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纸质出版日期:2018
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李正飞, 卢燚, 张洁瑛, 等. 加味通关汤配合推拿手法治疗中风后尿潴留的疗效机制[J]. 中国实验方剂学杂志, 2018,24(5):155-159.
LI Zheng-fei, LU Yi, ZHANG Jie-ying, et al. Jiawei Tongguan Tang Combined with Massage Manipulation in Treating Uroschesis After Stroke[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(5): 155-159.
李正飞, 卢燚, 张洁瑛, 等. 加味通关汤配合推拿手法治疗中风后尿潴留的疗效机制[J]. 中国实验方剂学杂志, 2018,24(5):155-159. DOI: 10.13422/j.cnki.syfjx.2018050155.
LI Zheng-fei, LU Yi, ZHANG Jie-ying, et al. Jiawei Tongguan Tang Combined with Massage Manipulation in Treating Uroschesis After Stroke[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(5): 155-159. DOI: 10.13422/j.cnki.syfjx.2018050155.
目的:探讨加味通关汤配合推拿手法治疗缺血性脑中风后尿潴留肾气亏虚证的疗效,及对血清中P物质(SP)和降钙素基因相关肽(CGRP)水平及抗氧化作用的影响。方法:选择缺血性脑中风后尿潴留患者104作为研究对象,按数字表法随机分为观察组和对照组各52例。所有患者根据《中国脑卒中康复治疗指南》予常规治疗。对照组给予膀胱功能训练及常规尿潴留治疗。观察组在对照组治疗的基础上采用加味通关汤配合推拿手法治疗。两组患者连续治疗4周。比较两组患者治疗后单次尿量和尿管留置时间、尿动力学参数、中医主要症状评分及临床疗效。检测两组患者血清中SP和CGRP及黄嘌呤氧化还原酶(XOD),丙二醛(MDA),超氧化物歧化酶(SOD)水平。结果:治疗后观察组的单次尿量、最大尿流量、最大尿流率时逼尿肌压及最大尿意膀胱容量均明显高于对照组,尿管留置时间明显少于对照组(P<0.01);与对照组相比较观察组治疗后排尿无力、小腹坠胀、怠倦乏力评价均有降低(P<0.01);观察组总有效率为90.2%,显著高于对照组的72%(P<0.05);观察组治疗后血清中SP和CGRP水平均显著高于对照组(P<0.01);与对照组相比,观察组治疗后血清中XOD,MDA水平降低更明显,而SOD升高更显著(P<0.01)。结论:加味通关汤配合推拿手法治疗缺血性脑中风后尿潴留肾气亏虚证取得了一定疗效,其上调体内SP和CGRP水平及增强抗氧化作用可能与上述治疗作用有关。
Objective:To investigate the efficacy of Jiawei Tongguan Tang combined with massage manipulation in treating uroschesis after ischemic stroke and observe its effect on serum levels of substance P (SP)
calcitonin-gene related peptide (CGRP) and the antioxygenation. Method:One hundred and four patients with ischemic stroke were selected as object
study and randomly divided into observation group(52 cases)and control group(52 cases)by referring to random number table method. All cases were given with conventional measures according to ‘Chinese Stroke Rehabilitation Treatment Guidelines’. The patients in control group also received bladder function training and routine urinary retention therapy. On basis of the treatment in control group
the patients in observation group were also treated with modified Tongguan Tang combined with massage manipulation. Both groups were treated for 4 weeks. A single urine output
urinary catheter indwelling time
main traditional Chinese medicine symptom scores
and clinical efficacy were compared between two group. Serum levels of SP
CGRP
xanthine oxidoreductase (XOR)
malondialdehyde (MDA) and superoxide dismutase (SOD) were detected in both groups. Result:After treatment
the single urine output
maximum urine flow
the detrusor pressure at the maximum urine rate
and maximum urinary bladder capacity in observation group were obviously higher than those in control group
while the catheter indwelling time was significantly shorter than that in the control group (P<0.01). Scores of acraturesis
abdominal distension
fatigue and weakness in observation group were lower than those in the control group after treatment (P<0.01). The total effective rate was 90.2% in the observation group
higher than 72% in control group (P<0.05). After treatment
serum levels of SP and CGRP in observation group were remarkably higher than those in control group (P<0.01). As compared to control group
the decrease in serum levels of XOD and MDA and the increase in SOD in observation group were more obvious
in observation group after treatment (P<0.01). Conclusion:Jiawei Tongguan Tang combined with massage manipulation has a definite curative effect in treating uroschesis after ischemic stroke
which may be related to up-regulating levels of SP and CGRP and enhancing the antioxygenation.
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