地黄饮子合血府逐瘀汤联合温肾化气针刺治疗脊髓损伤恢复期神经源性膀胱的临床观察*

作者：杨燕平，李 珺，王建福，贾荣艳，佟 飞，陈 键

单位：承德市中医院，河北 承德 067000

引用：引用：杨燕平，李珺，王建福，贾荣艳，佟飞，陈键.地黄饮子合血府逐瘀汤联合温肾化气针刺治疗脊髓损伤恢复期神经源性膀胱的临床观察[J].中医药导报,2026,32(3):82-87.

DOI：10.13862/j.cn43-1446/r.2026.03.014

PDF： 下载PDF

摘要：目的：探讨地黄饮子合血府逐瘀汤联合温肾化气针刺治疗脊髓损伤恢复期神经源性膀胱的临床疗效。方法：选取70例脊髓损伤恢复期神经源性膀胱患者随机分为对照组和治疗组，每组各35例。两组患者均给予常规治疗，即口服甲钴胺片和脊髓损伤截瘫常规针刺治疗。对照组在常规治疗基础上接受膀胱功能康复训练；治疗组在对照组基础上加用地黄饮子合血府逐瘀汤加减，联合温肾化气针刺治疗。两组疗程均为4周。比较两组治疗前后的24 h排尿次数、漏尿次数、单次尿量及膀胱残余尿量、最大逼尿肌压、最大膀胱测压容积的变化，评估临床疗效。结果：最终纳入疗效分析的对照组和治疗组各30例。治疗组总有效率为86.67%（26/30），高于对照组[56.67%（17/30）]，差异有统计学意义（P<0.01）。治疗后，两组患者24 h排尿次数、漏尿次数均较治疗前显著减少，单次尿量均较治疗前显著增加，且治疗组排尿功能改善幅度显著大于对照组，差异均有统计学意义（P<0.05）；两组患者膀胱残余尿量均较治疗前显著减少，最大逼尿肌压和最大膀胱测压容积均较治疗前显著增加，且治疗组尿流动力学状况改善幅度显著大于对照组，差异均有统计学意义（P<0.05）。结论：地黄饮子合血府逐瘀汤联合温肾化气针刺在脊髓损伤恢复期神经源性膀胱的治疗中，具有显著的临床效果，不仅有助于恢复患者的排尿功能，还能改善其尿流动力学状况。

关键词：脊髓损伤；神经源性膀胱；地黄饮子；血府逐瘀汤；针刺；温肾化气

Abstract：

Objective: To investigate the clinical efficacy of Dihuang Yinzi combined with Xuefu Zhuyu Decoction and Warming Kidney and Transforming Qi Acupuncture in treating neurogenic bladder during the recovery period of spinal cord injury. Methods: Seventy patients in the recovery phase of spinal cord injury were randomly divided into a control group and a treatment group, with 35 patients in each group. Both groups received conventional treatment, including oral mecobalamin tablets and routine acupuncture for paraplegia following spinal cord injury. The control group received bladder function rehabilitation training in addition to the conventional treatment. The treatment group received the same treatment as the control group, with the addition of a modified Dihuang Yinzi combined with Xuefu Zhuyu Decoction, along with Warming Kidney and Transforming Qi Acupuncture. The treatment course for both groups was 4 weeks. Changes in 24-hour urinary frequency, leakage episodes, single voided volume, bladder residual urine volume, maximum detrusor pressure, and maximum cystometric capacity before and after treatment were compared, and the clinical efficacy was assessed. Results: A total of 30 cases in each group were included in the final efficacy analysis. The total effective rate in the treatment group was 86.67% (26/30), which was significantly higher than that in the control group [56.67% (17/30)], with a statistically significant difference (P<0.01). After treatment, the 24-hour urinary frequency and leakage episodes were significantly reduced, and the single voided volume was significantly increased in both groups compared to before treatment, the improvement in urinary function was significantly greater in the treatment group than in the control group, and the differences were statistically significant (P<0.05). After treatment, bladder residual urine volume was significantly reduced, and maximum detrusor pressure and maximum cystometric capacity were significantly increased in both groups compared to before treatment, and the improvement in urodynamic parameters was significantly greater in the treatment group than in the control group, and the differences were statistically significant (P<0.05). Conclusion: The combination of Dihuang Yinzi, Xuefu Zhuyu Decoction, and Warming Kidney and Transforming Qi Acupuncture demonstrates a significant clinical effect in the treatment of neurogenic bladder during the recovery period of spinal cord injury. It not only helps restore patients' urinary function but also improves their urodynamic status.

Key words：spinal cord injury; neurogenic bladder; Dihuang Yinzi; Xuefu Zhuyu Decoction; acupuncture; Warming Kidney and Transforming Qi

发布时间：2026-03-28

点击量：344