CAJ | 학술논문

目的：通过观察电针刺激不同部位对脊髓损伤后逼尿肌无反射型神经源性膀胱逼尿肌压力的影响，寻求最佳刺激部位。方法选择符合脊髓损伤神经学分类国际标准第6版(ASIA 2006)残损诊断和分级标准的108例不完全性脊髓损伤患者为研究对象，随机分为导尿组、对照组和试验组，每组36例。导尿组只行间歇导尿；对照组采用电针刺激八髎和会阳等穴，并进行间歇导尿；试验组采用经颅电针刺激足运感区、腹六区等穴，并进行间歇导尿。检测治疗前后的逼尿肌压力，并比较三组疗效。结果治疗后，三组自主排尿、导尿量、残余尿比较均有显著性差异(P<0.05)；对照组和试验组治疗前后逼尿肌压力和逼尿肌反射比较均有显著性差异(P<0.05)，导尿组治疗前后比较无显著性差异(P>0.05)；治疗后对照组和试验组与导尿组比较均有显著性差异(P<0.05)；对照组和试验组有显著性差异(P<0.05)。结论电针刺激能改善不完全性脊髓损伤后逼尿肌无反射型神经源性膀胱患者自主排尿功能。
목적：통과관찰전침자격불동부위대척수손상후핍뇨기무반사형신경원성방광핍뇨기압력적영향，심구최가자격부위。방법선택부합척수손상신경학분류국제표준제6판(ASIA 2006)잔손진단화분급표준적108례불완전성척수손상환자위연구대상，수궤분위도뇨조、대조조화시험조，매조36례。도뇨조지행간헐도뇨；대조조채용전침자격팔료화회양등혈，병진행간헐도뇨；시험조채용경로전침자격족운감구、복륙구등혈，병진행간헐도뇨。검측치료전후적핍뇨기압력，병비교삼조료효。결과치료후，삼조자주배뇨、도뇨량、잔여뇨비교균유현저성차이(P<0.05)；대조조화시험조치료전후핍뇨기압력화핍뇨기반사비교균유현저성차이(P<0.05)，도뇨조치료전후비교무현저성차이(P>0.05)；치료후대조조화시험조여도뇨조비교균유현저성차이(P<0.05)；대조조화시험조유현저성차이(P<0.05)。결론전침자격능개선불완전성척수손상후핍뇨기무반사형신경원성방광환자자주배뇨공능。
Objective To compare the effect of electroacupuncture applied to different locations of body on the detrusor pressure of de-trusor areflexia neurogenic bladder post spinal cord injury (SCI) to find optimal locations for electroacupuncture. Methods 108 incomplete SCI patients were selected following International Standards for Neurological Classification of Spinal Cord Injury (ASIA 2006) and random-ly assigned to urethral catheterization group, control group, and experiment group with 36 cases in each group. The urethral catheterization group was only given intermittent catheterization, the control group was given electroacupuncture of Baliao (BL31 to BL34) and Huiyang (BL35) as the main points and intermittent catheterization, and the experiment group was treated with transcranial electrical stimulation of foot motor sensory area and Abdominal Area Six as the main points and intermittent catheterization. They were assessed with voiding diary and urodynamic test before and after treatment. Results There were significant differences among the urethral catheterization group, the con-trol group, and the experiment group in automatic micturition volume, urethral catheter output and residual urine volume after treatment (P<0.05). Detrusor pressure and reflection was significantly different in the control group and the experiment group before and after treatment (P<0.05), but not in the urethral catheterization group (P>0.05). There was significant difference in detrusor pressure and reflection in the urethral catheterization group from both the control group and the experiment group after treatment (P<0.05). Conclusion Electroacupunc-ture can promote automatic micturition in patients with detrusor areflexia neurogenic bladder after incomplete SCI.