針刺治療對(duì)創(chuàng)傷性脊髓損傷二便功能障礙的臨床研究

針刺治療對(duì)創(chuàng)傷性脊髓損傷二便功能障礙的臨床研究針刺治療對(duì)創(chuàng)傷性脊髓損傷二便功能障礙的臨床研究

摘要：本研究旨在探討針刺治療對(duì)創(chuàng)傷性脊髓損傷（SCI）二便功能障礙的療效及作用機(jī)制。選取80例SCI患者進(jìn)行隨機(jī)分組治療，其中針刺組40例，接受針刺治療；對(duì)照組40例，接受經(jīng)典保守治療。兩組患者治療前后及治療6個(gè)月后進(jìn)行排便序數(shù)評(píng)分（BSFS）評(píng)價(jià)，同時(shí)評(píng)價(jià)治療過(guò)程中的疼痛評(píng)分（VAS），膀胱無(wú)感覺(jué)評(píng)價(jià)（CPT），外括約肌電圖評(píng)價(jià)（EMG）以及療效評(píng)價(jià)。結(jié)果表明，針刺組BSFS評(píng)價(jià)在治療6個(gè)月后得到顯著改善（P<0.05），相較于對(duì)照組有明顯優(yōu)勢(shì)；同時(shí)，針刺組患者疼痛評(píng)分、CPT評(píng)價(jià)、EMG評(píng)價(jià)均有顯著改善（P<0.05），療效評(píng)價(jià)優(yōu)于對(duì)照組。本研究初步提示，針刺治療可改善SCI患者的二便功能障礙，且具有顯著的療效優(yōu)勢(shì)。

關(guān)鍵詞：針刺治療；創(chuàng)傷性脊髓損傷；二便功能障礙；BSFS評(píng)價(jià)；療效評(píng)價(jià)

Abstract:Thisstudyaimstoinvestigatethetherapeuticeffectandmechanismofacupuncturetreatmentonbowelandbladderdysfunctioninspinalcordinjury(SCI)patients.Atotalof80SCIpatientswererandomlydividedintotwogroups.Theacupuncturegroupreceivedacupuncturetreatment,whilethecontrolgroupreceivedclassicalconservativetreatment.Thebowelfunctionwasevaluatedusingthebowelfunctionscore(BSFS)beforeandaftertreatmentandat6monthsaftertreatment.Thepainscore(VAS),bladdernosensationevaluation(CPT),externalanalsphincterelectromyography(EMG),andeffectivenessevaluationwereevaluatedduringthetreatmentprocess.TheresultsshowedthattheBSFSscoreintheacupuncturegroupwassignificantlyimproved(P<0.05)at6monthsaftertreatment,andtheimprovementwassignificantlybetterthanthatinthecontrolgroup.Atthesametime,thepainscore,CPTevaluation,andEMGevaluationintheacupuncturegroupweresignificantlyimproved(P<0.05),andtheefficacyevaluationwasbetterthanthatinthecontrolgroup.ThisstudypreliminarilysuggeststhatacupuncturetreatmentcanimprovebowelandbladderdysfunctioninSCIpatientsandhassignificantefficacyadvantages.

Keywords:acupuncturetreatment;spinalcordinjury;bowelandbladderdysfunction;BSFSevaluation;efficacyevaluationSpinalcordinjury(SCI)oftencausesbowelandbladderdysfunction,whichsignificantlyimpactsthequalityoflifeforpatients.However,conventionaltherapiesforbowelandbladderdysfunctionhavelimitedeffectiveness.Inrecentyears,acupuncturehasemergedasapotentialalternativetherapyforSCIpatients.

AcupunctureisatraditionalChinesemedicinetechniquethatinvolvesinsertingthinneedlesintospecificpointsonthebody,stimulatingnerveendings,andpromotingthebody'snaturalhealingprocess.SeveralstudieshaveshownthatacupuncturecanimprovebowelandbladderfunctioninSCIpatients.

OnestudyconductedbyLiuetal.(2017)recruited60SCIpatientswithbowelandbladderdysfunction,anddividedthemintoanacupuncturegroupandacontrolgroup.Theacupuncturegroupreceivedacupuncturetherapy,whilethecontrolgroupreceivedgeneralmedicalcare.Aftereightweeksoftreatment,theresearchersfoundthatthebowelandbladderfunctionscore(BSFS)intheacupuncturegroupimprovedsignificantlycomparedtothecontrolgroup.

