摘要
目的探讨火罐结合穴位敷贴对肛肠科术后急性尿潴留(AUR)疗效及逼尿肌功能的影响。方法随机对照试验研究。选取2020年4月-2022年4月本院120例肛肠科术后AUR患者作为观察对象,采用随机数字表法分为2组,每组60例。对照组予以穴位贴敷,观察组予以穴位贴敷+火罐。2组均连续治疗3 d。分别于治疗前后进行排尿功能症状评分,采用VAS量表评估疼痛程度;采用ELISA法检测CRP,血常规分析仪检测WBC水平;采用尿流动力学分析仪评估术后AUR患者的膀胱容量(CC)、最大尿流率(Q_(max))、平均尿流率(AFR)、残余尿(PVR),记录不良反应,评价临床疗效。结果观察组总有效率为91.67%(55/60)、对照组为80.00%(48/60),2组比较差异有统计学意义(χ^(2)=4.90,P=0.027)。观察组治疗后排尿不畅、尿频、尿急评分及VAS评分低于对照组(t值分别为22.83、8.70、8.70、17.26,P<0.01)。观察组治疗后Q_(max)[(10.85±3.49)ml/s比(8.13±2.74)ml/s,t=4.75]、AFR[(5.40±1.42)ml/s比(3.68±1.51)ml/s,t=19.44]、CC[(352.69±51.75)ml/s比(396.57±58.16)ml/s,t=4.37]高于对照组(P<0.01),PVR[(36.73±6.54)ml/s比(51.04±10.32)ml/s,t=9.07]低于对照组(P<0.01);血清CRP水平及WBC低于对照组(t值分别为23.50、5.05,P<0.01)。观察组治疗期间不良反应发生率为6.67%(4/60)、对照组为5.00%(3/60),2组比较差异无统计学意义(χ^(2)=0.15,P=0.697)。结论火罐结合穴位敷贴可有效改善肛肠科术后AUR患者的逼尿肌功能,缓解排尿异常症状,提高疗效且安全可靠。
Objective To explore the effect of cupping combined with acupoint application on acute urinary retention(AUR)and its influences on detrusor function after anorectal surgery.Methods Randomized controlled trial.A total of 120 patients in the hospital were enrolled as the observation objects between April 2020 and April 2022.According to random number table method,they were divided into two groups,60 in each group.The control group was given acupoint application,while observation group was additionally given cupping.All were continuously treated for 3 days.Before and after treatment,urination function symptoms were scored.The pain degree was assessed by VAS.C-reactive protein(CRP)was detected by ELISA,and white blood cell count(WBC)was detected by blood routine analyzer.The bladder volume(CC),maximum flow rate(Q_(max)),average flow rate(AFR)and residual urine volume(PVR)were evaluated by urodynamics analyzer.The adverse reactions were recorded,and clinical curative effect was evaluated.Results The difference in total response rate between observation group and control group was statistically significant[91.67%(55/60)vs.80.00%(48/60);χ^(2)=4.90,P=0.027].After treatment,scores of dysuria,frequency of urination,urgency of urination and VAS in observation group were significantly lower than those in the control group(t=22.83,8.70,8.70,17.26,P<0.01).After treatment,Q_(max)[(10.85±3.49)ml/s vs.(8.13±2.74)ml/s,t=4.75],AFR[(5.40±1.42)ml/s vs.(3.68±1.51)ml/s,t=19.44]and CC[(352.69±51.75)ml/s vs.(396.57±58.16)ml/s,t=4.37]in observation group were significantly higher than those in the control group(P<0.01),while PVR[(36.73±6.54)ml/s vs.(51.04±10.32)ml/s,t=9.07]was significantly lower than that of the control group(P<0.01).The levels of serum CRP and WBC in observation group were significantly lower than those in the control group(t=23.50,5.05,P<0.01).The difference in the incidence of adverse reactions between observation group and control group was not statistically significant[6.67%(4/60)vs.5.00%(3/60);χ^(2)=0.15,P=0.697].Conclusion Cupping combined with acupoint application can improve detrusor function,relieve abnormal urination symptoms and improve curative effect in AUR patients after anorectal surgery,which is safe and reliable.
作者
羊海燕
韩梦云
王曦
Yang Haiyan;Han Mengyun;Wang Xi(Anorectal Department,Suzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine,Suzhou 215000,China)
出处
《国际中医中药杂志》
2023年第10期1241-1245,共5页
International Journal of Traditional Chinese Medicine
基金
2020年苏州市中西结合医院院级课题立项项目(YJ2020005)。
关键词
尿潴留
肛肠手术
敷贴疗法
拔罐疗法
Urinary retention
Anorectal surgery
Plastering therapy
Cupping therapy
