耳鸣患者少阳经耳周及远端穴压痛反应及其压痛阈研究

发布时间：2018-05-26 10:33

本文选题：耳鸣 + 风池　；参考：《北京中医药大学》2017年硕士论文

【摘要】：1.研究目的:根据本团队前期研究结果,选取少阳经耳周的完骨、耳门、听会、翳风、风池5穴及肘膝关节以下的外关、中渚、阳陵泉、丘墟、足临泣5穴,将耳鸣组和非耳鸣对照组以上10穴的压痛反应及其压痛阈进行比较,研究10穴在耳鸣患者中的特异性反应,为针灸治疗耳鸣提供临床选穴依据。2.研究方法:选取耳鸣组90例,非耳鸣对照组30例,分别对其少阳经耳周的完骨、耳门、听会、翳风、风池5穴及肘膝关节以下的外关、中渚、阳陵泉、丘墟、足临泣5穴进行按压,记录压痛反应阳性穴位,并采用压痛测试仪分别对上述10穴压痛阈进行测量。3.研究结果3.1耳鸣组和非耳鸣对照组一般情况(1)性别:耳鸣组90例,其中男30例(33.33%),女60例(66.67%),女性耳鸣发病率高于男性,有极显著性差异(p0.01);非耳鸣对照组30例,其中男16例(53.33%),女14例(占46.67%);耳鸣组和非耳鸣对照组性别比较,无显著性差异(p0.05),具有可比性。(2)年龄:耳鸣组:年龄最小19岁,最大70岁,平均年龄48.5岁。其中50-60岁年龄段耳鸣发病率最高,为33.33%,其次为41-50岁,发病率为21.11%;非耳鸣对照组:年龄最小19岁,最大61岁,平均年龄43.7岁;两组各年龄段人数比较均为p0.05,无显著性差异,具有可比性。(3)耳鸣患者的病程:0～3个月者29例(急性耳鸣),3～12个月者16例(亚急性耳鸣),12个月以上者45例(慢性耳鸣),其中12个月以上的慢性耳鸣患者最为多见,发病率为50.0%。(4)耳鸣侧别:90例耳鸣患者中,左侧耳鸣30例,右侧耳鸣19例,双侧耳鸣39例,脑鸣2例,以双侧耳鸣患者发病率最高,占43.3%。(5)耳鸣严重程度分级:Ⅰ级41例(45.6%),Ⅱ级35例(38.9%),Ⅲ级9例(10.0%),Ⅳ级5例(5.6%),其中Ⅰ级病例数最多,占45.6%。3.2耳鸣组与非耳鸣对照组少阳经10穴压痛反应及其压痛阈比较(1)10穴压痛反应频次比较:90例耳鸣患者中,完骨穴的压痛反应频次为76次(84.4%),非耳鸣对照组完骨压痛反应频次为20次(66.7%),耳鸣组明显高于非耳鸣对照组(p0.05);其余9穴(耳门、听会、翳风、风池、外关、中渚、阳陵泉、丘墟、足临泣穴)与非耳鸣对照组比较均无显著性差异(p0.05)。(2)10穴压痛阈均值比较:耳鸣组的完骨、翳风、风池、外关4穴的压痛阈均值均小于非耳鸣对照组,有显著性差异(p0.05);中渚、阳陵泉、足临泣3穴的压痛阈均值也小于非耳鸣对照组,有极显著性差异(p0.01);其余3穴(耳门、听会、丘墟穴)两组比较,均无显著性差异(p0.05)。3.3耳鸣患者少阳经10穴压痛侧别分布(1)30例左耳鸣患者中,耳门、听会、翳风、完骨、风池、外关、中渚、丘墟、足临泣9穴在双侧有压痛反应者均高于单在左侧、右侧有反应者,有极显著性差异(p0.01);阳陵泉穴在双侧有压痛反应者亦高于单在左侧、右侧有反应者,分别有显著性差异(p0.05)及极显著性差异(p0.01);10穴单在左、右侧有压痛反应者比较,均无显著性差异(p0.05)。(2)19例右耳鸣患者中,听会、翳风、完骨、风池、中渚、阳陵泉、丘墟、足临泣8穴在双侧有压痛反应者均高于单在左侧、右侧有反应者,有极显著性差异(p0.01);耳门穴在双侧有压痛反应者亦高于单在左侧、右侧有反应者,分别有显著性差异(p0.05)及极显著性差异(p0.01);外关穴单在左侧、右侧、双侧有压痛反应者相互比较,均无显著性差异(p0.05);10穴单在左、右侧有压痛反应者比较,均无显著性差异(p0.05)。(3)39例双耳鸣患者中,耳门、听会、翳风、完骨、风池、外关、中渚、丘墟、足临泣9穴在双侧有压痛反应者均高于单在左侧、右侧有反应者,有极显著性差异(p0.01);阳陵泉穴单在左侧、双侧有压痛反应者均高于单在右侧有反应者,有极显著性差异(p0.01),而单在双侧与单在左侧有压痛反应者比较,无显著性差异(p0.05);除阳陵泉穴外,其余9穴单在左、右侧有压痛反应者比较,均无显著性差异(p0.05)。4结论4.1耳鸣组与非耳鸣对照组比较,压痛最敏感的穴位是耳后的完骨穴,其次为耳后的翳风、风池穴,以及肘膝关节以下的外关、中渚、阳陵泉、足临泣穴,提示这些穴位可以作为治疗耳鸣的优先选穴4.2无论单侧耳鸣还是双侧耳鸣,其压痛频次大都表现为双侧高于单侧。提示临床治疗耳鸣可选取双侧穴位。
[Abstract]:1. research purposes: according to the results of the previous study of the team, we selected the bone of the ear, the ear door, the hearing, the Yifeng, the 5 acupoints of the wind pool and the elbow and knee joints, the middle Zhu, Yang Ling spring, Qiu Xu and the 5 acupoints, and compared the tenderness reaction and the pressure pain threshold of the 10 points above the tinnitus group and the non tinnitus control group, and studied the 10 acupoints in the tinnitus patients. Specific reaction, to provide clinical point selection basis.2. research method for acupuncture treatment of tinnitus: 90 cases of tinnitus group and 30 non tinnitus control groups, which were pressed to record the positive acupoints of pressure pain response, respectively, to press the bone of the ear, the ear door, the hearing, Yifeng, the 5 points of the wind pool and the outside of the elbow and knee joint, the middle Zhu, Yangling spring, Qiu Xu and the foot Lin weeping 5 points. The 10 points of the 10 acupoint pressure pain threshold were measured by the pressure pain test instrument, 3.1 of the tinnitus group and the non tinnitus control group (1) sex: 90 cases of tinnitus group, including 30 men (33.33%) and 60 women (66.67%). The incidence of tinnitus in women was higher than that of men (P0.01); the non tinnitus control group was 30 cases, of which 16 men (53.) were male (16 men (53.). 33%), 14 women (46.67%); there was no significant difference in sex between the tinnitus group and the non tinnitus control group (P0.05). (2) age: tinnitus group: the youngest age 19, the maximum 70 years old, and the average age of 48.5 years. The incidence of tinnitus in 50-60 years of age was the highest, 33.33%, and 41-50 years, and the incidence was 21.11%; non tinnitus control group: age group: age The minimum 19 years, the maximum 61 years old, the average age of 43.7 years, the two groups of age groups are P0.05, no significant difference, there is a comparable. (3) the course of tinnitus patients: 0~3 months, 29 cases (acute tinnitus), 3~12 months in 16 cases (subacute tinnitus), 12 months more 45 cases (chronic tinnitus), among them more than 12 months of chronic tinnitus patients most The incidence was 50.0%. (4) tinnitus: in 90 cases of