薄氏腹针配合药物疗法治疗强直性脊柱炎的临床疗效评价

发布时间：2018-03-03 07:05

  本文选题：强直性脊柱炎　切入点：腹针　出处：《广州中医药大学》2011年硕士论文　论文类型：学位论文

【摘要】：背景 强直性脊柱炎(ankylosing spondylitis, AS)是一种原因不明的慢性炎性疾病,主要侵犯中轴骨,以骶髂关节炎和附着病为其特征。强直性脊柱炎虽大多不会对人的生命造成严重的威胁,但由于患病者可出现明显的腰背部僵硬、疼痛,晚期甚至可发生脊柱强直、畸形,造成严重的躯体功能活动障碍,故给患者带来很大的痛苦,严重影响患者的生存质量。目前尚无可完全治愈的理想方法,是国际上公认的一种难治疾病。 本文回顾了中西医在认识强直性脊柱炎方面的历程,总结了中西医对强直性脊柱炎病因、病机、诊断及药物、针灸作用机理等方面的相关认识及研究,归纳概括了现阶段治疗强直性脊柱炎的主要方法,论述了腹针治疗强直性脊柱炎的理论依据,通过对照实验分析,对腹针治疗强直性脊柱炎的临床疗效做出评价。对今后腹针治疗强直性脊柱炎的临床研究方面提出自己的一些观点和看法。 目的 本课题通过对口服柳氮磺胺吡啶片、双氯芬酸钠缓释片与腹针联合口服柳氮磺胺吡啶片、双氯芬酸钠缓释片这两种方法治疗强直性脊柱炎的临床疗效进行对照观察,应用多项量化指标对两者的疗效进行评价,为日后运用腹针治疗强直性脊柱炎方面的研究及疗效评价体系的建立提供一定的文献依据及数据支持。 研究对象与方法 对广东省中医院珠海医院门诊及住院部患者进行筛选,符合纳入标准的患者共计40名(针药组19名,药物组21名)进行随机对照研究。两组即针药组和药物组均接受西药治疗,即口服双氯芬酸钠缓释片75mg,每日1次；柳氮磺胺吡啶片第1周每次口服0.5g,每日3次,第2周每次口服0.75g,每日3次,第3周起每次口服1.0g,每日3次,维持至3个月治疗结束。针药组在此基础上,加用薄氏腹针进行治疗。基本处方：中脘(D)、下脘(D)、气海(D)、关元(D)、中极(D)、气穴(D)、大横双(M)、外陵双(M)、滑肉门双(M)。下腰椎及骶椎疼痛,根据部位高低加关元上或关元下。合并髋关节疼痛：下风湿内点M(患)。必要时并配合局部定位取穴。手法采用轻刺激,无酸麻胀痛感,但指下有如鱼吞饵之沉紧。施术后留针20-30分钟,针后10分钟左右调针一次。每周一至六连续治疗6天后休息1天,连续治疗3个月。两组的主要疗效观测指标包括疼痛评分、ESR、HSCRP、IgA、IgG、IgM水平、指地距、扩胸距和20m步行时间。将相关数据录入数据库,建立数据库系统,运用相关软件进行统计学分析,最后得出结论。 结果 本研究的数据结果显示：腹针配合药物治疗强直性脊柱炎3个月,对与强直性脊柱炎相关的主要症状、体征及指标,如：疼痛评分、ESR、HSCRP、IgA、IgG、IgM水平、指地距、扩胸距和20m步行时间,都有明显的改善作用,其中在疼痛评分、ESR、IgA水平、指地距、扩胸距及20m步行时间方面腹针配合药物治疗效果更优于单纯药物治疗。腹针配合药物与单纯药物治疗强直性脊柱炎其显著疗效差异有统计学意义。 结论 薄氏腹针配合柳氮磺胺吡啶片、双氯芬酸钠缓释片治疗强直性脊柱炎可以取得良好的疗效。
[Abstract]:background
Ankylosing spondylitis (ankylosing spondylitis AS) is a chronic inflammatory disease of unknown cause, mainly affects the axial skeleton, with sacroiliitis and infirmity is characterized. Although most of ankylosing spondylitis does not pose a serious threat to human life, but because the disease can be significant lower back stiffness. Pain, late or even spinal stiffness, deformity, causing severe body movement disorder, so it brings great suffering to patients, seriously affect the life quality of the patients. No ideal method can be completely cured, is considered the a refractory disease.
This paper reviews the progress in the understanding of ankylosing spondylitis of traditional Chinese medicine and Western medicine, summarizes the Chinese and Western medicine in the etiology, pathogenesis, diagnosis and drug related knowledge and research of acupuncture mechanism, summed up the main methods at this stage in the treatment of ankylosing spondylitis, discusses the theoretical basis for the treatment of ankylosing spondylitis abdominal acupuncture, by contrast experiment analysis, the clinical curative effect of abdominal acupuncture in the treatment of ankylosing spondylitis. To evaluate future clinical research of abdominal acupuncture in the treatment of ankylosing spondylitis and put forward some own views and opinions.
objective
Based on the study of oral sulfasalazine tablets, Diclofenac Sodium Sustained Release Tablets and abdominal acupuncture combined with oral sulfasalazine tablets, the clinical curative effect of Diclofenac Sodium Sustained Release Tablets of the two methods in the treatment of ankylosing spondylitis were observed to evaluate the curative effect of applying a number of quantitative indicators of the two, the establishment of the day after the application and curative effect of abdominal acupuncture treatment of ankylosing as the evaluation system to provide literature basis and data support.
Research objects and methods
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本文编号：1560005