginger and garlic moxibustion besides the treatment in the control group. Routine rehabilitation treatment was administered once per day,five times per week.Indirect moxibustion with ginger and garlic was administered 3 times per week. Both groups were treated for 4 weeks. Before and after treatment,24 h voiding diary,urodynamics and urinary incontinence scale were applied to record the condition of patients,and the treatment effects were compared between the two groups. Results:In both groups after the treatment,24 h urination times,urinary incontinence times,single urine volume and maximum bladder capacity,detrusor leakage point pressure,residual urine volume,and urinary incontinence scores all improved compared with before treatment(P<0.05),and the observation group improved more significantly than the control group,with statistically signifisant difference(P<0.05). Conclusion :Indirect moxibustion with ginger and garlic is of obvious therapeutic effect on PSUI,for it could significantly improves the symptoms such as urine leakage,and effectively regulate store and disposal of urine function by the urinary bladder.
[1]宇传华，罗丽莎，李梅，等.从全球视角看中国脑卒中疾病负担的严峻性[J].公共卫生与预防医学，2016,27(1):1-5.
[2]王陇德，刘建民，杨弋，等.我国脑卒中防治仍面临巨大挑战———《中国脑卒中防治报告2018》概要[J].中国循环杂志，2019,34(2):105-119.
[3]郭应禄，杨勇.尿失禁[M].济南：山东科学技术出版社，2007:269.
[4] THOMAS L H,COUPE J,CROSS L D,et al. Interventions for treating urinary incontinence after stroke in adults[J].Cochrane Database Syst Rev,2019,2(2):CD004462.
[5]向凤选，申旭东.神经源性膀胱的临床分型及影像学分析[J].中国医药指南，2012,10(24):526-527.
[6]张珂铭，李晋芳.中枢神经损伤后膀胱功能障碍的治疗[J].国际神经病学神经外科学杂志，2015,42(6):556-560.
[7] CAI W Z,WANG J,WANG L,et al. Prevalence and risk factors of urinary incontinence for post-stroke inpatients in Southern China[J]. Neurourol Urodyn,2015,34(3):231-235.
[8] ROTAR M,BLAGUS R,JEROMEL M,et al. Stroke patients who regain urinary continence in the first week after acute first-ever stroke have better prognosis than patients with persistent lower urinary tract dysfunction[J]. Neurourol Urodyn,2011,30(7):1315-1318.
[9]刘兰群，李惠兰，陈之罡，等.隔盐隔姜灸神阙穴治疗脑卒中后急迫性尿失禁的效果观察[J].中国康复理论与实践，2015,21(4):475-478.
[10]中国老年医学学会神经医学分会，天津市卒中学会.卒中后神经源性膀胱诊治专家共识[J].王毅，赵耀瑞，执笔.中国卒中杂志，2016,11(12):1057-1066.
[11]吴泽文，谢家辉，陈绮璐，等.隔姜蒜督灸治疗腰椎融合内固定术后腰痛临床研究[J].新中医，2020,52(16):89-92.
[12]马梅青，张学伟.督灸临床治疗病种及“督灸粉”组成浅谈[J].针灸临床杂志，2016,32(2):80-82.
[13] BRIGHT E,COTTERILL N,DRAKE M,et al. Developing and validating the International Consultation on Incontinence Questionnaire bladder diary[J]. Eur Urol,2014,66(2):294-300.
[14] BATES P,BRADLEY W E,GREFLITHS D,et al. Standardization of terminology of lower urinary tract function.First and second reports:International Continence Society[J]. Urology,1977,9(2):237-241.
[15]王燕，张立宁.脑卒中患者神经源性膀胱康复治疗进展[J].解放军医学院学报，2015,36(12):1255-1258.
[16]许志秀，姜宏，汤克仁.卒中后尿失禁[J].国际脑血管病杂志，2006,14(10):771-773.
[17]鞠彦合，廖利民，李东，等.神经源性膀胱尿道功能障碍患者的影像尿动力学研究[J].中华外科杂志，2008,46(20):1525-1528.
[18] JOHN G,BARDINI C,COMBESCURE C,et al. Urinary incontinence as a predictor of death:a systematic review and meta-analysis[J]. PLoS One,2016,11(7):e0158992.
