【目的】观察电针八髎穴联合金匮肾气丸汤剂治疗肾阳虚型脑卒中后神经源性膀胱 （PSNB） 的临床疗效。 【方法】将86例 肾阳虚型PSNB患者随机分为观察组和对照组，每组各43例，对照组给予电针八髎穴及常规康复治疗，观察组在对照组治疗 的基础上，给予金匮肾气丸汤剂治疗，连续治疗4周。治疗4周后，评价2组临床疗效，观察2组患者治疗前后改良Barthel 指数量表 （MBI） 评分的变化情况，以及每日排尿情况和尿动力学指标的变化情况。比较2组患者治疗前后血清超氧化物歧化 酶 （SOD） 水平的变化情况。 【结果】（1） 观察组总有效率为95.35% （41/43） ，对照组为79.07% （34/43） 。观察组疗效优于对照组， 差异有统计学意义 （P＜0.05） 。 （2） 治疗后，2组患者的每日排尿情况包括日均排尿次数、日均单次排尿量和日均尿失禁次数 均明显改善 （P＜0.05） ，且观察组在改善日均排尿次数、日均单次排尿量和日均尿失禁次数方面明显优于对照组，差异有统 计学意义 （P＜0.05） 。 （3） 治疗后，2组患者的尿动力学指标包括最大膀胱容量、最大尿流速率、残余尿量、膀胱顺应性、最 大尿道压和逼尿肌压力均明显改善 （P＜0.05） ，且观察组在改善最大膀胱容量、最大尿流速率、残余尿量、膀胱顺应性、最 大尿道压和逼尿肌压力方面明显优于对照组，差异均有统计学意义 （P＜0.05） 。 （4） 治疗后，2组患者的血清SOD水平均明显 改善 （P＜0.05） ，且观察组在改善血清SOD水平方面明显优于对照组，差异有统计学意义 （P＜0.05） 。 （5） 治疗后，2组患者的 MBI评分均明显改善 （P＜0.05） ，且观察组在改善MBI评分方面明显优于对照组，差异有统计学意义 （P＜0.05） 。 【结论】电针 八髎穴联合金匮肾气丸汤剂治疗肾阳虚型PSNB，能明显改善患者的排尿功能，有效改善患者的尿流动力学指标，下调患者 的血清SOD水平，提高患者的日常生活质量，疗效显著。

Objective To observe the clinical efficacy of electroacupuncture at Baliao points combined with Jingui Shenqi Wan Decoction in the treatment of post-stroke neurogenic bladder of kidney-yang deficiency type. Methods A total of 86 patients with post-stroke neurogenic bladder （PSNB） of kidney-yang deficiency type were randomly divided into observation group and control group，with 43 cases in each group. The control group was given electroacupuncture at Baliao points and routine rehabilitation treatment. On the basis of the treatment of the control group，the observation group was treated with Jingui Shenqi Wan Decoction for four weeks. After four weeks of treatment，the clinical efficacy of the two groups was evaluated，and the changes of Modified Barthel Index （MBI） score，daily urination and urodynamic indexes of the two groups were observed before and after treatment. The changes of serum superoxide dismutase （SOD） level were compared before and after treatment between the two groups. Results （1） The total effective rate was 95.35%（41/43） in the observation group and 79.07%（34/43） in the control group. The curative effect of the observation group was superior to that of the control group，and the difference was statistically significant （P＜0.05） . （2） After treatment，the daily urination conditions of the two groups of patients，including the average daily urination times，the average daily single urination volume and the average daily urinary incontinence times，were significantly improved （P＜0.05），and the improvement of the average daily urination times，the average daily single urination volume and the average daily urinary incontinence times in the observation group were significantly superior to those in the control group，and the differences were statistically significant（P＜0.05） . （3）After treatment， the urodynamic indexes including maximum bladder capacity，maximum urinary flow rate，residual urine volume，bladder compliance，maximum urethral pressure and detrusor pressure in the two groups were significantly improved （P＜0.05） ，and the improvement of maximum bladder capacity，maximum urinary flow rate，residual urine volume，bladder compliance，maximum urethral pressure and detrusor pressure in the observation group was significantly superior to that in the control group，the differences were statistically significant （P＜0.05） . （4） After treatment，the level of serum SOD in the two groups were significantly improved （P＜0.05） ，and the improvement in the observation group was superior to that in the control group，the difference being significant （P＜0.05） . （5） After treatment，the MBI scores of the two groups were significantly improved（P＜0.05）， and the improvement of MBI scores in the observation group was significantly superior to that in the control group，the difference was statistically significant （P＜0.05） . Conclusion Electroacupuncture at Baliao points combined with Jingui Shenqi Wan Decoction in the treatment of PSNB of kidney-yang deficiency type can significantly improve the urination function of patients，effectively improve the urodynamic indexes of patients，down-regulate the serum SOD level of patients，and improve the quality of daily life of patients.

R246.9

国家中医药管理局资助项目 （编号：lc20160220）；四川省科技计划资助项目 （编号：2021YFS0017）