January 25, 2020 / By admin
Moxibustion gods treat dysuria after stroke
Current research mainly believes that urinary incontinence, urgency, and frequent urination after stroke are caused by the displacement of the brain’s micturition center and nerve conduction pathways, including the frontal lobe, parietal lobe, basal ganglia, internal capsule, cerebellum, and brain stemBladder, urethral dysfunction, called neurogenic bladder.
Acute urinary retention often occurs in the acute phase, and urinary incontinence (often accompanied by varying degrees of residual urine at the same time), urgency, and frequent urination are more apparent in the recovery and sequelae periods.
Urinary tract infection is the most common complication of neurogenic bladder. Almost every patient with neurogenic bladder has a history of urinary system infection of varying degrees.
Because patients often have varying degrees of residual urine, the resistance of the urinary tract to bacteria is reduced, infections often recur, and it is not easy to completely control.
Infection can aggravate the abnormality of bladder function.
Catheterization is one of the most basic and simple treatments, which is suitable for patients with urinary retention and recurrent incontinence.
Most of the domestic indwelling catheterization methods are used, but the long-term indwelling catheterization, the urine bacterial culture positive rate is almost 100%.
Drug treatment is not ideal in many cases, and there are more obvious alternatives for long-term use.
Through continuous practice, combined with the warm-pass method of He Puren’s “Hee’s Three-way Method” and the experience of Jin Needle Wang Leting, a method of moxibustion and shivering with ginger and salt was summarized for the treatment of dysuria after stroke and a prospective study.
By evaluating the urination diary and urinary incontinence classification before and after treatment for 72 hours, it was found that: ① Compared with before treatment, this therapy can improve the symptoms of urinary frequency, effectively reduce the average daily urination frequency, and effectively reduce the number of calls by night care workers.Mean frequency; there is no significant difference in reducing urinary frequency symptoms after treatment compared with before treatment.
② Compared with plasma, this therapy can effectively reduce the occurrence of urinary incontinence during the day and sleep incontinence at night, and can effectively improve the classification of urinary incontinence in patients.
③ By observing the occurrence of urinary tract infections before and after treatment, it was found that the moxibustion method may reduce the occurrence of urinary tract infections, but there will be no significant difference (may be related to the small sample size).
④ In terms of safety, this therapy has high safety, strong compliance, and scalding caused by inadequate care, which can be completely avoided by careful operation.
In order to solve the allergies and other problems that moxibustion smoke may cause, patients can be arranged to perform moxibustion treatment in the treatment room to avoid affecting others.
In addition, the therapy is simple and easy for family members to master, and family treatment can continue after discharge.
Moxa is cheap and easy to buy; ginger and salt are daily necessities and very economical.
Treatment method: Take Shenxian acupoint.
Fill the navel (shenque point) with edible salt and cut the ginger to a thickness of about 0.
Ginger slices with a diameter of 8 cm and a round shape have a minimum diameter of not less than 4 cm.
Moxa is kneaded into a cone with a diameter of about 3 cm on the bottom and a height of about 3 cm, and placed on top of ginger slices.
Then put ginger slices and moxa into the shrine hole filled with salt.
Ignite moxa and wait until it is completely burned. Moxibustion is continued for 2 times, once a day.
Patients also received conventional acupuncture treatment for stroke, with twelve acupuncture hands and feet, that is, bilateral Quchi, Hegu, Neiguan, Zusanli, Yanglingquan, and Sanyinjiao.
All the above treatments were treated 5 times a week for 3 weeks.
From the etiology perspective, urodynamic tests are very important for clarifying the cause of dysuria. It is the only objective indicator for grading the lower urinary tract urinary function, which can more accurately reveal the functional state of the lower urinary tract, and at the same time subjective perception of patients.It is specifically related to the bladder storage and discharge capacity, and provides a variety of practical parameters for the clinic.
At present, it is generally believed that permanent damage to the cerebral cortical lesions and neural pathways that control urination will affect the subjective ability to inhibit detrusor reflex contractions, leading to hyperactive bladder reflexes, and detrusor muscles respond to stress, pain, and swelling.Hyperreflexia, an unstable bladder, increased intravesical pressure, and varying degrees of sphincter relaxation, leading to frequent urination, urgency, and urgency incontinence, often accompanied by urinary system infections.
Therefore, before and after treatment, urodynamic tests including bladder compliance, bladder manometry, bladder stability, bladder sensation, and detrusor systolic blood pressure at the maximum urinary flow rate during micturition are performed.It is helpful to explore the mechanism of ginger and salt moxibustion.
In addition, ginger and salt moxibustion improves urinary frequency. Is the mechanism of urinary incontinence related to the reduction of residual urine volume in the bladder after treatment, which indirectly enhances the stability of the bladder?
Is this moxibustion beneficial to the prevention of urinary tract infections and is it related to the reduction of residual urine volume in the bladder after treatment, thereby increasing the urinary tract resistance to bacteria?
These questions need to be answered by measuring residual bladder volume before and after treatment and further research.