胡青　　吕伯东　　楼国光　　钱乐　　张杰

[關键词] 电针;防己黄芪汤;TURP术后;膀胱过度活动症

[中图分类号] R694          [文献标识码] A          [文章编号] 1673-9701（2021）14-0032-04

Observation on the curative effect of electroacupuncture combined with Fangji huangqi decoction in the treatment of overactive bladder after TURP

HU Qing1   LV Bodong1  LOU Guoguang2   QIAN Le1   ZHANG Jie1

1.Department of Urinary Surgery， The Second Affiliated Hospital of Zhejiang Chinese Medical University， Hangzhou， Zhejiang   310005， China; 2.Department of Urinary Surgery， The First Affiliated Hospital， Zhejiang University School of Medicine， Hangzhou   310003， China

[Abstract] Objective To investigate the clinical efficacy of electroacupuncture combined with Fangji Huangqi Decoction in the treatment of overactive bladder after TURP. Methods From January 2012 to December 2016， 80 patients with prostate hyperplasia complicated with OAB who underwent TURP were selected and randomly divided into TCM electroacupuncture group， electroacupuncture group， TCM group and control group， with 20 cases in each group. The TCM electroacupuncture group was given combined with Fangji Huangqi Decoction， the electroacupuncture group was given electroacupuncture treatment， the TCM group was given Fangji Huangqi Decoction， and the control group was given tolterodine sustained-release tablets. The changes of OABSS scores， bladder volume of first desire to void， and maximum cystometric capacity were observed before treatment and two months after treatment. Results The OABSS scores of the four groups were lower than those before treatment to varying degrees（P<0.01， P<0.05）. The TCM electroacupuncture group was significantly lower than that in the other three groups（P<0.01）. The electroacupuncture group was lower than the TCM group and the control group（P<0.05）; the bladder capacity of first desire to void（FDV） and maximum cystometric capacity（MCC） in the TCM electroacupuncture group， the electroacupuncture group， and the TCM group were all higher than those before the surgery to varying degrees（P<0.01， P<0.05）. Among them， the TCM electroacupuncture group was significantly higher than the other two groups（P<0.01）， and the comparison before and after treatment in the control group was not statistically significant（P>0.05）. Conclusion Electroacupuncture combined with Fangji Huangqi Decoction in the treatment of overactive bladder after TURP can more effectively increase the bladder capacity of first desire to void and the maximum cystometric capacity， and improve clinical symptoms.

[Key words] Electroacupuncture; Fangji Huangqi Decoction; Postoperative TURP; Overactive bladder

前列腺增生（Benign  prostatic  hyperplasia，BPH）是老年男性常见疾病，通常导致膀胱出口梗阻而出现下尿路症状（Lower urinary tract symptoms，LUTS），其中大約47%会出现膀胱过度活动症（Overactive bladder，OAB）[1]。临床上大约50%的患者在经尿道前列腺电切术（Transurethral resection of the prostate，TURP）解除梗阻后仍存在OAB症状[2]，难以恢复。目前临床上已有一些中西医治疗手段，但在疗效、安全性和耐受性方面仍不理想，仍需努力寻求更优治疗。本研究选择2012年1月至2016年12月前列腺增生合并OAB行TURP术的患者80例，分别给予不同治疗并观察疗效，现报道如下。

1 资料与方法

1.1 一般资料

根据病例纳入及排除标准，共选择2012年1月至2016年12月前列腺增生合并OAB行TURP术的患者80例，按简单随机化法（随机数字表）将病例分成电针中药组、电针组、中药组及对照组，每组各20例。电针中药组给予电针加防己黄芪汤治疗，电针组给予电针治疗，中药组给予防己黄芪汤治疗，对照组予托特罗定缓释片治疗。

1.2 病例选择

1.2.1 纳入病例标准  ①男性，55周岁以上（包括55周岁）;②经医院伦理委员会同意;③患者知情同意，并签字;④前列腺增生合并OAB行TURP术;⑤逼尿肌肌力无减退;⑥无泌尿系统肿瘤及脏器功能不全。

1.2.2 排除病例标准  ①女性或男性55周岁以下;②前列腺增生未合并OAB;③未行TURP术;④逼尿肌肌力减退; ⑤患者和家属对本项研究高度敏感，难以解释与沟通;⑥法律规定的残疾患者;⑦患有泌尿系肿瘤或脏器功能不全。

1.3 方法

为避免麻醉及术后镇痛药对本试验结果的干扰，每例研究对象均于术后第3天给予相应治疗措施。……