[Effect of auricular acupuncture combined with intermittent catheterization on urethral sphincter overactivity in the patients with neurogenic bladder after spinal cord injury].

Abstract

Objectives: To observe the clinical efficacy of auricular acupuncture combined with intermittent catheterization on urethral sphincter overactivity in patients with neurogenic bladder (NB) after spinal cord injury (SCI).

Methods: A total of 90 patients with SCI were randomly divided into an auricular acupuncture group, an intermittent catheterization group and a combined treatment group, 30 cases in each group. All the patients in the three groups received the basic rehabilitation nursing and normal rehabilitation training. Additionally, in the auricular acupuncture group, auricular acupuncture was applied to "Spleen" (CO13), "Kidney" (CO10), "Bladder" (CO9) and "Subcortex" (AT4). In the intermittent catheterization group, the intermittent catheterization was operated. In the combined treatment group, the auricular acupuncture and the intermittent catheterization were delivered in combination. In the auricular acupuncture and the combined treatment group, the needles were retained for 1 h, once daily. One course of treatment was composed of 6 d and 4 courses were required. At the baseline and after interventions, the maximum urethral pressure (MUP), the residual urine volume (RU), the case number of urethral sphincter opening, the case number of vesicoureteral reflux, the number of white blood cells in urine, the case number of bladder function balance and traditional Chinese medicine (TCM) syndrome score were compared, with clinical efficacy evaluated.

Results: Compared with the baseline, MUP, RU, the case number of urethral sphincter opening, the case number of vesicoureteral reflux, the number of white blood cells in urine, the case number of bladder function balance, and TCM symptom score were improved in the combined treatment group after 4 weeks of treatment (P<0.05);and the therapeutic effects of the above indicators except the number of white blood cells in urine and TCM symptom score were improved more significantly when compared with the auricular acupuncture group and the intermittent catheterization group (P<0.05). In the auricular acupuncture group, MUP, RU, the case number of urethral sphincter opening, the case number of vesicoureteral reflux, the case number of bladder function balance and TCM symptom score were ameliorated in comparison with the baseline (P<0.05);while in the intermittent catheterization group, the improvements were obtained in the RU, the case number of urethral sphincter opening, the case number of vesicoureteral reflux, the case number of bladder function balance and the number of white blood cells in urine (P<0.05). The total effective rate in combined treatment group was significantly higher than that in auricular acupuncture group and intermittent catheterization group (P<0.05).

Conclusions: The combination of auricular acupuncture and intermittent catheterization is clearly effective on overactivity of the urethral sphincter in the patients with NB after SCI. It can significantly reduce the MUP, the RU, and the incidence of urinary tract infections in the patients, regulate bladder balance status, and attenuate the symptoms of TCM.