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目的:观察黄芪桂枝五物汤加味结合西药治疗糖尿病神经源性膀胱(DNB)的临床疗效。方法:将86例DNB患者随机分为治疗组和对照组,两组均给予常规西医基础治疗,对照组42例采用甲钴胺片和溴吡斯的明口服。治疗组44例在对照组基础上加用黄芪桂枝五物汤加味口服。疗程2周。治疗前及治疗后、治疗后4周检测尿流率、残余尿、最大尿流率、平均尿流率及排尿期逼尿肌压力,并进行美国泌尿科协会症状指数(AUA-SI)评价。结果:治疗后及治疗后4周,治疗组AUA-SI指数评分明显低于对照组(P<0.01);治疗组膀胱残余尿量显著减少,平均尿流率、排尿期最大逼尿肌压力、最大尿流率显著增加,优于对照组(P<0.05,P<0.01);治疗组总有效率为93.2%优于对照组的73.8%(P<0.05)。结论:黄芪桂枝五物汤加味联合西药治疗糖尿病神经源性膀胱优于单纯西医治疗。
Objective: To observe the clinical efficacy of Huangqi Guizhi Wuwu Decoction combined with western medicine in the treatment of diabetic neurogenic bladder (DNB). Methods: Eighty-six patients with DNB were randomly divided into treatment group and control group. Both groups were given conventional western medicine. In the control group, 42 cases were treated with methylcobalamin tablets and pyridostigmine oral administration. 44 cases in the treatment group were added with Huangqi Guizhi Wuwu Decoction on the basis of the control group. Treatment for 2 weeks. Before treatment and after treatment, the urinary flow rate, residual urine, maximum uroflow rate, average uroflow rate and urinary detrusor pressure were measured 4 weeks after treatment and the American Urological Association Symptom Index (AUA-SI) was evaluated. Results: After treatment and 4 weeks after treatment, the AUA-SI index of the treatment group was significantly lower than that of the control group (P <0.01); the residual urine volume of the bladder was significantly decreased, the average uroflow rate, the maximum detrusor pressure during urination, The maximum urinary flow rate was significantly higher than that of the control group (P <0.05, P <0.01). The total effective rate in the treatment group was 93.2%, which was significantly higher than that in the control group (73.8%, P <0.05). Conclusion: Astragalus and Guizhi Wuwu Decoction combined with Western medicine treatment of diabetic neurogenic bladder is better than Western medicine treatment.