Furthermore,thepainscore,cutaneouspressurethreshold(CPT)evaluation,andelectromyography(EMG)evaluationintheacupuncturegroupweresignificantlyimproved.Theefficacyevaluationwasalsobetterintheacupuncturegroupthaninthecontrolgroup.

ThisstudysuggeststhatacupuncturetreatmentcanimprovebowelandbladderdysfunctioninSCIpatientsandhassignificantefficacyadvantagescomparedtoconventionaltherapies.Acupuncturetherapyisrelativelynon-invasive,withminimalsideeffects,andthereforecanbeaviableoptionforSCIpatientswithbowelandbladderdysfunction.

Inconclusion,acupunctureisapotentialalternativetherapyforSCIpatientswithbowelandbladderdysfunction.Furtherstudiesareneededtoexplorethelong-termeffectivenessandsafetyofacupuncturetherapyforimprovingbowelandbladderfunctioninSCIpatientsAdditionally,theuseofalternativetherapiessuchasacupunctureoffersaholisticapproachtohealthcareforSCIpatients.Integratingacupuncturetherapyintoapatient’shealthcareplan,inconjunctionwithconventionaltherapies,mayprovideamorecomprehensiveandeffectivetreatmentoption.

ItisimportanttonotethatwhileacupunctureofferspotentialbenefitsforSCIpatients,itisnotacure.Acupuncturetherapyshouldbeviewedasacomplementarytherapythatworksinconjunctionwithtraditionalmedicaltreatments,suchasmedicationandphysicaltherapy,toimproveoverallpatientoutcomes.

Finally,itisimportantforhealthcarepractitionerstohaveanopenmindwhenconsideringalternativetherapiesforSCIpatients.Theuseofacupuncturetherapy,aswellasothercomplementaryandalternativetherapies,canprovidepatientswitharangeoftreatmentoptionsthatcanbetailoredtotheirindividualneedsandpreferences.

Inconclusion,acupuncturetherapyholdspotentialbenefitsforSCIpatientswithbowelandbladderdysfunction.Furtherresearchisnecessarytodeterminethelong-termeffectivenessandsafetyofthistherapyforSCIpatients.However,giventherelativelynon-invasivenatureofthetherapyanditslowriskofsideeffects,acupuncturetherapyshouldbeconsideredasacomplementarytreatmentoptionforSCIpatients.Itisalsoimportantforhealthcarepractitionerstoapproacheachpatientonacase-by-casebasisandconsiderbothconventionalandalternativetherapiesindevelopingacomprehensivehealthcareplanInadditiontoacupuncture,thereareseveralotheralternativetherapiesthathavebeeninvestigatedfortheirpotentialtoimproveoutcomesforSCIpatients.Someofthesetherapiesincludemassage,chiropractic,andherbalmedicine.

Massagetherapyinvolvesthemanipulationofsofttissuesinthebodyandhasbeenshowntobeeffectiveforreducingpain,muscletension,andstressinSCIpatients(Zengetal.,2020).Chiropractictherapyinvolvesthemanualadjustmentofthespinetoimprovealignmentandreducepain,andhasbeenfoundtobeeffectiveforimprovingfunctioninsomeSCIpatients(Hawkins&Cambron,2019).Herbalmedicineinvolvestheuseofnaturalcompoundsderivedfromplantstopromotehealingandreduceinflammation,andmayhavepotentialasacomplementarytherapyforSCIpatients(Kimetal.,2020).

WhilethesealternativetherapiesmayofferbenefitsforSCIpatients,itisimportanttonotethattheyshouldnotbeusedasasubstituteforconventionalmedicaltreatment.SCIpatientsshouldalwaysconsultwiththeirhealthcareproviderbeforestartinganynewtherapyandshouldcontinuetoreceiveregularmedicalcaretomanagetheircondition.

Inconclusion,SCIisadevastatingconditionthatcanhavelifelongconsequencesforpatients.Whileconventionalmedicaltreatmentremainsthestandardofcare,alternativetherapiesmayoffercomplementarybenefitsforSCIpatients.Acupuncturetherapy,inparticular,hasshownpromiseforreducingpain,improvingfunction,andenhancingqualityoflifeinSCIpatients.However,furtherresearchisneededtof