电针深刺天枢穴治疗中风后便秘的临床疗效观察及其对血清SP、VIP含量的影响

发布时间：2018-03-16 14:34

本文选题：中风　切入点：便秘　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察电针深刺天枢穴治疗中风后便秘的临床疗效,研究其对血清SP、VIP含量的影响。通过观察电针深刺天枢穴、电针支沟上巨虚以及西药治疗对中风后便秘的临床疗效,来较大幅度的提高中风后便秘患者的生活质量,为中风后便秘提供更好的治疗方法,同时研究针灸治疗中风后便秘的机制。方法:从江苏省中医院针灸康复科住院病人中选取中风后便秘患者90例,将90例患者随机分为天枢组、上巨虚支沟组和西药组,每组各30例。天枢组患者选择双侧天枢穴,局部消毒后直刺至手下有突破感,后接电针,选疏密波,患者耐受为度,每次治疗30分钟,每日一次,1周6次,2周为1疗程;上巨虚支沟组选择双侧上巨虚、双侧支沟穴,常规针刺后连接电针,选疏密波,患者耐受为度,每日1次,每次30min,1周6次,2周为一疗程;西药组口服乳果糖,每日1次,早晨顿服,一次10mg,2周为1疗程。疗程结束后观察各项积分情况,检测指标,对数据进行分析,得出结果。结果:治疗前3组患者性别、年龄、中风类型、大便性状评分、CCS评分、症状积分、便秘患者生存质量评分、血清SP含量、血清VIP含量均无统计学差异,具有可比性。治疗后天枢组疗效优于上巨虚支沟组、西药组,有统计学意义(p0.05);治疗后3组大便性状无显著性差异(p0.05);治疗后天枢组CCS评分、症状积分、便秘患者生存质量评分均低于上巨虚支沟组和西药组,有统计学意义(p0.05)。天枢组患者治疗后血清SP含量高于上巨虚支沟组和西药组,VIP含量低于上巨虚支沟组和西药组,具有统计学意义(p0.05)。结果还提示天枢组、上巨虚组的复发率均低于西药组,有统计学意义(p0.05)。结论:电针深刺天枢穴治疗中风后便秘显著,对比电针上巨虚、支沟穴和西药能更有效的改善临床症状,且具有安全、复发率低等优势。电针深刺天枢通过升高SP、降低VIP含量从而改善便秘症状。
[Abstract]:Objective: to observe the clinical effect of electroacupuncture at Tianshu point in treating constipation after apoplexy, and to study the effect of electroacupuncture on the content of serum SPN VIP in patients with constipation after apoplexy. To greatly improve the quality of life of patients with post-stroke constipation, and to provide a better treatment for post-stroke constipation. At the same time, the mechanism of acupuncture and moxibustion in treating constipation after apoplexy was studied. Methods: 90 cases of constipation after apoplexy were selected from Department of Acupuncture and Rehabilitation, Jiangsu Provincial Hospital of traditional Chinese Medicine. 90 patients were randomly divided into Tianshu group, Shangjuxujigou group and western medicine group. There were 30 cases in each group. The patients in Tianshu group were treated with bilateral Tianshu acupoints. After local disinfection, the patients were directly punctured to have a sense of breakthrough, followed by electroacupuncture, selective dense wave, patient tolerance, 30 minutes each time, 6 times a day, 6 times a week, 2 weeks as a course of treatment. In the Shangjuxu Zhigou group, the patients were divided into two groups: bilateral superior asthenia and bilateral branchogou points. After routine acupuncture, electroacupuncture was connected with electroacupuncture to select the dense wave. The patient tolerance was one course of treatment once a day, 6 times a week for 30 mins, 6 times a week for 2 weeks, while the western medicine group took lactofructose once a day, while the patients in the western medicine group were treated with lactulose once a day. At the end of the course, the scores were observed, the indexes were measured, the data were analyzed and the results were obtained. Results: before treatment, the three groups received CCS score, including sex, age, stroke type, stool trait score and so on. There was no statistical difference in symptom score, quality of life score, serum SP content and serum VIP content in patients with constipation, but there was no significant difference between the two groups. After treatment, the curative effect of Tianshu group was better than that of Shangjuxuzhigou group and western medicine group. There was no significant difference in defecation traits among the three groups after treatment, and the scores of CCS, symptom score and quality of life of constipation patients in Tianshu group were lower than those in Shangjuxu Zhigou group and western medicine group. After treatment, the serum SP content in Tianshu group was higher than that in Shangjuxujiigou group and western medicine group, which was significantly lower than that in Shangjuxujigou group and western medicine group. The recurrence rate of Shangjuxu asthenia group was lower than that of western medicine group, which had statistical significance (P 0.05). Conclusion: the treatment of constipation after apoplexy by electroacupuncture deep needling Tianshu point is significant. Compared with Shangju deficiency, Zhigou acupoint and western medicine, the clinical symptoms can be improved more effectively and safely. Electroacupuncture can improve constipation symptoms by increasing VIP content.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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