OBJECTIVE: To observe the clinical effect and safety of fire needle therapy combined with bladder function training on neurogenic bladder (NB) caused by spinal cord injury. METHODS: A total of 60 patients with NB caused by spinal cord injury were randomly divided into an observation group and a control group , with 30 cases in each group. On the basis of conventional treatment with western medicine, the bladder function training was adopted in the control group, once a day and for 4 weeks. In the observation group, on the basis of the interventions as the control group, fire needling was operated at bilateral Sanyinjiao (SP 6) and Guanyuan (CV 4) and Zhongji (CV 3), once every two days and for 4 weeks (14 interventions in total). Separately, at the baseline and in 2 and 4 weeks of interventions, the urination conditions (average daily urination frequency, average daily leakage frequency, average daily single urination volume) were recorded in the two groups; the urodynamic parameters (maximum flow rate [Qmax], maximum detrusor pressure at maximum flow rate [PdetQmax], residual urine volume [RUA], maximum cystometric capacity [MCC], and bladder pressure) were detected; the neurogenic bladder symptom score (NBSS), urinary symptom distress score (USDS) were observed. Before and after treatment, the score of World Health Organization quality of life assessment scale-brief (WHOQOL-BREF) was observed in the two groups. The therapeutic effect, the incidence of urinary infection, and the safety were evaluated. RESULTS: In 2 and 4 weeks of interventions, the average daily urination frequency, the average daily leakage frequency, RUA, and the scores of NBSS and USDS decreased in the two groups when compared with the baseline (P<0.05). In 4 weeks of interventions, the above-mention outcomes were lower than those in 2 weeks of interventions (P<0.05); and the results in the observation group were lower in 2 and 4 weeks of interventions when compared with the control group (P<0.05). In 2 and 4 weeks of interventions, the average daily single urination volume, Qmax, PdetQmax, MCC, and bladder pressure increased in the two groups compared with the baseline (P<0.05). In 4 weeks of interventions, the above-mention outcomes were elevated in comparison with those in 2 weeks of interventions (P<0.05); and except for bladder pressure, the results in the observation group in 2 and 4 weeks of interventions were higher when compared with the control group (P<0.05). In 4 weeks of interventions, the scores of each dimension and the total scores of WHOQOL-BREF increased in comparison with the baseline in the two groups (P<0.05), and the scores of the observation group were higher than those of the control group (P<0.05). The incidence of urinary infection was 0% (0/30) in the observation group and 10.0% (3/30) in the control group, without significant difference (P>0.05). The total effective rate of the observation group was 93.3% (28/30), which was higher than that (73.3%, 22/30) of the control group (P<0.05). No serious adverse reactions occurred in the patients of the observation group. CONCLUSION Fire needle therapy combined with bladder function training can effectively relieve the clinical symptoms, ameliorate urination, restore bladder function and improve the quality of life in the patients with NB caused by spinal cord injury. This therapeutic regimen presents a high safety in practice.
Humans ; Spinal Cord Injuries/therapy* ; Female ; Male ; Acupuncture Therapy ; Middle Aged ; Adult ; Urinary Bladder, Neurogenic/etiology* ; Urinary Bladder/physiopathology* ; Urination ; Young Adult ; Treatment Outcome ; Aged ; Adolescent ; Combined Modality Therapy

Objective To investigate the expression of heme oxygenase-1 (HO-1) in type 2 diabetes mellitus (T2DM) as well as hidden diabetes mellitus (HDM) and explore its clinical significance.Methods A total of 384 suspected patients with T2DM having underwent oral glucose tolerance test were enrolled in this study:216 cases of patients were T2DM (T2DM group),and 168 cases of patients were HDM (HDM group).T2DM patients were divided into single-vessel lesion group(122 cases),double-vessel lesion group(54 cases),and more-vessel lesion group(40 cases).Another 60 healthy person were as control group.The intima-media thickness (IMT) of carotid was measured by ultrasonography.The level of serum HO-1 was detected with enzyme-linked immunosorbent assay.Results The serum level of HO-1 in control group,HDM group and T2DM group was (1.24 ± 0.53),(2.12 ± 0.84),(3.46 ± 1.23) μ g/L.The serum level of HO-1 in T2DM group was significantly higher than that in control group and HDM group (P ＜ 0.05),and in HDM group it was significantly higher than that in control group(P ＜ 0.05).There were significant differences in the serum level of HO-1 and IMT of carotid among single-vessel lesion group,double-vessel lesion group,and more-vessel lesion group [(2.94 ± 1.14),(3.72 ± 1.36),(4.64 ± 1.58) μg/L and (1.21 ±0.16),(1.44 ± 0.20),(1.62 ± 0.27) mm] (P ＜ 0.05).The serum level of HO-1 and IMT of carotid in double-vessel lesion group was higher than that in single-vessel lesion group,and in more-vessel lesion group it was higher than that in double-vessel lesion group and single-vessel lesion group (P＜ 0.05 or ＜ 0.01).The serum level of HO-1 was positively related with IMT of carotid (r =0.512,P ＜0.01).Conclusion The high-level expression of HO-1 is found in HDM and T2DM patients,which maybe play a key role in the early diagnosis of T2DM.