tinnitus, there were 30 cases of left tinnitus, 19 cases of right tinnitus, 39 cases of bilateral tinnitus and 2 cases of brain ringing. The incidence of bilateral tinnitus patients was the highest, accounting for the severity of 43.3%. (45.6%), 35 cases (38.9%), grade III 9 cases (10%) and grade IV 5 cases. At most, the group of 45.6%.3.2 tinnitus group and non tinnitus control group were compared with the 10 acupoint pressure pain response and the pressure pain threshold (1) the 10 acupoint pressure pain response frequency comparison: 90 cases of tinnitus patients, the frequency of the pressure pain reaction was 76 times (84.4%), the non tinnitus control group was 20 times (66.7%), and the tinnitus group was significantly higher than the non tinnitus control group (P0.05 There was no significant difference between the other 9 points (ear, hearing, Yifeng, yoshu, Yangling spring, yangmausu spring, Qiu Xu, foot Lin weeping point) and non tinnitus control group (P0.05). (2) the mean of the 10 acupoint pressure pain threshold was compared with that of the tinnitus group, Yifeng, the wind pool and the 4 acupoints in the outer gate were less than the non tinnitus control group, and there were significant differences (P0.05); Zhong Zhu and Yang Mausoleum The mean value of the pressure pain threshold of the 3 acupoints in the 3 points was also less than that of the non tinnitus control group (P0.01); the other 3 points (ear, hearing, Qiu Xuxue) had no significant difference (P0.05), there were 30 cases of left tinnitus in the patients with.3.3 tinnitus (1) in 30 cases of left tinnitus, the ear door, hearing, Yifeng, the bone, the wind pool, the outer Guan, Zhong Zhu, and the ruins. There were significant difference (P0.01) in both sides of the 9 acupoints with pressure pain in the two sides of the foot and facing sobs, and there were significant difference (P0.01) in the right side. There were significant difference (P0.05) and significant difference (P0.01) in the right side reacting people at the right side of the Yang Ling spring acupoint, respectively. The 10 points were in the left and the right side had the pain response. All There was no significant difference (P0.05). (2) in 19 cases of right tinnitus, hearing, Yifeng, bone, wind pond, middle Zhu, Yang Ling spring, Qiu Xu, foot facing weeping 8 were higher than single in the left side, and there was a significant difference (P0.01) in the right side. There were significant differences (P0.05) and significant difference (P0.01); there was no significant difference in the left, right side, and bilateral pressure pain response (P0.05). There was no significant difference between the 10 points on the left and the right side with the pain response (P0.05). (3) in 39 cases of double tinnitus, the ears, hearing, Yifeng, the bone, the wind pool, the outer customs, and the Zhu Zhu There were significant difference (P0.01) in both sides of the 9 acupoints of Qiu Xu and foot facing weeping in both sides and on the right side, and there was a significant difference (P0.01) in the left side of the acupoint of Yang Ling Quan, which was higher than that in the right side (P0.01), but there was no significant difference between the two sides and the one on the left side. The difference (P0.05); in addition to the Yang mauling spring point, the other 9 points were in the left, and there was no significant difference in the right side. (P0.05).4 conclusion the 4.1 tinnitus group was compared with the non tinnitus control group. The most sensitive acupoint of the tenderness was the acupoint of the bone after the ear, followed by the Yifeng, the wind pool point, and the outside of the elbow and knee joints, the Zhu Zhu, the Yang Maling spring, the foot and the face. Weeping points suggest that these acupoints can be used as a priority selection for treatment of tinnitus 4.2 regardless of unilateral tinnitus or bilateral tinnitus. The frequency of the pressure is mostly bilateral higher than unilateral. It suggests that the clinical treatment of tinnitus can be selected as a bilateral acupoint.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.81

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