耳穴揿针联合行为疗法治疗轻中度膀胱过度活动症伴焦虑症状:随机对照试验OA

Objective To observe the effect of auricular thumbtack needle combined with behavioral therapy on anxiety symptoms,clinical symptoms,and peripheral serum 5-hydroxytryptamine(5-HT)content in female patients with mild to moderate overactive bladder(OAB)accompanied by anxiety symptoms.Methods A total of 118 female patients with mild to moderate OAB and anxiety symptoms were randomly divided into an experimental group(59 cases,10 dropouts)and a control group(59 cases,2 dropouts).In the control group,the behavioral therapy and basic treatment were provided.In the experimental group,auricular thumbtack needle therapy was given in addition to treatments in the control group.The thumbtack needles were applied to the auricular points of heart(CO15),liver(CO12),kidney(CO10),and bladder(CO9).Behavioral therapy was conducted daily,and the thumbtack needles were replaced every 3-4 days,alternating between both ears,for a total of 6 weeks.The following indicators were observed before and after treatment:overactive bladder symptom score(OABSS),Hamilton anxiety scale(HAMA)score,overactive bladder questionnaire(OAB-q)score,Pittsburgh sleep quality index(PSQI)score,Hamilton depression scale(HAMD)score,traditional Chinese medicine(TCM)syndrome score,urodynamic parameters(maximum flow rate[MFR],maximum cystometric capacity[MCC],and residual urine volume[RUV]),nocturia frequency,and serum 5-HT content measured by ELISA.Results After 2,4,and 6 weeks of treatment,the scores of OABSS,HAMA,OAB-q,PSQI,HAMD,and TCM syndrome scores in both groups decreased significantly(P<0.05)compared with those before treatment.After 6 weeks of treatment,the nocturia frequency of patients in both groups were lower(P<0.05)than those before treatment,while the MFR,MCC and serum 5-HT contents were all higher(P<0.05)than those before treatment;RUV of the experiment group decreased(P<0.05).Compared with the control group at different time points after treatment,the experimental group showed lower scores of OABSS,HAMA,OAB-q,PSQI,HAMD,TCM syndrome scores as well as reduced nocturia frequency(P<0.05),along with elevated MFR,MCC and serum 5-HT contents(P<0.05).The total effective rate of the experimental group was 95.92%(47/49),which was significantly higher than that of the control group(80.70%,46/57,P<0.05).Conclusion On the basis of behavioral therapy,combined with auricular thumbtack needle stimulation of the vagus nerve,it can effectively alleviate anxiety,improve clinical symptoms and nocturia in patients,and this therapy is safe in clinical application.