[19] WADE D, COOPER J, DERRY F, et al. Uro-Vaxom versus placebo for the prevention of recurrent symptomatic urinary tract infections in participants with chronic neurogenic bladder dysfunction:a randomised controlled feasibility study[J]. Trials,2019,20(1):223.
[20] WILLIAMS M P,SRIKANTH V,BIRD M,et al. Urinary symptoms and natural history of urinary continence after first-ever stroke———a longitudinal population-based study[J]. Age and Ageing,2012,41(3):371-376.
[21]郭卓丹，王文珍，刘小春.急迫性尿失禁的发病情况及危险因素[J].医学综述，2018,24(11):2206-2210,2215.
[22] SAKAKIBARA R. Lower urinary tract dysfunction in patients with brain lesions[J]. Handb Clin Neurol,2015(130):269-287.
[23] BEAN J F,KIELY D K,CAIRNS K D,et al. Influence of poststroke urinary incontinence on disability:the nursing home setting[J]. Am J Phys Med Rehabilitation,2003,82(3):175-181.
[24]治娜，吴燕燕，郭英英，等.膀胱功能训练对脑卒中后尿失禁患者排尿功能的影响[J].临床医学研究与实践，2017,2(17):157-158.
[25]姚丹，邢丽敏，李鑫，等.脑卒中老年患者并发尿失禁的治疗与护理进展[J].中西医结合心血管病电子杂志，2020,8(23):20,23.
[26] CHANCELLOR M B,WATANABE T. Making a case for not prescribing antimuscarinic drugs to treat overactive bladder in older adults[J]. J Urol,2019,201(4):676-677.
[27] ABRAMS P,ANDERSSON K E,BIRDER L,et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee:evaluation and treatment of urinary incontinence,pelvic organ prolapse,and fecal incontinence[J]. Neurourol Urodyn,2010,29(1):213-240.
[28]陈晓彤，阮传亮.脑卒中后尿失禁治疗的研究进展[J].中国医药导刊，2020,22(7):451-455.
[29]阮传亮，陈若蓝，黄梅，等.苏稼夫温经通督外治方结合督脉铺灸对脊髓损伤后神经源性膀胱尿流动力学的影响[J].中国针灸，2019,39(11):1177-1180.
[30]王群群，牛红英，赵栩，等.中医药治疗脊髓损伤后神经源性膀胱研究进展[J].辽宁中医药大学学报，2018,20(7):216-219.
[31]郭文，冷军，刘会敏，等.任脉灸治疗脑卒中后尿失禁疗效分析[J].山东中医杂志，2021,40(11):1240-1244.
[32]叶琴.艾灸治疗肛肠患者术后尿潴留的临床护理效果分析[J].实用临床护理学电子杂志，2018,3(47):21,26.
[33] SHEN X Y,DING G H,WEI J Z,et al. An infrared radiation study of the biophysical characteristics of traditional moxibustion[J]. Complement Ther Med,2006,14(3):213-219.
[34]王晓彤，王欣欣，李妍，等.中医康复技术操作规范·督灸[J].康复学报，2020,30(4):266-269.
[35]林兆辉，车伟军，闫爱珍，等.督脉隔姜灸治疗脊髓损伤后神经源性膀胱30例临床观察[J].国医论坛，2019,34(3):28-29.
[36]罗丹妮，庞亚铮，鲁士友.督灸疗法起源及应用探析[J].山东中医杂志，2018,37(5):360-363.
[37]张蕾，杨颐，刘慧林，等.古代中医文献对于尿失禁的认识和治疗述要[J].中医文献杂志，2013,31(2):54-56.
基本信息:
DOI：10.16295/j.cnki.0257-358x.2022.07.010
中图分类号:R246.6
引用信息:
[1]张晨,冷军,房晓磊,等.隔姜蒜督灸治疗脑卒中后尿失禁疗效观察[J],2022,41(07):753-758.DOI:10.16295/j.cnki.0257-358x.2022.07.010.
基金信息:
山东省中医药科技发展计划项目（编号：2019-0247）