基于“脑肾相济”理论探讨动留针术联合功能性磁刺激对脑卒中后尿潴留的临床疗效

谢冰; 李硕; 廖焦鲁; 王毅刚; 樊沙沙; 刘秋红; 李元

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谢冰, 李硕, 廖焦鲁, 王毅刚, 樊沙沙, 刘秋红, 李元.基于“脑肾相济”理论探讨动留针术联合功能性磁刺激对脑卒中后尿潴留的临床疗效[J].湖南中医药大学学报,2026,46(4):739-744[点击复制]

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基于“脑肾相济”理论探讨动留针术联合功能性磁刺激对脑卒中后尿潴留的临床疗效

谢冰,李硕,廖焦鲁,王毅刚,樊沙沙,刘秋红,李元

(中南大学湘雅医学院附属长沙医院, 湖南长沙 410153;湖南中医药大学湘杏学院, 湖南岳阳 414615;重庆市中医院, 重庆 400021;重庆医药高等专科学校, 重庆 401331)

摘要:

目的观察动留针术联合功能性磁刺激（FMS）治疗脑卒中后尿潴留的临床疗效。方法选取2024年2月至2025年8月就诊于中南大学湘雅医学院附属长沙医院的60例脑卒中后尿潴留患者，随机分为对照组和观察组，每组30例。两组患者均予以基础治疗、康复训练、FMS和针刺治疗：对照组基于脑肾相济理论及脑卒中后尿潴留选穴规律选穴，采用常规针刺手法；观察组选穴同对照组，采用动留针术。治疗均为每日1次，连续治疗5 d后休息2 d，共治疗15次。比较两组患者治疗前后残余尿量、膀胱最大容量及中医症状积分，并对比治疗后尿管留置时间、拔管率及临床疗效。结果治疗后，两组患者残余尿量较治疗前减少（P<0.01），膀胱最大容量较治疗前增大（P<0.01），中医症状积分（排尿无力、淋漓不尽、下腹胀满）均较治疗前降低（P<0.01）；且观察组残余尿量少于对照组（P<0.05），膀胱最大容量大于对照组（P<0.05），上述中医症状积分均低于对照组（P<0.05,P<0.01）。治疗后，观察组尿管留置时间少于对照组（P<0.01），拔管率和总有效率均高于对照组（P<0.01）。结论动留针术联合FMS治疗脑卒中后尿潴留疗效优于常规针刺联合FMS，可有效改善膀胱功能及排尿情况，值得临床推广。

DOI：10.3969/j.issn.1674-070X.2026.04.011

投稿时间：2025-12-12

基金项目:王毅刚全国名中医传承工作室(国中医药人教函[2021]202号);国家卫生健康委员会重大课题(SZ2024HL021);湖南省自然科学基金医卫联合项目(2025JJ80794);重庆市科卫联合中医药科研项目(2024ZYQN016);重庆巴渝王氏针灸传承流派工作室

Clinical efficacy of active needle retention combined with functional magnetic stimulation on post-stroke urinary retention based on the theory of "brain-kidney synergy"

XIE Bing, LI Shuo, LIAO Jiaolu, WANG Yigang, FAN Shasha, LIU Qiuhong, LI Yuan

(Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410153, China;Xiangxing College, Hunan University of Chinese Medicine, Yueyang, Hunan 414615, China;Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, China;Chongqing Medical and Pharmaceutical College, Chongqing 401331, China)

Abstract:

Objective To observe the clinical efficacy of active needle retention combined with functional magnetic stimulation(FMS) on post-stroke urinary retention. Methods A total of 60 patients with post-stroke urinary retention treated at Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, from February 2024 to August 2025 were enrolled and randomly divided into control group and observation group, with 30 patients in each group. Both groups received basic treatment, rehabilitation training, FMS, and acupuncture treatment. Based on the theory of "brain-kidney synergy" and acupoint selection rules for post-stroke urinary retention, the control group receiv ed conventional acupuncture manipulation, while the observation group adopted the same acupoints as the control group but with active needle retention. The treatment was administered once daily, with a two-day rest period after five consecutive days of treatment, for a total of 15 sessions. Changes in residual urine volume, maximum bladder capacity, and TCM pattern scores were compared between the two groups before and after treatment.Additionally, duration of indwelling urinary catheterization, catheter removal rate, and clinical efficacy after treatment were also compared. Results Compared with pre-treatment, patients in both groups showed decreased residual urine volume(P<0.01), increased maximum bladder capacity(P<0.01), and decreased TCM pattern scores(weak urination, incomplete voiding, lower abdominal distension,and fullness) after treatment(P<0.01). Meanwhile, compared with the control group, the observation group showed lower residual urine volume(P<0.05), greater maximum bladder capacity(P<0.05), and lower scores for the above TCM patterns(P<0.05, P<0.01). After treatment, the duration of indwelling urinary catheterization in the observation group was shorter than that in the control group(P<0.01), and both the catheter removal rate and the total efficacy rate were higher than those in the control group(P<0.01). Conclusion Active needle retention combined with FMS is superior to conventional acupuncture combined with FMS in treating post-stroke urinary retention. It can effectively improve bladder function and urination status, and is worthy of clinical promotion.

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