“灸刺任脉”联合膀胱功能训练治疗卒中后神经源性膀胱：随机对照试验

黄强; 李春宁; 解鸿宇; 王保国; 王振亚; 曹奕

doi:10.13703/j.0255-2930.20250302-0001

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“灸刺任脉”联合膀胱功能训练治疗卒中后神经源性膀胱：随机对照试验

临床研究 | 更新时间：2025-10-11

- “灸刺任脉”联合膀胱功能训练治疗卒中后神经源性膀胱：随机对照试验
- Jiuci renmai therapy combined with bladder function training for post-stroke neurogenic bladder: a randomized controlled trial
- 中国针灸 2025年45卷第10期页码：1427-1433
- 作者机构：
  
  安徽中医药大学研究生院，合肥　230012
  安徽中医药大学第一附属医院
  安徽中医药大学第二附属医院脑病科，合肥　230061
  安徽中医药大学第二附属医院老年病科，合肥　230061
- 作者简介：
  
  黄强，安徽中医药大学硕士研究生。E-mail：18273040520@163.com
  ✉曹奕，主任医师。E-mail：zjyycaoyi@163.com
- 基金信息：
  
  国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号);安徽省中医药高水平传承人才支持项目(皖中医药发展秘〔2024〕1号)
- DOI：10.13703/j.0255-2930.20250302-0001
  中图分类号：
- 收稿：2025-03-02，
  
  网络首发：2025-07-30，
  
  纸质出版：2025-10-12
- 稿件说明：
移动端阅览
黄强, 李春宁, 解鸿宇, 等. “灸刺任脉”联合膀胱功能训练治疗卒中后神经源性膀胱：随机对照试验[J]. 中国针灸, 2025,45(10):1427-1433.

HUANG Qiang, LI Chunning, XIE Hongyu, et al. Jiuci renmai therapy combined with bladder function training for post-stroke neurogenic bladder: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2025, 45(10): 1427-1433. DOI: 10.13703/j.0255-2930.20250302-0001.
黄强, 李春宁, 解鸿宇, 等. “灸刺任脉”联合膀胱功能训练治疗卒中后神经源性膀胱：随机对照试验[J]. 中国针灸, 2025,45(10):1427-1433. DOI： 10.13703/j.0255-2930.20250302-0001.

HUANG Qiang, LI Chunning, XIE Hongyu, et al. Jiuci renmai therapy combined with bladder function training for post-stroke neurogenic bladder: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2025, 45(10): 1427-1433. DOI: 10.13703/j.0255-2930.20250302-0001. DOI：

摘要

目的：

观察“灸刺任脉”联合膀胱功能训练治疗卒中后神经源性膀胱（PSNB）的临床疗效及安全性。

方法：

将60例PSNB患者随机分为观察组和对照组，各30例。在常规西药治疗基础上，对照组采用膀胱功能训练，每日1次，训练4周；观察组在对照组基础上联用“灸刺任脉”疗法，取关元、中极、气海、曲骨为主穴，横骨、中脘、下脘、水分为配穴，采用针刺加温和灸法，隔日治疗1次，共治疗4周。分别于治疗前及治疗2、4周后检测两组患者尿流动力学参数[最大尿流率（Qmax）、最大逼尿肌压力（PdetQmax）、膀胱残余尿量（RUV）、充盈期最大膀胱容量（MCC）、排尿期最大膀胱内压（Pvesmax）]，记录排尿情况（日均排尿次数、漏尿次数及单次排尿量），评估两组患者神经源性膀胱症状评分（NBSS）、下尿路症状（LUTS）评分，并于治疗前后观察尿失禁生活质量量表（I-QoL）评分，评价两组患者临床疗效及安全性。

结果：

治疗2、4周后，两组患者Qmax、PdetQmax、MCC、Pvesmax及日均单次排尿量均较治疗前逐渐升高（

0.05），且观察组高于对照组（

0.05）；两组患者RUV、日均排尿次数、日均漏尿次数、NBSS、LUTS评分较治疗前逐渐降低（

0.05），且观察组低于对照组（

0.05）。治疗4周后，观察组尿失禁患者日均漏尿次数降低幅度大于对照组（

0.05），观察组尿潴留患者RUV改善程度优于对照组（

0.05）。治疗4周后，两组患者I-QoL各维度评分及总分均较治疗前升高（

0.05），且观察组高于对照组（

0.05）。观察组患者总有效率为90.0%（27/30），高于对照组的70.0%（21/30，

0.05）。观察组不良反应发生率为3.3%（1/30），与对照组[10.0%（3/30）

]

比较差异无统计学意义（

0.05）。

结论：

“灸刺任脉”联合膀胱功能训练治疗可有效减轻PSNB患者的临床症状，恢复膀胱排尿功能，提升生活质量，安全性良好。

Abstract

Objective

To observe the clinical effect and safety of

Jiuci renmai

therapy (moxibustion and acupuncture on the conception vessel) combined with bladder function training in treatment of post-stroke neurogenic bladder (PSNB).

Methods

Sixty patients with PSNB were randomly divided into an observation group and a control group

30 cases in each group. On the basis of conventional treatment with western medication

bladder function training was delivered in the control group

once a day for 4 weeks. In the observation group

Jiuci renmai

therapy was supplemented besides the regimen as the control group. The main acupoints were Guanyuan (CV4)

Zhongji (CV3)

Qihai (CV6) and Qugu (CV2); and the supplementary acupoints were Henggu (KI11)

Zhongwan (CV12)

Xiawan (CV10) and Shuifen (CV9). Warm needling and moxibustion were operated

once every other day

for 4 weeks. Separately

before treatment and in 2 and 4

weeks of treatment

the urodynamic parameters were detected in the two groups

including maximal urine flow rate (Qmax)

maximal detrusor pressure (PdetQmax)

residual urine volume (RUV)

maximal bladder capacity in the filling phase (MCC)

and maximal intravesical pressure in the voiding phase (Pvesmax); the voiding parameters (the average daily number of micturition

urinary leakage episodes

and single voiding volume) were recorded; neurogenic bladder symptom score (NBSS)

lower urinary tract symptom score (LUTS) and the score of quality of life scale for incontinence of urine (I-QoL) were evaluated

as well as the clinical effect and safety in the two groups.

Results

In 2 and 4 weeks of treatment

Qmax

PdetQmax

MCC

Pvesmax

and average daily single voiding volume were increased compared with the levels before treatment in each group (

0.05)

and the above indexes in the observation group were higher than those of the control group (

0.05). RUV

the average daily number of micturition

urinary leakage episode

NBSS and LUTS scores of the two groups were reduced in comparison with those before treatment (

0.05 )

and these indexes in the observation group were lower than those of the control group (

0.05). In 4 weeks of treatment

the average urinary leakage episode was reduced largely in comparison with the control group (

0.05); and the improvement in RUV for the patients with retention of urine in the observation group was superior to the control group (

0.05). In 4 weeks of treatment

the score of each dimension in I-QoL and the total score were elevated compared with those before treatment in the two groups (

0.05)

and the scores in the observation were higher when compared with the control group (

0.05). The total effective rate in the observation group was 90.0% (27/30) which was higher than 70.0% (21/30

) of the control group (

0.05). The incidence of adverse reactions was 3.3% (1/30) in the observation group

which was not significantly different from that in the control group [10.0% (3/30)

0.05

]

Conclusion

The combination of

Jiuci renmai

therapy and bladder function training can effectively alleviate clinical symptoms

recover bladder voiding function

and improve the quality of life in the patients with PSNB

presenting the favorable safety profile in treatment.

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