针刺配合盆底肌锻炼治疗急性脑梗死后强制性尿失禁59例临床观察

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1、河北中医2015年4月第37卷第4期HebeiJTCM，April2015，Vol37，No．4563针灸按摩doi:10．3969/j．issn．1002－2619．2015．04．031针刺配合盆底肌锻炼治疗急性脑梗死后强制性尿失禁59例临床观察顾圣高(江苏省启东市中医院康复科，江苏启东226200)【摘要】目的观察针刺配合盆底肌锻炼治疗急性脑梗死后强制性尿失禁的临床疗效。方法将118例急性脑梗死后强制性尿失禁患者随机分为2组。对照组59例实施盆底肌锻炼，治疗组59例在对照组基础上实施针刺，疗程30d。比较2组患者逼尿肌与尿道外

2、括约肌异常情况、膀胱指征的改变情况、治疗效果及尿路感染情况。结果治疗组治疗后逼尿肌与尿道外括约肌异常改善情况明显优于对照组(P＜0．05)。2组治疗后患者膀胱最大容积、膀胱最大收缩压、膀胱充盈初始量及尿道闭合压均明显改善(P＜0．05)，且治疗组改善情况优于对照组(P＜0．05)。治疗组愈显率89．83%、总有效率98．31%，对照组分别为61．02%、88．14%，2组愈显率及总有效率比较差异有统计学意义(P＜0．05)。治疗组尿路感染发生率3．39%，明显低于对照组(13．56%，P＜0．05)。结论针刺配合盆底肌锻炼治疗急性脑

3、梗死后强制性尿失禁安全有效，可明显改善临床症状，显著提高治愈率，减少尿路感染。【关键词】脑梗死;尿失禁;针灸疗法【中图分类号】Ｒ694．54;Ｒ245【文献标识码】A【文章编号】1002－2619(2015)04－0563－04Clinicalobservationofacupuncturecombinedwithpelvicfloormuscleexercisesonmandatoryurinaryincon-tinenceafteracutecerebralinfarctionGUShenggao．DepartmentofＲeh

4、abilitation，QidongCityHospitalofTradi-tionalChineseMedicineinJiangsuProvince，Jiangsu，Qidong226200【Abstract】ObjectiveToinvestigatetheeffectsofacupuncturecombinedwithpelvicfloormuscleexercisesonmandatoryurinaryincontinenceafteracutecerebralinfarction．Methods118patientswi

5、thmandatoryurinaryin-continenceafteracutecerebralinfarctionwererandomlydividedintotwogroups，59patientsincontrolgroupweretreatedbypelvicfloormuscleexercises，59patientsintreatmentgroupweretreatedbyacupunctureonthebasisofcontrolgrouptreatment．Thecoursewas30daysintwogroups

6、．Abnormalconditionsofdetrusormuscleandexternalu-rethralsphincter，changesofbladderindications，clinicaleffectsandurinarytractinfectionsintwogroupswerecom-pared．ＲesultsAbnormalconditionsofdetrusormuscleandexternalurethralsphincterintreatmentgroupaftertreat-mentwereobvious

7、lyimprovedascomparedwiththoseincontrolgroup(P＜0．05)．Themaximumbladdercapacity，maximumbladdersystolicpressure，initialamountofbladderfillingandurethraclosurepressureaftertreatmentwereobviouslyimprovedintwogroups(P＜0．05)，andtheimprovementintreatmentgroupweresuperiortothos

8、eincon-trolgroup(P＜0．05)．Themarkedlyeffectiverateandtotaleffectiverateintreatmentgroup(89．83%，98．31%)weresuperiortoth