穴位贴敷加针刺对妇科腹腔镜术后胃肠功能紊乱临床研究

发布时间：2018-07-05 20:30

本文选题：穴位贴敷 + 针刺　；参考：《广州中医药大学》2014年硕士论文

【摘要】：目的：利用随机对照的方法,观察穴位贴敷结合针刺对妇科腹腔镜术后胃肠道功能恢复的影响,探讨中医治疗术后胃肠道功能紊乱的优效方案。方法： 1.选取60例术前辨证为脾阳虚证的妇科腹腔镜手术后患者,运用随机数字表方法分为治疗组(穴位贴敷结合针刺)和对照组(针刺治疗) 2.治疗方法：治疗组先用吴茱萸粉和生姜水调至粘稠状,制成1cm*1cm*1cm的药饼,贴敷于神阙穴、双(胃俞、膈俞、脾俞),贴敷时间为3小时。穴位贴敷治疗结束后进行针刺操作,针刺穴位：足三里、上巨虚、太冲、三阴交(均双侧),深度10mm-30mm,得气后留针20min。对照组仅做针刺处理,针刺处方及操作同治疗组。 3.观察的指标：记录患者术后首次排气、排便的时间,并利用《中药新药临床研究指导原则》、Prince-henry和尼莫地平法对患者治疗前后腹胀、恶心呕吐和腹痛等症状进行评价。结果： 1.治疗前一般资料比较两组受试者在年龄构成、身高、体重、麻醉时间、手术时间和治疗前症状积分等各方面比较上无显著性差异(P0.05),具有可比较性,提示两组患者在治疗前临床资料方面具有同质性,均衡可比。 2.治疗后比较 (1)两组治疗前、后自身比较通过对治疗前后总症状评分比较,两组治疗后症状积分均低于治疗前,有显著性差异(p0.05),提示两组均可改善术后胃肠道的功能,有一定疗效。 (2)治疗后组间比较 .①首次排气、排便时间比较：经组间t检验,治疗组的排气、排便时间均较对照组短,二者有显著性差异(P0.05),提示治疗组在改善术后排气、排便症状方面明显优于对照组。 ②治疗后恶心、腹胀、腹痛等症状积分比较：经t检验,治疗后治疗组在恶心呕吐、腹胀、腹痛等症状积分比较上明显低于对照组,二者有显著性差异(P0.05),提示治疗组在改善术后恶心呕吐、腹胀、腹痛等方面明显优于对照组,有利于术后胃肠道功能的恢复。 (3)总体疗效比较经尼莫地平法评价,结果显示治疗组痊愈2人,显效21人,有效7人；对照组痊愈1人,显效17人,有效12人。经秩和检验Z=-2.553,p=0.0110.05,提示治疗组在总体疗效上明显优于对照组。结论：穴位贴敷结合针刺和单纯针刺法对腹腔镜术后患者胃肠功能恢复均有一定疗效,其中穴位贴敷结合针刺法在改善术后患者的恶心呕吐、腹胀腹痛及术后排气排便等方面明显优于单纯针刺组,提示穴位贴敷结合针刺有利于妇科腹腔镜术后胃肠道功能的恢复,且缩短了术后首次排气、排便的时间,各项症状改善较明显。
[Abstract]:Objective: to observe the effect of acupoint application combined with acupuncture on the recovery of gastrointestinal function after gynecological laparoscopy, and to explore the effective scheme of traditional Chinese medicine (TCM) in the treatment of postoperative gastrointestinal dysfunction. Methods: 1. Sixty patients with spleen yang deficiency syndrome were selected and randomly divided into treatment group (acupoint application combined with acupuncture) and control group (acupuncture treatment). Treatment methods: the treatment group was treated with Evodia rutaecarpa powder and ginger water to the viscous form, made of 1cm*1cm*1cm medicine cake, applied to Shenque point, double (Weishu, Geshu, Pi Yu), the application time was 3 hours. Acupuncture operation was carried out after acupoint application treatment. Acupuncture acupoints: Zusanli, Shangjuxu, Taochong, Sanyinjiao (both sides), depth 10mm-30mm, retention of acupuncture for 20 mins after getting qi. The control group was treated with acupuncture only, the acupuncture prescription and operation were the same as that in the treatment group. Outcome measures: the first time of exhaust and defecation was recorded, and the symptoms of abdominal distension, nausea, vomiting and abdominal pain were evaluated by Princeton -henry and nimodipine before and after treatment. Results: 1. There was no significant difference in age composition, height, weight, anesthetic time, operation time and symptom score before treatment between the two groups (P0.05). The results suggest that the two groups have homogeneity in the clinical data before treatment, balanced and comparable. 2. 2. Comparison after treatment (1) before and after treatment, the symptom scores of the two groups were lower than those before and after treatment by comparing the total symptom scores before and after treatment. There was significant difference (p0.05), suggesting that the two groups can improve the gastrointestinal function after operation, and have a certain curative effect. (2) the comparison of the first exhaust and defecation time between the two groups after treatment: after t test, the exhaust of the treatment group was better than that of the control group. The time of defecation was shorter than that of the control group (P0.05), suggesting that the treatment group was superior to the control group in improving postoperative exhaust and defecation symptoms. 2 comparison of symptoms such as nausea, abdominal distension and abdominal pain after treatment: t test. After treatment, the scores of nausea and vomiting, abdominal distension and abdominal pain in the treatment group were significantly lower than those in the control group (P0.05), indicating that the treatment group was superior to the control group in improving postoperative nausea and vomiting, abdominal distension, abdominal pain, etc. (3) the overall curative effect was evaluated by nimodipine method. The results showed that 2 patients were cured in the treatment group, 21 were effective and 7 were effective in the treatment group, while in the control group, 1 was cured and 17 were significantly effective. Effective 12. The rank sum test showed that the treatment group was superior to the control group in overall curative effect. Conclusion: acupoint application combined with acupuncture and simple acupuncture has certain curative effect on gastrointestinal function recovery after laparoscopic surgery, among which acupoint application combined with acupuncture can improve postoperative nausea and vomiting. The abdominal distention and abdominal pain and postoperative exhaust and defecation were better than those in the simple acupuncture group. It suggested that the combination of acupoint application and acupuncture was beneficial to the recovery of gastrointestinal function after gynecological laparoscopy, and shortened the time of first exhaust and defecation after operation. The symptoms were improved obviously.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R246.3

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