Clinical Study Of Overactive Bladder Ear Acupuncture Treatment

This thesis includes two parts, a literature review and details of the clinical research conducted.The literature review was done after comprehensive review of270publication material. A discussion on the Overactive Bladder (OAB) from the Traditional Chinese Medicine (TCM) and Western Medicine perspective is provided. The first section of the review gives a summary of OAB and its corresponding names in TCM. Both historical and modern understandings of OAB etiology, its pathogenesis, syndrome classification and diagnosis are given. Following this, the role of acupuncture and herbal formulas in the treatment of this disease is explored. And introduced the system of diagnosis and treatment method in auricular points The second section focuses on the definition, classification, pathogenic mechanisms, diagnostic measures and possible modes of treatment of OAB from a Western Medicine perspective.The third section gives an elaboration of the clinical research conducted. This includes the study objectives, patients’case details, various criterions for diagnosis, inclusion and elimination, research methods and results, as well as a conclusion and discussion.Objective:To observe the clinical effect of auricular needle treatment on OAB, in order to find a simple and effective treatment with little side effects; to identify auricular points associated with OAB. This can serve to guide auricular point selection during future OAB treatment. An ear detector equipment was used to the patients before treatment, to find the auricular points witch might be related to OAB in order to provide clinical guidance for the use in treatment.Methods:First, an OBASS scale is designed to measure the extent of excessive bladder activity. Also included in this scale is the patient’s basic information, predisposing factors, presenting symptoms and treatment details. Using auricular needle therapy, the following auricular points are needled:kidney, bladder, urethra, genitalia, shenmen, auricular sympathetic point and subcortical brain nuclei point. In addition, the lung point was needled for patients who exhibited lung qi deficiency, the spleen point was needled for patients who had spleen qi deficiency, and the liver point was needled for patients who had liver qi stasis. Auricular pain pressure points were also directly needled. Additional points were needled based on other presenting symptoms. Patients with insomnia were needled at the shenjingshuairuo point, those with stomach discomfort were needled at the stomach point, and those with an accompanying cough were needled at the bronchial point. Treatment was conducted with two sessions a week; a complete treatment course was four weeks, or eight sessions. During these four weeks, improvements in the patients’ conditions were recorded. Ear detector equipment was used for patient of OAB to detect auricular point during recording. Symptoms before and after the treatment were compared. Statistical analysis of the data was done with SPSS17.0software. Through this analysis, a group of common auricular points with positive pain pressure reaction were identified, in order to facilitate the search for auricular points relevant to OBS treatment.Results:The OABSS rating scores before and after treatment were (12.5±6.6)/(5.1±5.0) respectively. Using a paired t test statistical analysis, P=6.18×10-10<0.05, the difference between both rating scores is statistically significant. Using the Nimodipine efficacy index calculation method, of the32total cases, out of which2had full recuperation and treatment was shown to be highly effective for10cases, and effective for16cases,3were invalid, the curative rate was6.3%, high treatment efficacy rate was31.2%, moderate treatment efficacy rate was50%,12.5%of the cases showed no treatment efficacy, and the total treatment efficacy rate was87.5%. An ear detector equipment was used to the patients before treatment, to find that auricular points-shoulder, heart, genitals, pelvis, eye, kidney, triple burner, clavicle, shenmen and lung were appeared to be positive more times than others.Conclusion:This study is supportive of the curative effect of auricular needle therapy on OAB, and there are no major side effects displayed. Such treatment is easily accepted by patients, it is simple and convenient to implement in a clinical setting and also easy to promote at the community level. These auricular points-shoulder, and collarbone are possibly related to OAB, and this can serve as guidance for future OAB treatment.Meaning:Through this study, the effect of auricular needle therapy on OAB is better understood. The study serves to provide clinical guidelines and a theoretical basis for the use of acupuncture in OAB treatment, in particular at community clinics. It also gives emphasis to the advantages of acupuncture in the treatment of this disease.